Academic literature on the topic 'PSYCHOLOGY / Psychotherapy / Group'

We surveyed 185 clinical psychology doctoral programs accredited by the American Psychological Association to examine whether and how group psychotherapy was taught. While respondents of all Psy.D. programs to the survey offered a course in group psychotherapy, less than one-third of Ph.D. programs offered one. Among programs that offered a course in group psychotherapy, less than half required that students take it. Most instructors had an in-class experiential component, focused either primarily or exclusively on outpatient therapy and used Yalom's interpersonal approach. Discussion focused on the importance of making group psychotherapy a higher priority and the suggestion that courses include a variety of theoretical approaches and important specialty groups such as psychiatric inpatients.

Thesis (MSc (Clinical Psychology) ) -- University of Limpopo, 2012.
The Clinical Psychology training programme at the University of Limpopo (Medunsa Campus) is contextualized within the theoretical paradigm of the General Systems Theory. The main focus during the first block of training is on equipping trainees with a person-centered stance and the necessary skills that go with it such as empathy, unconditional positive regard and congruence and also to develop a frame of reference in the trainees which is suitable to form a basis as a therapist. Thus training within this context is experiential. The aim of this study was to explore the subjective emotional experiences of the Msc1-Clinical Psychology trainees at the University of Limpopo (Medunsa Campus) during their first block of training. The research was conducted through qualitative interviews with the trainees shortly after being exposed to the first block of training. The sample size consisted of five trainees of the 2011 Masters in Clinical Psychology training programme at Medunsa Campus. Interviews were analysed in accordance with qualitative methodology through thematic analysis. Finally, an attempt was made to discuss and integrate the research findings into which the strengths and limitations of the study and future recommendations were made. Results from this study indicated that trainees during their first block of training experienced different challenges which are not only emotional but mental as well as academic in nature. Moreover, it became evident that trainees further experienced challenges in their social contexts such as families and relationships outside the training context.

Prior research in individual therapy has provided evidence that therapists are poor predictors of client outcome without the aid of objective measures and often misjudge clients' perceptions of the therapeutic relationship. The focus of the current research was to conduct a similar study in a group setting. Therapists from a university counseling center and a state psychiatric hospital were recruited to test their accuracy in predicting client outcome, quality of therapeutic relationship and their own use of empirically supported group interventions. Results indicated that therapists are poor predictors of all three, providing support for the implementation of measure-based feedback systems to inform therapists about key information that may affect the effectiveness of group psychotherapy.

This qualitative study utilized a phenomenological research approach (Moustakas, 1994) to examine the question How do group psychotherapy clients experience post-processing? The conceptual framework for the study was Yalom’s interpersonal process approach to group psychotherapy (Yalom & Leszcz, 2005). Participants were 12 university counseling center clients who were members of an interpersonal process-oriented psychotherapy group at a large urban university. Data collection consisted of in-depth interviews. Data analysis procedures followed recommendations by Smith and Osborn (2003) and Creswell (2007). In order to increase the trustworthiness and rigor of the study, the researcher engaged in reflexive journaling, member checking, and the use of two external auditors. Results of the study are presented as a description of how participants experienced post-processing, and are organized within two domains: (a) Experiences of post-processing; and (b) Contextual pieces. Within the first domain, eight categories emerged: (a) verbal report card; (b) silent observer phenomenon; (c) leader expertise; (d) emotional homework; (e) light bulb moments; (f) validation and reinforcement; (g) connections; and (h) final chapter experiences. Categories were made up of one or more related themes. Within the second domain were four related themes: (a) intensity or depth; (b) outside stressors; (c) group constellation; and (d) time in group. Quotes from participants are included to illustrate the findings. The role of the researcher as an instrument in the study is described. The results are discussed in relation to the theoretical framework of the study and the existing literature. Implications for research and practice of group psychotherapy are identified. Strengths and weaknesses of the study are included, as well as suggestion for future research.

Adlerian Brief Therapy is a specific approach to Individual Psychology that uses relational strategies to bring about effective change in the lives of individuals, groups, couples, and families (Bitter, Christensen, Hawes, & Nicoll, 1998; Sonstegard, Bitter, Pelonis-Peneros, & Nicoll, 2001). In this article, the authors discuss a relationship- intervention continuum as an integration of two approaches. A therapy session demonstrating Adlerian Brief Therapy with individuals is used to highlight the integration.

