The Theory and Practice of Group Psychotherapy (117 page)

50
McLeod and Ryan, “Therapeutic Factors Experienced by Members.”

51
L. Lovett and J. Lovett, “Group Therapeutic Factors on an Alcohol In-patient Unit,”
British Journal of Psychiatry
159 (1991): 365–70.

52
R. Morgan, S. Ferrell, and C. Winterowd, “Therapist Perceptions of Important Therapeutic Factors in Psychotherapy of Therapy Groups for Male Inmates in State Correctional Facilities,”
Small Group Research
30 (1999): 712–29.

53
J. Prochaska and J. Norcross, “Contemporary Psychotherapists: A National Survey of Characteristics, Practices, Orientations, and Attitudes,”
Psychotherapy: Theory, Research, and Practice
20 (1983): 161–73.

54
R. Dies, “Models of Group Therapy: Sifting Through Confusion,”
International Journal of Group Psychotherapy
42 (1992): 1–17.

55
It is noteworthy that my book,
The Gift of Therapy,
(New York: HarperCollins, 2002) which offers eighty-five existential tips for therapy had a wide readership stemming from all the various therapy ideological schools.

56
S. Mitchell,
Hope and Dread in Psychoanalysis
(New York: Basic Books, 1993). S. Mitchell and M. Black,
Freud and Beyond: A History of Modern Psychoanalytic Thought
(New York: Basic Books, 1995).

57
E. Jones,
The Life and Work of Sigmund Freud,
vol. 1 (New York: Basic Books, 1953), 40.

58
I. Yalom,
Existential Psychotherapy
(New York: Basic Books, 1980).

59
I. Yalom,
Love’s Executioner
(New York: Basic Books, 1989).

60
I. Yalom,
When Nietzsche Wept
(New York: Basic Books, 1992).

61
I. Yalom,
The Gift of Therapy
(New York: HarperCollins, 2002).

62
I. Yalom,
Momma and the Meaning of Life
(New York: Basic Books, 1999).

63
I. Yalom,
The Schopenhauer Cure
(New York: HarperCollins, 2005).

64
R. Tedeschi, L. Calhoun, “The Posttraumatic Growth Inventory: Measuring the Positive Legacy of Trauma,”
Journal of Traumatic Stress
9 (1996): 455–71.

65
M. Antoni et al., “Cognitive-Behavioral Stress Management Intervention Decreases Prevalence of Depression and Enhances Benefit Finding Among Women Under Treatment for Early-Stage Breast Cancer,”
Health Psychology
20 (2001): 20–32.

66
D. Cruess et al., “Cognitive-Behavioral Stress Management Reduces Serum Cortisol by Enhancing Benefit Finding Among Women Treated for Early Stage Breast Cancer,”
Psychosomatic Medicine
62 (2000): 304–8.

67
I. Yalom and C. Greaves, “Group Therapy with the Terminally Ill,”
American Journal of Psychiatry
134 (1977): 396–400. Bower et al., “Cognitive Processing, Discovery of Meaning, CD4 Decline.” P. Goodwin et al., “The Effect of Group Psychosocial Support on Survival in Metastatic Breast Cancer,”
New England Journal of Medicine
345 (2001): 1719–26.

68
E. Fromm,
Escape from Freedom
(New York: Henry Holt, 1995).

69
M. Heidegger,
Being and Time
(New York: Harper & Row, 1962), 210–24.

70
J. Sartre,
Being and Nothingness,
trans. Hazel Barnes (New York: Philosophical Library, 1956), 633.

71
K. Jaspers, cited in J. Choron,
Death and Western Thought
(New York: Collier Books, 1963), 226.

72
Yalom and Greaves, “Group Therapy with the Terminally Ill.”

73
Bower et al., “Cognitive Processing, Discovery of Meaning, CD4 Decline.”

74
F. Nietzsche,
Twilight of the Idols
(London: Penguin Books, 1968), 33. Yalom,
The Gift of Therapy.

75
D. Spiegel, J. Bloom, and I. Yalom, “Group Support for Patients with Metastatic Cancer,”
Archives of General Psychiatry
38 (May 1981): 527–34. I. Yalom,
Existential Psychotherapy
(New York: Basic Books, 1980), 36–37.

