Recently, Irvin Yalom's books on group psychotherapy have gained quite a lot of popularity. This approach to working with people in medicine has been practiced relatively recently and has its followers and opponents. It is difficult to deny that group therapy is not always effective, but it is equally impossible not to recognize its positive aspects. There are many cases where group work was the only method of successfully curing patients.
What is it about?
Group psychotherapy involves the formation of a group of interested persons who meet regularly on an agreed neutral territory under the supervision of the attending doctor. The task is to solve urgent issues by people who need the help of a psychotherapist. This approach was first applied in practice by J. H. Pratt, who specialized in internal medicine. In 1905, he simultaneously worked with several persons suffering from severe tuberculosis. Almost all of them could not afford expensive medical services, and Pratt helped them find an alternative method. It was decided from time to time to collect a group of patients,tell them how the disease proceeds, receive information about changes in the condition of patients. Practice soon showed that those treated in such groups recovered noticeably faster than those who had access to expensive individual recovery.
For the first time, the group formation method was applied to psychiatry in 1925. The author of the new approach was Jacob Moreno, who developed the theory of psychodrama. The approach became widespread during the Second World War, since it was then that the number of people in need of the help of a psychotherapist increased markedly, while the number of doctors was not large enough to conduct individual counseling.
Today, the theory and practice of group psychotherapy continues to evolve. Many are convinced that this method is the future of psychiatry, but there are also people who point out the shortcomings of this approach. First of all, it is the impossibility of working directly with the client. In addition, group therapy is not for everyone - often people are too closed, and this is especially pronounced when placed in an environment of strangers.
Development of the theory
Since group psychotherapy began to gain momentum, the method is being actively improved, and modern doctors have much more information, ways to influence patients than doctors of the second half of the last century. For the optimal effect, patients are divided into groups, the classification of which is based on specific problems, disorders. Currently, this method of treatment is indicated for certaineating disorders, as well as victims of rapists. It is not uncommon for individuals struggling with cancer to undergo psychotherapy in groups. At the same time, it is not possible to formulate an exact canon: when work in groups is applicable and mandatory, and when it is unacceptable and harmful. It all depends on individual patients and the characteristics of their mental state.
The basis of group psychotherapy is working with several people who have similar life difficulties. It is rare that there are less than five patients in a group, but it is not practiced to work with more than 15 at the same time. Sometimes patients are under the control of one doctor, but the simultaneous presence of several psychotherapists at once is possible. The optimal meeting frequency is once or twice a week. Results can be seen after six or more sessions, although doctors advise treatment for at least a year.
What suits me?
There are two main approaches to psychotherapy:
- group counseling;
- individual interaction.
One of the main advantages of working with groups is financial availability. Psychotherapy is a rather expensive pleasure, but the modern rhythm of life and the conditions of our everyday life are such that it is becoming increasingly difficult to do without it. In addition, working with a group allows you to get closer to reality, since each of the patients has the opportunity to interact with other people, the same as himself. You can hear someone else's point of view, get acquainted with the opinion of another person and expand your own view of things.
During a group session, each participant can observe others, receiving a lot of useful information, food for thought. The more people, the richer the event, the more experiences it causes, gives rise to a strong emotional response from each participant. This makes it possible for everyone present to open up in a short time.
At the same time, with the listed features, the doctor also has the advantages and possibilities of group psychotherapy, since work is easier than with an individual client attending consultations. When interacting with multiple people, you can use different methods to obtain customer data. When working one-on-one, a specialist can only focus on what the visitor said, but with group interaction, he has the opportunity to observe how each of those present behaves.
How to choose the working method?
The best option is a combination of group psychotherapy techniques and individual communication between the doctor and the patient. Recently, people who can afford to undergo treatment exclusively in a group are increasingly seeking help, but the combination of the two options is considered the most successful and promising.
A common practice is group therapy, in which all the participants are united by some strictly limited problem. This approach is widely used in the treatment of depressive disorders, panic, bipolar. The group technique in psychiatry is relevant when working with sociophobes and people with OCD. The group is the most convenient and effectivea method to support, to help a person who is faced with difficult conditions provoked by the loss of a loved one. This psychotherapeutic method is applicable in the fight against incontinence, stiffness.