There is a need for structured research into the psychodynamic psychotherapies to strengthen evidence-based practice knowledge and communicate this knowledge to practitioners and funders. We know that group psychotherapy is effective, but many outcome assessment instruments fail to reflect process and individual experience. The current study used the Therapeutic Factors Questionnaire in an attempt to add to research knowledge of process. In this exploratory study, twenty-two participants in small group psychotherapy at a day attendance therapeutic community rated eleven factors for perceived helpfulness in a modified version of Yalom's Therapeutic Factors Questionnaire, at five time points in the year. Therapists completed an identical version for each member, conveying what they thought each member had found most helpful in that period. Members who had been in the group for a year participated in a semi-structured interview, which was analysed using Interpretative Phenomenological Analysis. TFQ data was collated into three six-month phases dependent on length of time in the group. Admission data on individual clinical problems was coded by the researcher into nine categories. Lower than expected numbers made the drawing of conclusions from the quantitative data impossible, though statistical analysis showed certain trends. However, interviews provided a particularly rich source of information, which also suggested that the TFQ trends were probably authentic. Two complete cases were explored in terms of the relationship between TFQ and interview results.

The study confirms the importance of R.P. Liberman's Group training in social skills for schizophrenic patients and applied in Peru by Sotillo et al. (1991) in a public mental health institution. We applied this same experience in a private psychiatric clinic of Lima. Since the management of patients in public and private institutions are different, we carried out a study to train the staff and to adapt the program. Nine in patients with DSM III-R diagnosis of chronic schizophrenia were selected. The inclusion criteria were: basic behaviors, minimal speech repertoire and no positive symptoms. Twenty-seven behaviors, grouped in 4 areas, were assessed before and after training. Results reveal an increase in the number of social skills in 8 of the 9 sujects that participated in the study.
El presente programa corrobora la importancia del entrenamiento grupal en habilidades sociales con pacientes esquizofrénicos crónicos, desarrollado por Liberman, y aplicado en el Perú por Sotillo et al. (1991) en un instituto nacional de salud mental. Conocedores que el manejo de los pacientes psiquiátricos en una clínica privada es diferente al utilizado en los institutos del Estado, consideramos relevante aplicar este programa, que sirvió tanto para capacitar al personal de la clínica, como para adaptar este programa a una infraestructura y dinámica de atención distintas. Se seleccionó una muestra de 9 pacientes esquizofrénicos crónicos, según diagnóstico del DSM III-R, evaluados bajo criterios como: repertorio de conductas básicas, repertorio verbal mínimo y con ausencia de síntomas positivos prominentes de la enfermedad. Los resultados son presentados en base a la evaluación de 27 conductas, agrupadas en 4 áreas, que se evaluaron antes y después del entrenamiento, lo que nos permitió observar el incremento de habilidades sociales en 8 de los 9 pacientes.

A review of the adult psychotherapy outcome literature reveals decades of empirical studies that support the efficacy of group treatment for mental health concerns (Burlingame, Fuhriman, & Mosier, 2003; Horne & Rosenthal, 1997). Although research demonstrates positive results for the utilization of group therapy, between 33-50% of clients drop out before treatment is completed (Baekeland & Lundwall, 1975; Wierzbicki & Pekarik, 1993). Methods for improving psychotherapy retention have been addressed through the application of a client feedback model (i.e., monitoring treatment outcome routinely). Although using client feedback has been found to be beneficial for improving retention and even enhancing client outcome in both individual (Lambert et al., 2001a; Lambert et al., 2002; Miller, Duncan, Brown, Sorrell, & Chalk, 2006; Reese, Norsworthy, & Rowlands, 2009; Whipple et al., 2003) and couples psychotherapy (Anker, Duncan, & Sparks, 2009; Reese, Toland, Slone, & Norsworthy, 2010), evidence of client feedback efficacy in a group format is limited but worthy of investigation given the positive individual and couples therapy findings. In the current study, I evaluated the effects of client feedback in group psychotherapy using a randomized clinical trial design. Participants (N = 85) attended psychotherapy groups that were randomly assigned to a client feedback (Feedback) or treatment as usual (TAU) condition. Clients in the Feedback condition were predicted to experience a statistically significantly higher pre-post gain on the ORS compared to group clients in the TAU when controlling for their initial functioning. The effect size (ES) for Feedback between treatment conditions was found to be d = 0.35 on the Outcome Rating Scale when initial treatment functioning was controlled, which is a medium ES (Cohen, 1988). Additionally, statistically significantly more clients in the Feedback condition experienced reliable and clinically significant change, attended statistically significantly more sessions, and dropped out at a lower rate than clients in the TAU condition. Results of this study were similar to those generated by other studies that evaluated the efficacy of client feedback with individuals (Reese et al., 2009) and couples (Anker et al., 2009; Reese et al., 2010). Study limitations and implications for future work are provided.

