A comparison of curative factors in different types of group psychotherapy

Cognitive behavioral group therapy versus psychoeducational intervention in Parkinson's disease

OBJECTIVE

The aim of the current study was to evaluate whether cognitive behavioral group therapy has a positive impact on psychiatric, and motor and non-motor symptoms in Parkinson's disease (PD).

METHODS

We assigned 20 PD patients with a diagnosis of psychiatric disorder to either a 12-week cognitive behavioral therapy (CBT) group or a psychoeducational protocol. For the neurological examination, we administered the Unified Parkinson's Disease Rating Scale and the non-motor symptoms scale. The severity of psychiatric symptoms was assessed by means of the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Brief Psychiatric Rating Scale, and the Clinical Global Impressions.

RESULTS

Cognitive behavioral group therapy was effective in treating depression and anxiety symptoms as well as reducing the severity of non-motor symptoms in PD patients; whereas, no changes were observed in PD patients treated with the psychoeducational protocol.

CONCLUSION

CBT offered in a group format should be considered in addition to standard drug therapy in PD patients.

“I’m Not the Only One!” Group Therapy with Older Children and Adolescents Who Have Learning Disabilities

Children and adolescents with learning disabilities (LD) are vulnerable to psychosocial difficulties. Both the detrimental impact of LD on social adjustment and the significance of peer relations for developmental needs make group therapy a natural intervention. Despite modifications that are required due to their cognitive deficits, many students with LD fit the criteria and can benefit from group psychotherapy. In this paper, a model of group therapy for older children and adolescents with LD is presented. The approach is informed by a combination of self psychology, mutual aid, and interpersonal group therapy. The leaders use special techniques to accommodate the LD and to foster the group process. Examples are presented to illustrate the approach.

Service users' experiences of a therapeutic group programme in an acute psychiatric inpatient unit

Psychiatric nurses have been facilitating therapeutic groups in acute psychiatric inpatient units for many years; however, there is a lack of nursing research related to this important aspect of care. This paper reports the findings of a study which aimed to gain an understanding of service users' experiences in relation to therapeutic group activities in an acute inpatient unit. A qualitative descriptive study was undertaken with eight service users in one acute psychiatric inpatient unit in Ireland. Data were collected using in-depth semi-structured interviews and analysed using Burnard's method of thematic content analysis. Several themes emerged from the findings which are presented in this paper.

Perceptions of Turkish psychiatric inpatients about therapeutic factors of group psychotherapy

Many studies on therapeutic factors in group psychotherapy were done during the 1970s and 1980s, primarily with Western samples, The present study was carried out in a psychiatric inpatient clinic in Turkey. Using Yalom's (1975) therapeutic factor questionnaire administered at discharge, patients rated existential factor, instillation of hope and self-understanding as the most helpful factors and identification as the least helpful. There were significant differences among patients with regard to gender, age, education, comorbid personality disorder, but not with Axis I diagnosis or number of attended sessions. Patients' and psychiatrist's rating showed significant differences. Differences between this Turkish sample and those reported in common Western literature are discussed under the light of relatedness psychology, which is an important concept of cross-cultural psychology.

Therapeutic factors of cognitive behavioral group treatment for social phobia

This study investigated the therapeutic factors influencing the outcome of cognitive behavioral group treatment for social phobia and the most helpful therapeutic component. Fifty psychiatric outpatients who were diagnosed with social phobia according to the DSM-IV criteria were chosen as subjects. Patients were asked to complete the Yalom's Curative Factors Questionnaire and Therapeutic Components Evaluation Form at the end of their Cognitive Behavioral Group Treatment (CBGT). The patients who showed more improvement rated significantly higher in therapeutic factors such as "Interpersonal learning-output", "Guidance", "Universality", "Group cohesiveness" than the patients who showed less improvement. Among the four components of CBGT for social phobia, cognitive restructuring was rated as most helpful. These results suggest which therapeutic factors and components should be highlighted in CBGT for social phobia.

Chinese inpatients' subjective experiences of the helping process as viewed through examination of a nurses' focused, structured therapy group

AIMS AND OBJECTIVES

This study examined Chinese inpatients' views on what aspects of a nurses' focused, structured therapy group worked to help their psychological and interpersonal problems and what traditional Chinese cultural values influenced their viewpoints.

METHODS

Nine Chinese inpatients with mental illness participated in the four-session nurses' focused, structured therapy group. After they completed the last session of therapy, they were invited to participate in a structured interview and a semi-structured interview regarding their perceptions of the change mechanisms in nurses' focused, structured group therapy. The semi-structured interviews were recorded and transcribed to be further analysed according to the principal of content analysis.

