Recently, Irvin Yalom 's books on group psychotherapy have gained quite a lot of popularity. This approach to working with people in medicine is practiced relatively recently, has its followers and opponents. It is difficult to deny that group psychotherapy is not always effective, but it is equally impossible not to recognize its positive aspects. There are many cases when it was the work in the group that was the only method for the successful healing of patients.
What is it about?
Group psychotherapy involves the formation of a group of stakeholders who regularly meet in a specified neutral territory under the supervision of a treating doctor. The task is to solve urgent issues by people who need the help of a psychotherapist. For the first time, such an approach was put into practice by J.H. Pratt, who specialized in internal medicine. In 1905, he simultaneously worked with several persons with severe tuberculosis. Almost all of them could not afford expensive medical services, and Pratt helped them find an alternative method. It was decided from time to time to assemble a group of patients, tell them how the disease is proceeding, and receive information about changes in the patients' condition. Practice soon showed that those who underwent treatment in such groups recovered much faster than people who had access to expensive individual health improvement.
The method of group formation was first applied to psychiatry in 1925. The author of the new approach was Jacob Moreno, who developed the theory of psychodrama. The approach became widespread during the Second World War, as it was then that the number of people requiring the help of a psychotherapist increased noticeably, while the number of doctors was not large enough to conduct counseling individually.
Nowadays, the theory and practice of group psychotherapy continues to evolve. Many are convinced that this method is the future of psychiatry, but there are people who point out the shortcomings of this approach. First of all, this is the impossibility of direct work with the client. In addition, the therapy in the group is not suitable for everyone - often people are too closed, and this is especially pronounced if they are surrounded by strangers.
Theory development
As group psychotherapy began to gain momentum, the method is being actively improved, and modern doctors have much more information, ways to influence patients, than doctors of the second half of the last century. For the optimal effect, patients are divided into groups, the classification of which is based on specific problems, disorders. Currently, this method of treatment is indicated for certain eating disorders, as well as victims of rapists. Often, psychotherapy in groups is carried out by individuals struggling with cancer. At the same time, it is not possible to formulate an exact canon: when work in groups is applicable and mandatory, and when - it is unacceptable and harmful. It all depends on the specific patients and the characteristics of their mental state.
The basis of group psychotherapy is to work with several people who have similar life difficulties. Rarely in a group are fewer than five patients, but work with more than 15 is not practiced at the same time. Sometimes patients are under the control of one doctor, but the simultaneous presence of several psychotherapists at once is possible. The optimal meeting frequency is once or twice weekly. The effectiveness can be seen if six or more sessions are passed, although doctors advise treatment for at least a year.
What suits me?
There are two main approaches to psychotherapy:
- group counseling;
- individual interaction.
Of the main advantages of working with groups is financial affordability. Psychotherapy is quite an expensive pleasure, but the modern rhythm of life and the conditions of our everyday life are such that it becomes more and more difficult to do without it. In addition, working with a group allows you to get closer to reality, since each patient has the opportunity to interact with other people, such as himself. You can hear someone else's point of view, get acquainted with the opinion of another person and expand your own view of things.
During a group session, each participant can observe others, receiving a lot of useful information, food for thought. The more people, the richer the event, the more experiences it causes, gives rise to a strong emotional response for each participant. This makes it possible for everyone to be revealed in a short time.
Along with the listed features, the doctor has the advantages and possibilities of group psychotherapy, since work is easier than with an individual client attending consultations. Interacting with several individuals, you can resort to different methods of obtaining customer data. When working one-on-one, a specialist can focus only on what the newcomer has said, but with group interaction, he has the opportunity to observe how each of those present behaves.
How to choose a method of work?
The best option is a combination of group psychotherapy techniques and individual communication between the doctor and the patient. Recently, people who can afford to undergo treatment exclusively in a group are increasingly asking for help, but combining the two options is considered the most successful, promising.
A common practice is group therapy, in which all gathered are united by some strictly limited problem. This approach is widely used in the treatment of depressive disorders, panic, bipolar. The group technique in psychiatry is relevant when working with sociophobes and people with OCD. A group is the most convenient and effective method to support and assist a person who is faced with difficult conditions provoked by the loss of a loved one. This psychotherapeutic method is applicable in the fight against incontinence, constriction.