76
A. Schopenhauer, in
Complete Essays of Schopenhauer,
trans. T. Saunders, Book 5 (New York: Wiley, 1942), 18.

77
In a widely cited report, R. Corsini and B. Rosenberg (“Mechanisms of Group Psychotherapy: Processes and Dynamics,”
Journal of Abnormal Social Psychology
51 [1955]: 406–11) abstracted the therapeutic factors from 300 pre-1955 group therapy articles; 175 factors were clustered into nine major categories, which show considerable overlap with the factors I have described. Their categories, and my analogous categories in parentheses, are:

1. Acceptance (group cohesiveness)

2. Universalization (universality)

3. Reality testing (includes elements of recapitulation of the primary family and of interpersonal learning)

4. Altruism

5. Transference (includes elements of interpersonal learning, group cohesiveness, and imitative behavior)

6. Spectator therapy (imitative behavior)

7. Interaction (includes elements of interpersonal learning and cohesiveness)

8. Intellectualization (includes elements of imparting information)

9. Ventilation (catharsis)

W. Hill, in 1957, interviewed nineteen group therapists and offered these therapeutic factors: catharsis, feelings of belongingness, spectator therapy, insight, peer agency (that is, universality), and socialization (W. Hill, “Analysis of Interviews of Group Therapists’ Papers,”
Provo Papers
1 [1957], and “Further Consideration of Therapeutic Mechanisms in Group Therapy,”
Small Group Behavior
6 [1975]: 421–29).

78
Fiedler’s study, described in chapter 3, indicates that experts, regardless of their school of conviction, closely resemble one another in the nature of their relationship with patients (F. Fiedler, “A Comparison of Therapeutic Relationships in Psychoanalytic, Nondirective, and Adlerian Therapy,”
Journal of Consulting Psychology
14 (1950): 436–45. Truax and Carkhuff’s work, also discussed in chapter 3 (C. Truax and R. Carkhuff,
Toward Effective Counseling and Psychotherapy
[Chicago: Aldine, 1967]), and the Ablon and Jones analysis of the NIMH depression trial provide further evidence that effective therapists operate similarly in that they establish a warm, accepting, understanding relationship with their clients (Ablon and Jones, “Psychotherapy Process in the National Institute of Mental Health,” and J. Ablon and E. Jones, “Validity of Controlled Clinical Trials of Psychotherapy: Findings from the NIMH Treatment of Depression Collaborative Research Program,”
American Journal of Psychiatry
159 [2002]: 775–83). Strupp, Fox, and Lessler, in a study of 166 patients in individual therapy, reached a similar conclusion: successful patients underscored the fact that their therapists were attentive, warm, respectful, and, above all, human (H. Strupp, R. Fox, and K. Lessler,
Patients View Their Psychotherapy
(Baltimore: Johns Hopkins University Press, 1969). A comprehensive review of the rapidly accumulating research in this area reveals that therapist qualities of acceptance, nonpossessive warmth, and positive regard are strongly associated with successful outcomes. See H. Conte, R. Ratto, K. Clutz, and T. Karasu, “Determinants of Outpatients’ Satisfactions with Therapists: Relation to Outcome,”
Journal of Psychotherapy Practice and Research
4 (1995): 43–51; L. Alexander, J. Barber, L. Luborsky, P. Crits-Christoph, and A. Auerbach, “On What Bases Do Patients Choose Their Therapists,”
Journal of Psychotherapy Practice and Research
2 (1993): 135–46; S. Garfield, “Research on Client Variables in Psychotherapy,” in
Handbook of Psychotherapy and Behavior Change,
4th ed., ed. A. Bergin and S. Garfield (New York: Wiley, 1994), 190–228; M. Lambert, “The Individual Therapist’s Contribution to Psychotherapy Process and Outcome,”
Clinical Psychology Review
9 (1989): 469–85; S. Butler, L. Flather, and H. Strupp, “Countertransference and Qualities of the Psychotherapist,” in
Psychodynamic Treatment Research: A Handbook for Clinical Practice,
ed. N. Miller, L. Luborsky, J. Barber, and J. Docherty (New York: Basic Books, 1993), 342–60; and S. Van Wagoner, C. Gelso, T. Hayes, and R. Diemer, “Countertransference and the Reputedly Excellent Therapist,”
Psychotherapy
28 (1991): 411–21. Furthermore, as reviewed in chapter 3, the link between a positive therapeutic bond and favorable outcome is one of the most consistent and certain findings in all of psychotherapy research. These conclusions regarding therapist contributions to successful psychotherapy are so well established that they have been incorporated in professional practice psychotherapy guidelines (K. MacKenzie et al., “Guidelines for the Psychotherapies in Comprehensive Psychiatric Care: A Discussion Paper,”
Canadian Journal of Psychiatry
44 (suppl 1) (1999): 4S–17S).

79
Schaffer and Dreyer, “Staff and Inpatient Perceptions.”

80
Lovett and Lovett, “Group Therapeutic Factors.”

81
M. Lee, L. Cohen, S. Hadley, and F. Goodwin, “Cognitive Behavioral Group Therapy with Medication for Depressed Gay Men with AIDS or Symptomatic HIV Infection,”
Psychiatric Services
58 (1999): 948–52.