В настоящее время знания, полученные когнитивной наукой, приоткрыли содержание человеческого сознания и понимания метапознавательных процессов. Метапознание, как показано, занимает центральную роль в как в предмете психотерапетической работы, так и в эффективности деятельности и обучения. Однако, зачастую эти достижения не используются в практической работе, а в целом ситуация напоминает попытку двух людей, находящихся по разные стороны от забора сделать подкоп, но копают они в разных местах. Целью данного доклада выступает увязать между собой некоторые достижения когнитивной науки с практическими областями психотерапевтической работы и понять, чем в настоящее время эти достижения могут быть полезны в практике. В этом контексте важным видится обсуждение характера и значимости метакогниций со стороны клиента и терапевта, супервизанта и супервизора. В истории взаимоотношений психологии и психотерапии можно заметить ряд закономерностей. В конце 1950-х годов психоаналитики активно занимались изучением закономерностей формирования психической деятельности, и практическим путем была сформулирована концепция У.Биона о формировании психики и значение в этом процессе проективной идентификации. Одна из основных идея этой концепции заключалась в следующем – нормальное развитие психической деятельности происходит путем тестирования аффектом реальности и последующая индукция изменений. Позднее в ленинградской школе психологии в 1980-х –1990-х годах Б.Ф. Ломов, Л.М. Веккер, Б.Г. Ананьев и другие при экспериментальном изучении образа восприятия приходят к похожим выводам – формирование дифференцированосинтезированного образа восприятия происходит через активное взаимодействие с элементами реальности. Тем самым сформировалась доказательная база для теории, существующей в практической психотерапии. В наше время происходит похожая ситуация – в когнитивной психологии активно разрабатываются исследования сознания и метапознания, что может выступить доказательной базой для существующих в психотерапии современных концепций. Однако, в силу того, что традиционно психотерапия разрабатывалась преимущественно врачами и в рамках медицинских дисциплин, в психотерапию перекочевали те же проблемы с доказательностью, что и в медицине. В итоге мы видим неутешительный вывод, наблюдаемый в метанализах современных исследований эффективности психотерапии – за 129 концепции появившиеся за последние 30 лет не показали большей эффективности, чем ранее существующие. Вкупе с этим, нельзя забывать в целом о проблеме доказанной эффективности психотерапии. Таким образом, видится особая значимость в учете результатов когнитивной психологии в психотерапевтической работе и разработка психотерапевтических концепций на базе доказательной психологии. Рассматривая значение метакогнитивного познания в процессе психотерапии и супервизии, можно обратить внимание на такие понятия как, стратегии поведения в когнитивно-поведенческой терапии, внутриличностиная структура в психодинамических концепциях и индивидуальный опыт в феноменологических концепциях. Каждое из этих понятий, по сути, используется для описания ментальной репрезентации, которые сейчас активно изучаются в рамках исследований метапознавательных процессов. В ряде теоретических моделей, например модель Е.Ерткина, особую значимость имеют взаимодействие метакогнитивного знания (ментальной репрезентации), метакогнитивных навыков (способов переработки информации и знаний о себе) и метакогнитивных переживаний (реакции на предыдущие процессы переработки). Особо ярко взаимодействие этих 3-ех компонентов мы видим в рамках супервизионного процесса, когда супервизант приносит метакогнитивные переживания о клиенте, уже интегрированные в знания о клиенте, о себе или находящиеся в этом процессе. Там, на супервизии, группа или супервизор помогают специалисту пройти цикл между этими тремя компонентами, для углубления понимания клиента, возникновения метакогнитивных переживаний нового уровня и разряжения этих переживай. Таким образом, понимание разнообразия организации всех трех компонентов у разных людей и в целом необходимо для эффективного супервизора. В противном случае риск превращения супервизии из способа преодоления трудности во времяпрепровождение оказывается очень высоким. Эти выводы можно также применить и к психотерапевтической работе. В свете описанного, хочется привлечь внимание коллег к взаимоотношениям исследований в психологии и психотерапевтическими концепциями. Автору видится, что взаимосвязь этих областей может помочь преодолеть застой, который наблюдается в психотерапии последние 10-15 лет, и дать почву для решения проблем эффективности и доказательности в психотерапии. The knowledge gained by cognitive science has now opened up the content of human consciousness and understanding