Important aspects
Of the positive aspects of group psychotherapy, mention should be made of:
- the opportunity to feel the approval of ordinary people;
- learning how to deal with difficulties using the experience of others;
- the opportunity to understand yourself by analyzing interaction with other persons.
At the same time, a person turning to the possibilities of psychotherapy in a group, as if gets a "refuge": at the same time he has the opportunity to interact with representatives of society, but for this a safe environment is created in which you can not worry about rejection, disapproval.
The features of the human psyche are such that the cause of the difficulties is much easier to understand if you observe from the side those who struggle with the same problems. But when trying to analyze oneself, a person is faced with difficulties: it is extremely difficult to adequately assess the situation and realize what the “root of evil” is. The Institute of Group and Family Psychology and Psychotherapy is the same branch of medicine that gives everyone interested the opportunity to understand themselves while observing others. By analyzing the behavior of people faced with similar situations, one can formulate how to change your thinking and actions. Cooperating with a psychiatrist, clients are usually open, honest, and that means that powerful feedback is being established, everyone can understand what impression he makes on others, what features of his behavior become obstacles for adaptation to society.
Where are the pros and cons
Group psychotherapy methods are not a universal solution to any problem. Not every person can be treated in this format, it all depends on personal, individual characteristics. Some come to the course, but actually only interfere with others, and they themselves do not get any benefit from attending classes.
There are times when a group turns into a conformal one, conflicts do not open, participants do not open. Everyone only plays the chosen role, in fact, the course becomes useless.
As you can learn from any modern book about group psychotherapy, the main idea is the formation of a group where participants behave openly, sincerely. Each one is required the maximum possible empathy for him. Such behavior is not characteristic of ordinary society, surrounding a person in everyday life, which gives rise to a desire to stay in a comfortable environment for life. A person wants to continue communication in an established group, avoiding reality, self-eliminating. By the way, about books: the above-mentioned authorship of Yalom is one of the basic publications, literally a reference book for a psychotherapist working with groups.
Tasks and Goals
Group psychotherapy is intended to alleviate the symptoms of mental disorders and achieve shifts in the patient's condition. The idea is to achieve the personal growth of each participant. To do this, you have to recognize and formulate the problem, reveal its essence, analyze the situation, realize the information obtained at the same time, assimilate it and correct it on the basis of the revealed own behavior. Successful completion of the course helps to normalize relations with other people, your own attitudes.
The psychotherapist forms an environment that is comfortable for all participants, favorable for people in need of support. Those around help each other, worry about each other and work together on the awareness of experience. One of the basic phenomena of the theory of group psychotherapy is the determination of the emotional content of a state or situation. All emotions must be voiced, understood and accepted. The therapist and group members formulate the tasks that must be achieved during the course. They are divided into two categories:
The first is psychodrama, discussion. The second - psychological gymnastics, music therapy, drawing.
What to do and how?
Considering how group psychotherapy began, it is worth remembering - participants gathered in groups to discuss their condition, obtain information about possible changes, as well as recommendations for therapy. At the present time, the aspect of conversation is as important as at the time of the birth of this method of treatment. Group discussion is the basic element of therapy, it is on this basis that the entire treatment process is based. The topics of conversation can be very different: the biography of participants, topics that they are interested in, aspects of behavior that attract attention.
All other approaches applicable within the framework of group psychotherapy are auxiliary. Psychodrama is a method by which, in a playful way, you can consider the situation in which participants play a certain social role. This helps to understand the problems of everyone present. Psycho-gymnastics is another effective auxiliary method. His idea is an emotional expression through gestures, facial expressions. Through this practice, each participant can open up, realize their own condition. Projective drawing has a similar effect - it makes it possible to bring to light the deep problems of man. The therapist sets the theme, and those present create drawings. The result of the work is discussed by all participants.
Music therapy is one of the methods actively studied at the Institute of Group Psychotherapy as a field of science. It is already clear that it is through music that people can be united, while the sounds have a relaxing effect on the participants. Music therapy is active, passive. The first option - all those present sing, play musical instruments, the second - a discussion of emotions, pictures that pop up in memory when listening to sounds.