Important aspects
Of the positive aspects of group psychotherapy, it is worth mentioning:
- an opportunity to feel the approval of ordinary people;
- learning how to deal with difficulties based on the experience of others;
- the ability to understand yourself by analyzing the interaction with other people.
At the same time, a person, having turned to the possibilities of psychotherapy in a group, seems to receive a “shelter”: at the same time he has the opportunity to interact with representatives of society, but for this, safe conditions are created in which you can not worry about rejection, disapproval.
Features of the human psyche are such that the cause of difficulties is much easier to understand if you watch from the outside for someone who is struggling with the same problems. But when trying to analyze oneself, a person encounters difficulties: it is extremely problematic to adequately assess the situation and realize what the “root of evil” is. The Institute of Group and Family Psychology and Psychotherapy is the very branch of medicine that gives everyone interested the opportunity to understand themselves by observing others. Analyzing the behavior of people faced with similar situations, one can formulate how one should change one's thinking and actions. Collaborating with a psychiatrist, clients are usually open, honest, and thereforepowerful feedback is being established, everyone can understand what impression he makes on others, what features of his behavior become obstacles to adapting to society.
Where there are pros, there are cons
Methods of group psychotherapy are not a one-size-fits-all solution to every problem. Not every person can undergo treatment in this format, it all depends on personal, individual characteristics. Some come to the course, but in fact only interfere with others, and they themselves do not receive any benefit from attending classes.
There are times when a group turns into a conformal one, conflicts are not revealed, the participants do not open up. Everyone only plays a chosen role, in fact, the course becomes useless.
As you can learn from any modern book on group psychotherapy, the main idea is the formation of a group where participants behave openly, sincerely. Everyone is required to have the maximum possible empathy for him. Such behavior is not typical for the ordinary society that surrounds a person in everyday life, which gives rise to a desire to stay in a comfortable environment for life. A person wants to continue communication in the established group, avoiding reality, withdrawing himself. By the way, about books: the one mentioned above by Yalom is one of the basic publications, literally a handbook for a psychotherapist working with groups.
Objectives and goals
Group psychotherapy is designed to relieve the symptoms of mental disorders and achieve changes in the patient's condition. The idea is to achieve personal growth of each participant. For thisone has to recognize and formulate the problem, reveal its essence, analyze the situation, realize the information received in this case, assimilate it and correct one's own behavior based on the revealed one. Successful completion of the course helps to normalize relationships with other people, one's own attitudes.
The therapist creates a comfortable environment for all participants, favorable for people in need of support. People around help each other, worry about each other and work together to understand the experience. One of the basic phenomena of the theory of group psychotherapy is the definition of the emotional content of a state, a situation. All emotions must be voiced, understood and accepted. The psychotherapist and the group members formulate the objectives to be achieved during the course. They are divided into two categories:
- verbal;
- nonverbal.
First - psychodrama, discussion. The second - psychological gymnastics, music therapy, drawing.
What to do and how?
When considering how group therapy began, it is worth remembering that participants gathered in groups to discuss their condition, receive information about possible changes, and also receive recommendations for therapy. The conversational aspect is just as important today as it was when this treatment was born. Group discussion is the basic element of therapy, it is on it that the entire treatment process is based. Topics of conversation can be very different: biography of the participants, topics that theyinteresting, aspects of behavior that attract attention.
All other approaches used in group psychotherapy are auxiliary. Psychodrama is a method by which, in a playful way, one can consider the situation of the performance of a certain social role by the participants. This helps to clarify the problems of all those present. Psycho-gymnastics is another effective auxiliary method. His idea is emotional expression through gestures, facial expressions. Through this practice, each participant can open up, realize their own state. Projective drawing has a similar effect - it makes it possible to bring to light the deepest problems of a person. The therapist sets the topic, and those present create drawings. The result of the work is discussed by all participants.
Music therapy is one of the methods actively researched at the Institute of Group Psychotherapy as a field of science. It is already clear that it is through music that people can be united, while the sounds have a relaxing effect on the participants. Music therapy can be active or passive. The first option - all those present sing, play musical instruments, the second - a discussion of emotions, pictures that pop up in memory when listening to sounds.
