Tuesday, July 14, 2009

Group Therapy Process by Tony Astro


Many studies confirm that optimism or positive anticipation are therapeutic and results to positive outcomes. When a client sees a group member who is a fellow alcoholic and has not drink for months and has better his life, client associates himself to his fellow group mate instilling hope. The inspiration provided to participants by their peers results in substantial improvements in medical outcomes, reduces health care costs, promotes the individual’s sense of self-efficacy, and often makes group interventions superior to individual therapies (Fawzy, Fawzy and Wheeler, 1996).


Kindness or willingness to help gives a sense of satisfaction in many normal individuals. The gratification of being part of a team and sharing the ability to help or giving out aid based on experience like prior drug addiction and what helps is satisfying to the client.

In a group setting there are many opportunities for the client with similar experience to share each other similar experiences and with pride gives information to fellow, for instance, one who has the same drug dependence / addiction with someone who was going through or has gone through. Being called selfish because of not sharing your experience is not healthy for an individual and this kind of self-sacrifice of being transparent helps in a group setting.

Group therapy is unique in being the only therapy that offers clients the opportunity to be of benefit to others (Yalom, 2005). It also encourages role versatility, requiring clients to shift between roles of help receivers and help providers (Holmes and Kivlighan, 2000).


Everyone needs a connection with someone at any point of life. During military deployment, many Sailors suffer from some type of stress because of lack of interaction with others, particularly with family and even fellow personnel due to highly stress environment. The feeling of isolation does not help a client if there is a need arise.
The theory of interpersonal relationships has become so much an integral part of the fabric of psychiatric thought that needs no further underscoring; people need people – for initial and continued survival, for socialization, for the pursuit of satisfaction (Yalom, 2005).

On a group therapy, there is 100% opportunity to interact with someone no matter what personality or issues of the client. A diverse group or a set of people with the same background or issues will set the tone of how the group will get along and interpersonal relationship will play a big role in having a successful group therapy.


If there is lack of confidence in a group and especially with the leader, the interaction and dynamics to get a therapy will not be successful. In order to be a thriving group, 3 out of the 15 Therapeutic Forces should be present:

1. Clarity of purpose for the leader and the members.
2. The leader’s attitude.
3. Level of trust among members.


Without a comprehensible goal and rationale of why the group exists – there will be no direction and majority of the 15 Therapeutic Forces will not be possible. For instance, a leader might say the group is educational but spend most of the time doing therapy, or the leader might say the group is for support but spend the majority of the time focusing on one person or on one topic that is not relevant for most of the members (Jacobs, Masson & Harvill, 2008).

There should be a clear objective and presented to the group members or clients step by step until it is comprehended.


The leader who facilitates the group has direct key to the success of the group because he or she has the capacity to implement any or all of the 15 therapeutic forces that may influence the outcome of the therapy. No matter how small or big the group or how long the session is or even how high the level of trust among the members are – the leader has the full control of the group.
If the group contains hostile, nonvoluntary members, the leader should try to find a way to get theses members involved; however, if the members are completely resistant and negative, the leader may need to remove them from the group (Jacobs, Masson & Harvill, 2008).


Once trust is lost, there is no looking back. There is always at the back of a person's mind that the issues or something else may not be resolve because an expectation or confidence was no longer there and leader has to resolve this fast.

Problems of trust often occur when members have very different points of view and if the group consists of members who do not like each other, the leader can try to change this by bringing it up in the group or by meeting with some members privately to see if their differences can be resolved (Jacobs, Masson & Harvill, 2008).

Each Factor theory from Yalom and 15 Forces from Jacob, Masson and Harvill has an important key to all group therapy and can be be applied on a case by case and the importance of one does not mean that one factor is not important.


Holmes, S. & Kivlighan, D. (2000). Comparison of Therapeutic Factors in group and Individual Treatment Processes,” Journal of Counseling Psychology: pages 447-48.

Jacobs, E., Masson, R. L., & Harvill, R. L. (2008). Group Counseling: Strategies and Skills. New York: Brooks Cole.

Yalom, I. D. & Leszcz, M. (2005). The Theory and Practice of Group Psychotherapy. New York: Basic Books.
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