RESULTS

The results indicate that (i) all patients believed that a nurses' focused, structured group psychotherapy enhanced their interpersonal learning and improved the quality of their lives, (ii) traditional Chinese cultural values--those emphasizing the importance of maintaining harmonious interpersonal relationships--influenced the Chinese inpatients' expression of negative emotions in the group and their motivation on interpersonal learning.

CONCLUSION

In conclusion, we found that transcultural modification for applying Western group psychotherapy in Chinese culture was needed. The modification included establishing a 'pseudo-kin' or 'own people' relationship among group members and the therapists, organizing warm-up exercises and structured activities, applying projective methods and focusing on the issues of interpersonal relationships and interpersonal problems.

RELEVANCE TO CLINICAL PRACTICE

The small sample size of the present study raises questions regarding how representative the views of the sample are with respect to the majority of Chinese inpatients. Nevertheless, this preliminary study revealed a cultural aspect in nursing training that requires significant consideration in order to work effectively with Chinese patients.

Cohesion and outcome in short-term psychodynamic groups for complicated grief

This study used two measures of cohesion for the process analysis of 12 short-term, time-limited groups for complicated grief. The measures had similar theoretical definitions but differed in terms of rater source (member vs. observer), measurement score (mean of items vs. global rating), and rating unit (individual vs. group). We examined the relationship between the measures, assessed the development of cohesion over the life of the group, and evaluated each measure's relationship to outcome. A principal components analysis with each measure yielded one cohesion component, which supported a unidimensional model; however, the two cohesion components were independent of each other, which supported a multidimensional model. Repeated measures analyses indicated that observer-rated cohesion developed in a quadratic manner (v pattern) across sessions, while member-rated cohesion developed in a linear manner. The object focus (the group, other members, the therapist) of the members' ratings determined whether cohesion increased or decreased across sessions. No significant relationships between cohesion and outcome were identified. Implications of the findings for the understanding of group cohesion are considered.

Helping processes in a mutual aid organization for persons with emotional disturbance

To date, the notion of helpfulness of group processes has been equivocal in research on self-help groups. This article argues that findings drawn from the participants' subjective appraisals of helpfulness carry meanings different from those drawn from the correlational approach. In a mutual aid organization serving adults with mental health problems, the study found that, whereas universality, self-disclosure, and instillation of hope were the most valued processes, support and catharsis were the strongest correlates of benefits of participation. The authors propose a two-level hierarchy that distinguishes sustaining and beneficial factors. Different sets of factors should constitute the focus of facilitation at different stages of group development.

Development of a tool to measure therapeutic factors in group process

A tool, the Therapeutic Group Interaction Factors Scale (TGIF), was developed for systematically and objectively measuring the extent to which therapeutic factors defined by Yalom are present or absent in group process. Preliminary findings suggest that the TGIF is relatively easy to learn and use by coders who are familiar with Yalom's work. Once this tool has been further developed and tested, it will permit nurses and other therapists who lead/facilitate therapeutic groups to study the relationship between Yalom's factors and therapeutic outcomes objectively, rather than by asking patients to evaluate the contribution of each factor subjectively.

In their own words: therapeutic factors for adolescents who have learning disabilities

A qualitative study explored the therapeutic elements in psychodynamic group therapy for adolescents with learning disabilities and related psychosocial problems. Four boys and four girls, diagnosed with learning disabilities, were interviewed on completion of group therapy, to obtain their subjective experiences. Therapeutic factors were identified, grouped, and found to be operative through an interpersonal process, termed mutual recognition. Mutual recognition is defined as the adolescents realizing that they saw themselves in the others and that the others saw themselves in the participants. The subcategories were trust, connection, and group issues/process. The subcategories were interactive: they contributed to, and were influenced by, mutual recognition.

Mother-infant psychotherapy: integrating techniques of group, family, and individual therapy

Mother-infant psychotherapy groups have become an increasingly popular modality for promoting adaptive change in the dyadic relationship before dysfunctional patterns become entrenched. One unique feature of this form of therapy is that it juxtaposes several different treatment modalities. In particular, because each mother-infant dyad functions as a self-contained unit, the techniques of family therapy--including the resolution of enmeshment and triangulation--may be applied. Similarly, because the mothers of infants often interact as peers, the techniques of group therapy--including cohesion and universality--become pertinent. The overlap of these modalities contributes to effective diagnostic and therapeutic management. This article discusses how different treatment modalities--and the shifts between these modalities--may guide the course of therapy. In addition, techniques for predicting such shifts are discussed. The therapist's skill in adjusting to shifts from modality to modality enhances the effectiveness of the therapeutic intervention.