Theory: present and future
As can be seen from the growing competition in specialized educational institutions, training in group psychotherapy attracts the masses. Indeed, young people see the potential in this method and strive to master it as the most accessible and effective. Do not forget that a psychiatrist practicing such approaches will always have clients:sessions are relatively inexpensive, and many can afford them. When people come to classes, they want to improve their daily routine, and the psychotherapist becomes their guide to a better world. At the same time, all existing groups are usually divided into three types:
- therapeutic;
- educational;
- aimed at improving the participants, solving their problems.
What is group psychotherapy for course participants? This is both an opportunity to learn and correct the experience gained. People work with emotions, normalize behavior, influence their own mind. Confrontation is one of the main techniques to achieve this success. On opposite sides of the "barrier" are the patient and his inherent difficulties. The psychotherapist helps him to realize and accept himself, to solve his own problems, using feedback with the participation of all members of the group. An important aspect is the exact transfer of the features of the client's perception by others.
Important aspects
Group psychotherapy for adolescents, adults assumes that the therapist assumes the functions of managing the process. His task is to lead the group, keep the members active, explain to others what each of those present understood. The doctor is responsible for the positive mood of the participants, removes bias, draws attention to any positive trends due to treatment, demonstrates them with the examples of those present. Already the very hope that it gives to all participants becomes an important tool for healing. Whena person sees how another fights and overcomes similar problems, thereby he is also filled with strength and confidently goes to success, realizes that any obstacles can be overcome, you just need to make an effort - the state will definitely change for the better.
An important step in group interaction is the realization of the fact that the members of society are not alone. It is necessary to be able to see this, to feel that everyone has problems in life, but people cope with them, go through them, learning new things, gaining experience, reconciling themselves with themselves. In the course of understanding these aspects, the group members, under the supervision of a psychotherapist, learn to trust others, to let them get closer to themselves. In life, people usually share their experiences with relatives and friends, while others completely close themselves, isolate themselves from external experience, against the background of which there is a feeling of the uniqueness of their problem, the incredible weight of the burden. Once in a group, realizing that others have similar difficulties, a person perceives the difficulty more easily, feels unity with others.
Awareness and attitude are key to success
During a group session, the client gets a general idea of what is included in the concept of mental he alth, what pathologies are possible, what dynamics are observed from the surrounding people and the doctor. You can hear advice, get a guide to action. All this gives a sufficient amount of information for the analysis and understanding of the processes of one's own psyche. A person understands the fallacy of his ideas and analyzes them, while the state becomes better, new ways out appear.from the current situation. The patient sees what measures need to be taken in order to come into harmony with his own inner world.
There are many cases when the very fact of understanding oneself, the processes occurring in one's psyche made a person independent enough not to need further therapy. The patient turns into a researcher, realizes the causes of problems, their consequences, solutions. Explanation, as theorists say, is the most significant key that allows you to control yourself and the world. Uncertainty, in turn, acts as a source of fear and anxiety.
At the same time, the success of the program is largely related to the patient's ability to give, awareness of one's own need, importance relative to others. There are a lot of cases when people turned to group psychotherapy, disappointed in themselves and their abilities to share, to give. They even feel like a burden to themselves. Having discovered that the opinion, experience they have acquired is important and useful for someone, they receive new strength, an impetus to life.
Past and future
Group therapy helps to leave in the past the conflicts associated with the peculiarities of family upbringing. At the same time, the group itself has much in common with the family, but reveals all the problems and difficulties that are caused by the person's past. The therapist and others help the client to get rid of negative emotions by expressing them, verbalize their childhood experiences, realize them, accept and change.
Group therapy helpsdevelop social skills. This may be the main objective of the course or an objective achieved indirectly. The first option involves the formation of a game situation, accompanied by difficulties for the client. The second option is to encourage strong feedback.
The therapist analyzes the patient's behavior, which helps all group members to learn about their habits and interactions with others. Against the background of the information received, everyone can develop and improve. Many learn to capture the atmosphere, acquire the skills to resolve a conflict situation, successfully avoid condemnation, understand themselves and those around them. After completing a course of group psychotherapy, a person acquires the skills of empathy.