of metacognitive processes. Metacognition has been shown to occupy a central role in both the subject matter of psychotherapy and in the effectiveness of activity and learning. However, these advances are often not used in practical work, and the overall situation resembles an attempt of two people on opposite sides of a fence trying to dig, but they are digging in different places. The purpose of this paper is to connect some achievements of cognitive science to practical areas of psychotherapy work and to understand how these achievements can currently be useful in practice. In this context, a discussion of the nature and significance of metacognitions on the part of client and therapist, supervisor and supervisee seems important. In the history of the relationship between psychology and psychotherapy, it is possible to notice a number of regularities. At the end of the 1950s, psychoanalysts were actively engaged in studying patterns of mental activity formation, therefore W. Bion's concept of mental formation and importance of projective identification in this process was formulated on basis of practical work in this field. One of the basic ideas of this concept was the following – the normal development of mental activity occurs through affect testing of reality and the subsequent induction of change. Later in the Leningrad school of psychology in the 1980's and 1990's B.F. Lomov, L.M. Vekker, B.G. Ananyev and others reached similar conclusions during the experimental study of the perceptual image – the formation of a differentiated and synthesized perceptual image occurs through active interaction with elements of reality. This formed the evidence base for the theory that exists in practical psychotherapy. Nowadays, a similar situation is occurring – studies of consciousness and metacognition are being actively developed in cognitive psychology, which can serve as an evidentiary base for current concepts existing in psychotherapy. However, due to the fact that psychotherapy was traditionally developed mainly by doctors and within the framework of medical disciplines, the same problems of evidence as in medicine have migrated to psychotherapy. As a result, we see the disappointing conclusion observed in metaanalyses of contemporary research on the efficacy of psychotherapy – the concepts that have emerged over the past 30 years have shown no greater efficacy than previously existing ones. Coupled with this, the problem of proven efficacy of psychotherapy in general cannot be forgotten. Consequently, it is seems especially important to take into consideration the results of cognitive psychology in psychotherapeutic work and to develop psychotherapeutic concepts on the basis of evidence-based psychology. Considering the importance of metacognition in the process of psychotherapy and supervision, should be paid attention to such concepts as behavioral strategies in cognitive-behavioral therapy, intrapersonal structure in psychodynamic concepts and individual experience in phenomenological concepts. Each of these concepts is essentially used to describe mental representations, which are now being actively explored in metacognitive research. In a number of theoretical models, such as E.Ertkin's model, the interactions of metacognitive knowledge (mental representation), metacognitive skills (ways of processing information and knowledge about oneself), and metacognitive experiences (reactions to previous processes of processing) are of particular importance. We see a particularly pronounced interaction of these 3 components in the supervisory process when the supervisor brings metacognitive experiences about the client that have already been integrated into, or are in the process of being integrated into, knowledge about the client, about the self. There, in supervision, the group or supervisor helps the professional to go through full cycle between these three components to deepen understanding of the client, emerge new level metacognitive experiences and defuse these 130 experiences. Thus, understanding the diversity of organization of all three components in different people and in general is necessary for an effective supervisor. Otherwise, the risk of turning supervision from a way of overcoming difficulty into just a conversation very high. These conclusions can also be applied to psychotherapeutic work. In the light of the above, I would like to draw colleagues' attention to the relationship between research in psychology and psychotherapy concepts. The author believes that the interrelation of these fields can help to overcome the stagnation observed in psychotherapy in the last 10-15 years and provide the ground for solving problems of effectiveness and evidence in psychotherapy.