The ghost in the group room: countertransferential pressures associated with conjoint individual and group psychotherapy

Concurrent Group and Individual Psychotherapy in a Psychiatric Day Hospital for Depressed Elderly

Concurrent psychotherapy is used in various settings for patients of different diagnoses and ages. The concurrent group and individual psychotherapy of older adults with depressive disorders in a psychiatric day hospital is described, emphasizing phases of treatment and transference and countertransference themes uniquely relevant to working with depressed elderly patients in a day hospital. Case examples are offered to illustrate these issues. The special technical considerations that need to be utilized when multiple therapists and settings are present are described. The model employs the use of an integrative, interactive group therapy, along with various other group treatments and antidepressant medication, with individual therapy serving a subordinate but organizing role.

The Group Therapist’s Shame: A Much Undiscussed Topic

The topic of shame in group therapy has received limited attention in the group therapy literature. When the topic has been addressed, the focus has been on the shame of the group members. The shame of the group leader and its effect on leadership efficacy and group process has received inadequate attention, given what seems to be its power and prevalence. In this article we examine shame and the group therapist with regard to (1) potentially shameful topics and (2) dynamics that evoke shame. Suggestions for both the mitigation of shame and the enhancement of the leader's self-esteem in dispatching the role and functions of group therapist are offered. In discussing this subject, we propose to normalize group therapist shame by emphasizing the challenges and complexity of group leadership. While the examples illustrate an array of emotions, our purpose is to focus on their shameful elements because they are (1) frequently ignored or overlooked; (2) not made explicit; or (3) discussed in other terms, such as narcissism. In doing so, we invite the reader to consider the clinical utility of the hypothesis that shame has a powerful presence and impact on our leadership image and effectiveness.

Evidence-based group psychotherapy: using AGPA's practice guidelines to enhance clinical effectiveness

Practice guidelines represent a useful approach to facilitate the delivery of evidence-based mental health care. In this article, we detail group psychotherapy practice guidelines developed by the American Group Psychotherapy Association (AGPA). Combining the research literature with expert consensus, the AGPA has created a resource that should prove useful for psychotherapists, administrators, and patients. We illustrate the guidelines through a series of clinical dilemmas and challenges.