Group therapy is a form of psychotherapy where a small group of clients meet with one or more therapists. The focus is on patient-patient and patient-therapist interactions to effect change. Irvin Yalom identified 12 therapeutic factors that can positively impact clients, such as instillation of hope, universality, and interpersonal learning. Group therapies are commonly used to treat substance use disorders and address issues like understanding addiction/recovery, physical/lifestyle changes, and psychological/family/social domains. Effective group therapy requires knowledgeable therapists familiar with addiction treatment and group dynamics.

1. Presented by: Raghda Elgamil

2. Group psychotherapy or group therapy is a form of
psychotherapy in which one or more therapists treat a
small group of clients together as a group.
Group therapy, focuses on the group of clients and
attempting to benefit from sharing their experiences.
In group therapy; both patient - patient interactions and
patient - therapist interactions are used to effect
changes in maladaptive behavior in each group
member.
Counseling is usually led by a therapist, but it is
encouraged in a group counseling session that all
members of the group contribute in some way.

3. Irvin Yalom was partially responsible for the continued
development of group counseling after WWII. He came
up with 12 therapeutic principles that describe the
different factors of counseling that can positively affect
the clients.
Yalom (1995) defined therapeutic factors as "the actual
mechanisms of effecting change in the patient“.
Yalom identified 12 factors that influence the processes
of change and recovery among group therapy clients.

4. • Instillation of hope - encouragement that recovery is
possible
• Universality - feeling of having problems similar to
others, not alone
• Altruism - helping and supporting others
• Guidance - nurturing support & assistance
• Self understanding- teaching about problem and
recovery
• Interpersonal learning - learning new ways to talk
about feelings, observations and concerns

5. • Imparting informations : finding out about themselves
& others from the group
• Cohesion - feeling of belonging to the group, valuing
the group
• Catharsis – release of emotional tension
• Existential factors – life & death are realities
• Identification– modeling another’s manners & recovery
skills
• Corrective recapitulation of family of origin
issues – identifying & changing the dysfunctional
patterns or roles one played in primary family

6. Group therapies are used widely in the treatment of
substance use disorders in short term residential
rehabilitation, long term therapeutic community, partial
hospital, intensive outpatient, drug free outpatient, and
after care programs.

7. Maintain
abstinence
Personal
and
lifestyle
changes to
Initiate support
abstinence abstinence

8. Members are in the 1st phase of abstinence.
Features They are in period of active dependency on the group.
usually use a great deal of denial for their addiction.
Goals Initiate abstinence by:
Providing education about addiction, recovery, and relapse.
Resolving ambivalence by overcoming denial and
enhancing motivation to change.
Installing hope and optimism for change.
Finding behavioral alternatives for using drugs.

9. Features • Members are in phase of maintaining abstinence
• Members begin to gain a sense of self - reliance
• Members have overcome their denial around addiction.
Goals Maintenance of abstinence by:
• Teaching recovery skills to manage the addictive disorder
over the long term.
• Creating an experience of positive membership and a
recovery oriented group
• Using interpersonal learning to improve interpersonal
relationship.
• Understanding and resolving rather than avoiding
problems contributing or resulting from addictive disorders

10. • Size:
3-15, Optimal size:8-10 members.
• Frequency & Duration:
Until the mid-1960s, the length of a group therapy session
seemed fixed: 80- to 90-minute session were part of the
entrenched wisdom of the field.
consensus among therapists that after about 2 hours,
the session reached a point of diminishing returns:
the group becomes weary, repetitious & inefficient.

11. • Groups that meet less than once weekly generally have
considerable difficulty maintaining an interactional
focus.
If a great deal has occurred between meetings in the lives
of the members, such groups have a tendency to focus
on life events and crisis intervention.
The number of sessions in group therapy depends on the
makeup, goals, and setting of the group.

12. • Supportive group therapy:
(Once a week up to 6 months)
• Analytically-oriented group therapy:
(1-3 times a week for 1-3 years)
• Psychoanalysis of groups:
(1-5 times a week for 1-3 years)
• Transactional group therapy:
(1-3 times a week for 1-3 years)
• Behavioral group therapy:
(1-3 times a week up to 6 months)

13. Milieu groups
Psycho-
Psychodrama
educational
Group
therapy
Therapy or
Skill groups
counseling

14. • Offered in a residential program, usually involve a
group meeting to start or end the day
• A community group may review the upcoming day
schedule, discuss issues, ask each patient to state a
goal of the day, and have patients listen to and reflect
on the reading of the day.

15. • Provide information about specific topics related to
addiction and recovery
• Help patients to learn how to cope with challenges of
recovery
• Use a combination of lectures, discussions, educational
videos, and behavioral rehearsals
• Completion of written assignments such as, a recovery
workbook, or a personal journal

16. • Aimed at helping patients develop and/or improve their
intra personal and interpersonal skills
• Example: problem solving methods, stress
management, and skills for relapse prevention
strategies.

17. • These groups are unstructured, and give the
participants an opportunity to create their own agenda.

18. Although many different types and structures of group
therapy are available for the treatment of addictive
disorder, many of the problems issues addressed are
similar:

19. • Understanding addiction and recovery:
o Understanding effects and symptoms of addiction.
o Denial and other defenses.
o Stages of recovery.
• Physical and lifestyle issues:
o Craving management.
o Types and purpose of treatment.
o Defining personal goals.
o Achieving balance in life.

20. • Psychological / behavioral and spiritual issues:
o Self esteem .
o Understanding feelings and their effects on relapse.
o Managing anxiety.
o High risk factors.
• Family/ interpersonal / social domains:
o Effects of addiction on family.
o Role of family in treatment.
o Resolving marital or family conflicts.
o Resisting social pressure to use.
o Managing high risk people, places, and events.

21. To provide effective group treatment, it is necessary for
the therapist to be familiar with and skillful in addiction
treatment and group therapy.
Knowledge base required for providing competent
addiction treatment involves the following:
 Knowledge of the effects of various drugs of abuse as
well as medical, psychological, social, family and
spiritual consequences of addiction.
 Understanding of the process of recovery and relapse.

22.  Tools or strategies required for the recovering persons
to manage the recovery process.
 The therapists should be familiar with the twelve steps
self help approaches (NA, AA).
 Counselor should have an understanding of counseling
theory and experience for individual counseling.
 The group leader should be able to respond to both
individual or group dynamics or group processes
simultaneously.
 Counselor should be familiar with stages of group
(e.g. beginning, middle, work stage, closing)

23.  Group leader should be familiar with the kinds of
interventions she/he would more often use, and how to
deal with problem situations that commonly occurs in
the group sessions.
 Basic intervention skills include; active listening,
clarification, questioning, summarization, encouraging
and supporting, modeling, eliciting feedback, and
addressing problems that commonly arise.

24. The therapist effectiveness is a complicated mix of
knowledge, experience, skills, talent, commitment and
dedication.
The leader can never close the gap between himself and
the group. If he does, he is no longer what he must be.
He must walk a tightrope between the consent he must
win and the control he must exert.

25. Individual commitment to a group effort - that is what
makes a team work, a company work, a society
work, a civilization work.

26. Thank you for your time
Raghda Elgamil