Theory: Present and Future
As can be seen from the growing competition in specialized educational institutions, the training of group psychotherapy attracts the masses. Indeed, young people see the potential in this method and seeks to master it as the most accessible and effective. Do not forget that a psychiatrist practicing such approaches will always have clients: sessions are relatively inexpensive, many can afford them. Coming to classes, people want to make their daily life better, and the therapist becomes their guide to a better world. Moreover, all existing groups are usually divided into three types:
- therapeutic;
- educational;
- aimed at improving the participants, solving their problems.
What is group psychotherapy for course participants? It is simultaneously an opportunity to learn and adjust the experience gained. People work with emotions, normalize behavior, affect their own mind. Confrontation is one of the main techniques for achieving success in this. On the different sides of the "barrier" are the patient and his inherent difficulties. The therapist helps him realize and accept himself, solve his own problems, using feedback with the participation of all members of the group. An important aspect is the accurate transmission of the perception of the client by others.
Important aspects
Group psychotherapy of adolescents, adults suggests that the therapist assumes the functions of managing the process. His task is to lead a group, maintain the activity of members, explain to others what each of those present understood. The doctor is responsible for the positive attitude of the participants, eliminates bias, draws attention to any positive trends caused by treatment, and demonstrates them with examples of those present. The very hope that he gives to all participants becomes an important healing tool. When a person sees how another is struggling and defeating similar problems, he, too, is filled with strength and confidently goes to success, realizes that any obstacles are overcome, you just need to make an effort - the state will definitely change for the better.
An important step in group interaction is the recognition of the fact that participants in society are not alone. You must be able to see this, to feel that everyone has problems in life, but people cope with them, go through them, learn new things, gain experience, and humble themselves. In the process of recognizing these aspects, the members of the group, under the supervision of a psychotherapist, learn to trust others, to let them closer to themselves. In life, people usually share their experiences with family and friends, while others completely close, isolate themselves from external experience, against which there is a feeling of uniqueness of their problem, an incredible burden. Once in a group, realizing that others have similar difficulties, a person more easily perceives difficulty, feels unity with others.
Awareness and attitude as the key to success
During the group lesson, the client gets a general idea from those around him and the doctor about what is included in the concept of mental health, what pathologies are possible, what dynamics are observed. You can hear tips, get a guide to action. All this gives a sufficient amount of information for analysis and awareness of the processes of one's own psyche. A person understands the fallacy of his ideas and analyzes them, while the condition becomes better, new ways out of this situation appear. The patient sees what measures need to be taken in order to come into harmony with his own inner world.
There are many cases when the mere fact of understanding oneself, processes occurring in one's psyche made a person independent enough not to need further therapy. The patient turns into a researcher, realizes the causes of problems, their consequences, solutions. The explanation, as theorists say, is the most significant key that allows you to control yourself and the world. Uncertainty, in turn, acts as a source of fear, anxiety.
Along with this, the success of the program is largely related to the patient’s ability to give, awareness of their own need, importance relative to others. There are many cases when people who turned to group psychotherapy are disappointed in themselves and their ability to share and give. Such people even feel themselves a burden. Upon discovering that the opinion, experience they have gained is important and useful to someone, they gain new strength, an impetus to life.
Past and future
Group psychotherapy helps to leave in the past conflicts related to the peculiarities of family education. At the same time, the group itself has much in common with the family, but reveals all the problems and difficulties that are caused by the person’s past. The therapist and others help the client to free themselves from negative emotions by expressing them, verbalizing their childhood experiences, realizing them, accepting and changing them.
Group psychotherapy helps to develop social skills. This may be the main objective of the course or a goal achieved indirectly. The first option involves the formation of a game situation, accompanied by difficulties for the client. The second option is to encourage strong feedback.
The therapist analyzes the patient's behavior, which helps all members of the group to learn about their habits and characteristics of interaction with others. Against the background of the information received, everyone can develop and improve. Many learn to capture the atmosphere, acquire skills to resolve a conflict situation, successfully avoid condemnation, understand themselves and others. After a course of group psychotherapy, a person acquires the skills of empathy.