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.
■ 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 lead by a therapist, but it is encouraged in a
group counseling session that all members of the group contribute in
some way.
3. ■ 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. Therapeutic Principles in Group
Counseling
■ Universality Members recognize that other members share similar
feelings, thoughts and problems العمومية
■ Altruism Members gain a boost to self concept through extending help to
other group members
اإليثار
■ Instillation of hope Member recognizes that other members’ success can
be helpful and they develop optimism for their own improvement األمل بث
التغيير في
■ Imparting information Education or advice provided by the therapist or
group members
■ Corrective recapitulation of primary family experience Opportunity to reenact
critical family dynamics with group members in a corrective manner
■ Development of socializing techniques The group provides members with an
environment that fosters adaptive and effective communication
5. Therapeutic Principles in Group
Counseling
■ Imitative behavior Members expand their personal knowledge and skills
through the observation of Group members’ self-exploration, working through
and personal development
■ Cohesiveness Feelings of trust, belonging and togetherness experienced by
the group members
اإلنتماء
■ Existential factors Members accept responsibility for life decisions
■ Catharsis Members release of strong feelings about past or present experiences
■ Interpersonal learning- input / output Members gain personal insight about
their interpersonal impact through feedback provided from other members
■ Self-understanding Members gain insight into psychological motivation
underlying behavior and emotional reactions
6. Types of group therapy used in
treatment of addiction
Group
therapy
Psycho-
educational
Skill groups
Therapy or
counseling
Psychodrama
Motivational
8. Early stages of treatment
Features of clients:
■ Ambivalent about ending substance use.
■ Have a tenuous commitment to recovery…fear of consequences vs.
sincere desire for change
■ Cognitive impairment from substances , so clients tend to be rigid
in their thinking and limited in their ability to solve problems…
■ Brain is changed ….?
■ Extreme emotional turmoil, grappling with intense emotions such as
guilt, shame, depression, and anger about entering treatment.
(Flores 1997)
9. Early stages of treatment
Therapeutic tasks :
■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
10. Ongoing stages of treatment
Features of clients:
• Members are in phase of maintaining abstinence
• Members begin to gain a sense of self - reliance
• Members have overcome their denial around addiction.
• Need vigorous assistance maintaining behavioral changes throughout
the middle, or action, stage of treatment.
• impaired decision making , euphoric recall ….?
11. Ongoing stages of treatment
Therapeutic tasks :
■ Maintain 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
12. Ongoing stages of treatment
Therapeutic tasks :
■Maintain abstinence by:
■Engage members actively in the treatment and recovery process.
■Pay special attention to internal cues, To prevent relapse, clients
need to learn to monitor their thoughts and feelings,
14. o Group Leadership Competencies.
o Group Leadership functions.
oGroup Leadership Techniques.
oEffective group leaders.
oIneffective group leaders.
15. Competencies have been established by
the Association for Specialists in Group
Work (ASGW):
– Knowledge Competencies.
– Skill Competencies.
– Supervised Practice (10-20 clock
hours).
16. ■ Group leaders must have a high tolerance for
anxiety, frustration, and disorganization.
■ Enough knowledge about the effects of various
drugs of abuse & consequences of addiction.
■ Understanding of the process of recovery and
relapse.
17. ■ promote independence and more effective
behavior and encourage group members to
be more responsible for what takes place in
the group.
■ Basic intervention skills include; active
listening, clarification, questioning,
summarization, encouraging and supporting,
modeling, eliciting feedback, and addressing
problems that commonly arise.
18. Basic standards required for providing a solid
foundation for the group in addiction treatment
involves the following ( ISAM, 2003):
■ Prepare members for the group.
■ Establish a climate of acceptance, caring, safety,
and mutual respect.
■ Therapist should Keep his own needs separate.
■ Model positive life skills.
■ Keep an appropriate self disclosure.
19. o Group Leadership Competencies.
o Group Leadership functions.
oGroup Leadership Techniques.
oEffective group leaders.
oIneffective group leaders.
20. ■ The therapist’s interventions consist of a
range of integrated but distinct actions
that are most effective when they are well
balanced with one another.
■ Four basic functions of the group leader
have been identified: executive function,
caring, emotional stimulation, and
meaning-attribution (Bernard et al., 2008).
21. ■ Executive function :
Setting limits, providing rules, managing
time etc. (Bernard et al., 2008).
Establishing Group Norms. establish and
reinforce productive group norms that
shape the therapy
22. ■ Caring:
Showing support, praise, warmth,
acceptance ..etc.
(Therapist sets the tone for how the members of the
group treat and regard each other. Useful
therapeutic work cannot occur without a solid
positive therapeutic alliance between each
member and the group, including but not limited
to the group therapist ) (Bernard et al., 2008).
23. ■ Emotional stimulation :
Refers to the therapist’s efforts to uncover
and encourage the expression of feelings,
values and personal attitudes.
Therapy groups work optimally when the
therapeutic dialogue is emotionally
charged, and yet at the same time
controlled enough
24. ■ Meaning-attribution
cognitive aspect of group treatment
Explaining, clarifying, interpreting ….etc.
( involves the therapist helping members to develop their ability to
understand themselves, each other, and people outside the group, as
well as what they might do to change things in their lives. (Bernard
et al., 2008).
25. Leadership functions
■ Fostering Client Self-Awareness :
“Insight” may be facilitated by the therapist’s
interpretation, or interpersonal learning
26. Leadership functions
■ Therapist Transparency and Use of Self.
Therapists should not reveal anything that they are
uncomfortable sharing about themselves;
The therapist’s personal disclosure is the conviction that it
will facilitate the work of the group at that moment in time.
Appropriate self-disclosures (appropriate level of detail,
focus remains on the client)
“excessive” self-disclosures (self-aggrandizing stories,
shifting the focus to the therapist)
27. Group process
■ Group process generally refers to what happens in the group.
■ These processes occur at both observable processes which
consist of verbal (e.g., speech content, expressed affects) and
nonverbal behaviors that have been conceptualized,
operationalized.
■ Inferred or covert group processes refer to conscious and
unconscious intentions, motivations, wishes, enacted by
individual participants, or the group as a whole. (Yalom & Leszcz,
2005).
28. The group will benefit from a
balance of three key elements:
Clients
(structure)
Group
process
Group
content
29. o Group Leadership Competencies.
o Group Leadership functions.
oGroup Leadership Techniques.
oEffective group leaders.
oIneffective group leaders.
30. Effective group leaders:
Respect group members
Is very patient with group members
Have skills to arouse and/or allow tension
within the group
Can be criticized by group members without
becoming angry or defensive
Pay attention to the "process“
not just the "content"
31. Ineffective group leaders:
Use warnings and threats to control group.
Give advice excessively to group members.
Force members to behave in a certain way.
pay attention to the content (the what) more than the
process (the how).
Try to avoid tension or conflicts in
the group and do not have skills to deal
deal with them.
32. ■ 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.
33. “Leadership is…..
the art of getting
someone else to do
something you want
done because he
wants to do it.”
Dwight D. Eisenhower
