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Group therapy



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  • 1. Mr. Jayesh Patidar (M.Sc. Nursing)
  • 2. CONCEPT:  Group psychotherapy is a treatment in which carefully selected people who are emotionally ill meet in a group guided by a trained therapist, & help one another effect personality change.  In other word, Group psychotherapy is a treatment of psychological problems in which two or more patients interact with each other on both an emotional & cognitive levels in the presence of one or more psychotherapists who serve as catalysts (the person who can be related to or who can understand the other’s point of view), facilitators or interpreters. 4/24/2013 2
  • 3. Count… Three major kinds of groups are:  Group Therapy  Therapeutic Groups  Adjunctive Groups  Group Therapy: Group Psychotherapy members gain a personal insight, improve their interpersonal relationship, change destructive behavior & make a necessary alteration in their behavior.4/24/2013 3
  • 4. Count…  Therapeutic Group: It is a group of patients who meet under the leadership of a therapist to work together to improve mental & emotional health. Example; Groups of expectant mothers, people who have just lost their husband or wife. Group of people with a chronic illness. - Therapeutic groups are self-help like Ashiana, Saheli in Delhi, who conduct these groups for drug addicts. 4/24/2013 4
  • 5. Count…  Adjunctive Groups: Adjunctive groups deal with selected needs of a group. For Example; for sensory stimulation allow them to have music therapy, for self-expression art therapy, for expression of feelings & emotions through dance therapy. These are a few examples which can be used for adjunctive groups 4/24/2013 5
  • 6. CONTRAINDICATION  Antisocial patients  Actively suicidal or severely depressed patients  Patients who are delusional & who may incorporate the group into their delusional system. 4/24/2013 6
  • 7. GROUP SIZE…  Optimal size for group therapy is 8 to 10 members. FREQUENCY AND LENGTH OF SESSIONS:  Most group psychotherapist conduct group sessions once a week; each session may last for 45 minutes to 1 hour. 4/24/2013 7
  • 8. Types Of Psychotherapy Groups 4/24/ 8 1. Traditional Groups 2. Encounter Group or T. Group 3. Homogeneous or heterogeneous groups 4. Open or close groups 5. Groups for psychosis or neurosis
  • 9. 1. Traditional Groups: 4/24/ 9 Traditional groups includes mainly the patients with mental illness & are from the hospital inpatient department. In the didactic group therapy, lecture is given to the patient along with some filmshow, like in the case of excessive drinking or use of drugs - Psychodrama is a technique of psychotherapy in which a patient acts out his feelings in front of a group of patients. The therapist guides & directs the patient & interprets the actions of the patient. This type of acting out provides an insight into the patient about his faulty patterns of learning which he can eliminate
  • 10. 2. Encounter Group or T. Group: 4/24/ 10 Encounter group is a form of small group in which an individual learns how his feelings & behavior affect him & others. This group is not necessarily a group of people with mental illness. The individual may have some coping difficulty which he would like to resolve at the right time For Example; a suspicious feeling gradually being developed about his wife or any other illusions. Theses groups are based on sensitivity training or T-groups.
  • 11. 3. Homogeneous or heterogeneous groups: 4/24/ 11 Homogeneous groups are composed of patients of the same age, race, sex, socioeconomic level & similar category of illness. Heterogeneous groups vary on all these aspects.
  • 12. 4. Open Groups & Closed Groups: 4/24/ 12 In open groups members may join & leave the group at anytime. Closed groups have a specific number of people, specific time to start & close the group sessions; the duration is three to four weeks. Inpatients & outpatients both are included in this group. Open & closed groups are used extensively in the hospital.
  • 13. 5. Group According to Mental Illness: 4/24/ 13 Neurotic group or patient suffering from psychotic illnesses come under this category.
  • 14. APPROACHES TO GROUP THERAPY  The therapist’s role is primarily that of a facilitator; he should provide a safe, comfortable atmosphere for self- disclosure.  Focus on the “here and now”.  Use any transferences situations to develop insight into their problems.  Protect members from verbal abuse or from scapegoating.  Whenever appropriate, provide positive reinforcement, this gives ego support & encourages future growth. 4/24/2013 14
  • 15. Count…  Handle circumstantial patients, hallucinating & delusional patients in a manner that protects the self- esteem of the individual & also sets limits on the behavior so as to protect other group members.  Develop ability to recognize when a group member is “fragile”, he should be approached in a gentle, supportive & non-threatening manner.  Use silence effectively to encourage introspection & facilitate insight. 4/24/2013 15
  • 16. Count…  Laughter & a moderate amount of joking can act as a safety valve & at times can contribute to group cohesiveness.  Role-playing may help a member develop insight into the ways in which he related to others. 4/24/2013 16
  • 17. THERAPEUTIC FACTORS INVOLVED IN GROUP THERAPY: 1. Sharing experience 2. Support to & from group members 3. Socialization 4. Imitation 5. International learning 4/24/2013 17
  • 18. 1. Sharing Experience  This helps the patients to realize that they are not isolated & that others also have similar experience & problems  Hearing from other patients that they have shared experiences is often more convincing & helpful than reassurance from the therapist. 4/24/2013 18
  • 19. 2. Support to and from group members:  Receiving help from other group members can be supportive to the person helped.  The sharing action of being mutually supportive is an aspect of the group cohesiveness that can provide a sense of belonging for patients who feel isolated in their everyday lives. 4/24/2013 19
  • 20. 3. socialization:  It is acquisition of social skills (for example, maintaining eye contact) within a group through comments that members provide about one another’s deficiencies in social skills.  This process can be helped by trying out new ways of interacting within the safety of the group. 4/24/2013 20
  • 21. 4. Imitation: 4/24/ 21  It is learning from observing & adopting the behaviors of other group members.  If the group is run well, patients imitate the adaptive behaviors of other group members. 5. Interpersonal learning:  It refers to learning about difficulties in relationships by examining the interaction of individuals with the other members of the group.
  • 22. STEPS OF GROUP THERAPY 4/24/ 22 1. Selecting group Members 2. Developing contact 3. Selection of group leaders
  • 23. 1. Selecting group Members: 4/24/ 23  It is very important function of a group therapist.  She has to decide based on the condition of the patient who all can be included in the group.  A very depressed patient may lead to withdrawal of other members of the group, whereas too many excited patients included in the group may lead to unsuccessful group therapy.
  • 24. 2. Developing Contact: 4/24/ 24  The purpose should be made clear to all the members in the group.  Time, length & place of the meeting should be announced.  Starting & ending time & how frequently the group sessions will be conducted.  Attendance of members.  Confidentiality to be maintained within the group.  Role of the members is; to report punctually, maintain confidentiality & interact freely.
  • 25. 3. Selection of Group Leaders: 4/24/ 25  Role of the therapist – the therapist acts as a facilitator & helper. I. To provide information to the group. II. Allow emotional catharsis. III. Share members’ perception. IV. Share feelings of fear, loneliness & frustration. V. Improve communication skills VI. Provide a role model. VII. Help to know what is reality. VIII. Set limits for some patients. IX. Make observation of all the non-verbal techniques being used by the patient.
  • 26. SOME TECHNIQUES USED IN GROUP THERAPY: 4/24/ 26  Reflecting or rewarding comments of group members  Asking for group reaction to one member’s statement  Asking for individual reaction to one member’s statement  Pointing out any shared feelings within the group  Summarizing various points at the end of session.
  • 27. 4/24/ 27 THANK YOU