82
R. Morgan and C. Winterowd, “Interpersonal Process-Oriented Group Psychotherapy with Offender Populations,”
International Journal of Offender Therapy and Comparative Criminology
46 (2002): 466–82. Morgan et al., “Therapist Perceptions of Important Therapeutic Factors.”J. MacDevitt and C. Sanislow, “Curative Factors in Offenders’ Groups,”
Small Group Behavior
18 (1987): 72–81.

83
D. Randall, “Curative Factor Rankings for Female Incest Survivor Groups: A Summary of Three Studies,”
Journal of Specialists in Group Work
20 (1995): 232–39.

84
H. Feifel and J. Eells, “Patients and Therapists Assess the Same Psychotherapy,”
Journal of Consulting Psychology
27 (1963): 310–18.

85
I. Yalom and G. Elkin,
Every Day Gets a Little Closer: A Twice-Told Therapy
(New York: Basic Books, 1975; reissued 1992).

86
D. Orlinsky, K. Grawe, and B. Parks, “Process and Outcome in Psychotherapy,” in
Handbook of Psychotherapy and Behavioral Change: An Empirical Analysis,
4th ed., ed. S. Garfield and A. Bergin (New York: Wiley, 1994): 270–370. D. Martin, J. Garske, and M. Davis, “Relation of the Therapeutic Alliance with Outcome and Other Variables: A Meta-Analytic Review,”
Journal of Consulting and Clinical Psychology
68 (2000): 438–50.

87
Colijn et al., “A Comparison of Curative Factors.” M. Kahn, P. Webster, and M. Storck, “Curative Factors in Two Types of Inpatient Psychotherapy Groups,”
International Journal of Group Psychotherapy
36 (1986): 579–85. Kapur et al., “Therapeutic Factors Within Inpatient and Outpatient Psychotherapy Groups.” V. Tschuschke and R. Dies, “Intensive Analysis of Therapeutic and Outcome in Long-Term Inpatient Groups,”
International Journal of Group Psychotherapy
44 (1994): 185–208. J. Maxmen and N. Hannover, “Group Therapy as Viewed by Hospitalized Patients,”
Archives of General Psychiatry
28 (1973): 404–8. Steinfeld and Mabli, “Perceived Curative Factors.” Butler and Fuhriman, “Patient Perspective on the Curative Process.” N. Macaskill, “Therapeutic Factors in Group Therapy with Borderline Patients,”
International Journal of Group Psychotherapy
32 (1982): 61–73. Leszcz et al., “The Value of Inpatient Group Psychotherapy.” Marcovitz and Smith, “Patients’ Perceptions of Curative Factors.” Schaffer and Dreyer, “Staff and Inpatient Perceptions.”Mushet et al., “In-patients’ Views of the Helpful Aspects.”

88
Marcovitz and Smith, “Patients’ Perceptions of Curative Factors.”

89
J. Falk-Kessler, C. Momich, and S. Perel, “Therapeutic Factors in Occupational Therapy Groups,”
American Journal of Occupational Therapy
45 (1991): 59–66.

90
P. Kellerman, “Participants’ Perceptions of Therapeutic Factors in Psychodrama,”
Journal of Group Psychotherapy, Psychodrama, and Sociometry
38 (1985): 123–32.

91
M. Lieberman and L. Borman,
Self-Help Groups for Coping with Crisis
(San Francisco: Jossey-Bass, 1979), 202–5.

92
S. Horowitz, S. Passik, and M. Malkin, “In Sickness and in Health: A Group Intervention for Spouses Caring for Patients with Brain Tumors,”
Journal of Psychosocial Oncology
14 (1996): 43–56.

93
P. Chadwick, S. Sambrooke, S. Rasch, and E. Davies, “Challenging the Omnipotence of Voices: Group Cognitive Behavior Therapy for Voices,”
Behavior Research and Therapy
38 (2000): 993–1003.

94
E. Pence and M. Paymar,
Power and Control: Tactics of Men Who Batter,
rev. ed. (Duluth: Minnesota Program Development, 1990).

95
F. Mishna, “In Their Own Words: Therapeutic Factors for Adolescents Who Have Learning Disabilities,”
International Journal of Group Psychotherapy
46 (1996): 265–72.

96
McLeod and Ryan, “Therapeutic Factors Experienced by Members.”

97
H. Riess, “Integrative Time-Limited Group Therapy for Bulimia Nervosa,”
International Journal of Group Psychotherapy
52 (2002): 1–26.

98
Kivlighan, Goldfine, “Endorsement of Therapeutic Factor.”

99
Tschuschke and Dies, “Intensive Analysis of Therapeutic Factors and Outcome.”V. Tschuchke, K. MacKenzie, B. Nasser, and G. Janke, “Self-Disclosure, Feedback, and Outcome in Long-Term Inpatient Psychotherapy Groups,”
Journal of Psychotherapy Practice and Research
5 (1996): 35–44.