THERAPEUTIC GROUPS

Therapeutic groups deal with the conscious and unconscious factors of its members, and the way they evolve will depend on how the potential of the multiples vectors which are part of the group field (disruptive and cohesive, harmonious and inharmonious…) is worked on and how efficiently.


Every human being has an innate tendency for wanting to know who he is and the role he plays in the groups to which he belongs, and it’s based on that notion that the therapist should try to make the group evolve.


Let’s now discuss some important aspects concerning therapeutic groups.

Setting
The setting is more than a normative need or requirement, it will have a therapeutic action on group members, creating a space or a hierarchy and promoting group cohesion. It will act as a “container” function for all anguishes and needs.

Container Function
The group must receive and contain its members’ anguishes, helping them to structure their psyche and adapt themselves, in a proper way, to all situations.

Identification Model
The group therapist will stand as a model, allowing other members of the group to identify with him and work on their anguishes and fears, based on the way that the therapist receives and deals with this material.

Mirror Function
The group will work as a “hall of mirrors”, resulting from an identification and projection game, that occurs within the same. It will act as an important therapeutic action, allowing each member to recognize himself while also allowing all members to be recognized by everyone else, thus helping them develop their social abilities.

Socialization
This is a fundamental difference in regards to individual therapy. The therapeutic group gives the individuals the appropriate conditions to interact and develop their ability to relate to others. They will feel as if they’re better “understood” by the other members, since they share the same language.

Communication
In many cases, as in couple therapy for example, this is a severe problem. In a therapy group, the communication part is easier due to the fact that every member within it shares a common language. It’s also important to work in the non-verbal communication and help all group members acquire insight.

Therapist’s Interventions
What kind of interventions can (and should) the therapist make inside the group? It depends on the group’s objectives, the therapeutic approach and, of course, the therapist himself and the way he or she works, but, in general, the therapist should ask questions (in a non interrogative way), give some subtle directives and nudge the group into the original subject every time he or she sees it as necessary. He should keep in mind his own interpretation, always taking into consideration the opposites permanently presented in the group. He should also verbalize his emerging impulses and emotions as it will help the group to work on the meaning of some important facts that will emerge within it. And, the most important of all, common sense and professionalism in everything he or she does.

Roles
The roles assigned within the group will be of main importance for its interaction as a whole, and should be carefully observed by the therapist. It’s quite important to realize if they have been altered over time, or if they have remained equal. What changed? Why, or why not? Was it beneficial for the group? The therapist should ask himself these and other questions and impartially evaluate the development of all group elements.

Repairs
Group therapy gives the patient an unique opportunity to help other people. This will be important for him in order to recognize his own abilities and worth, as well as allowing him to partake in an important damage repair exercise. However, it can also enable the rise of an aggressive posture inside of the group, which should be contained and crafted by the therapist.

Personality’s Psychoanalytic Function
This isn’t more than a healthy curiosity in a search for truth, which is, many times, numbed by intrapsychic conflicts and pathological organizations of personality. An individual must distinguish reality from fantasy and be able to elaborate on his own insights about the first one. Ideally, he should be able to keep doing this, even after the end of therapy.

Group Therapist
The therapist must have the conscience that he’s an important identification model for the other group members. He is fundamental for the development of the group and his attitudes towards it will define the way the group will evolve.

OPERATIVE GROUPS

When referring to a group, you must take into account the two great sets, in which they are divided: the operative groups and the psychotherapeutics. In this post, we’re talking about the first one and its specific characteristics.

According to Tubert-Oklander (1986, cit. by Zimerman & Osorio, 1997), an operative group is “a way of thinking and operating within groups, that can be applicable to the coordination of different types of groups.” As you see, it’s not easy to find a concrete definition of the notion, however, an operative group has, mandatorily, a very specific goal, and based on it I will introduce you to the following types of group, to better understand the concept.

 

Training Groups and Education

These groups are connected to teaching and learning and their founding goal is to learn.

They have many applications and they use their basis (learning) to teach their members, making them reflect and evolve in a positive and healthy way, through the specificity of what they learn.

T Groups (training group)

Introduced in 1949, the training groups (or basic skill training groups) had as their main goal turning the intra-group phenomena into a source of learning.

Reflection Groups

In the reflection groups, the main goal is to enable and develop in their participating members, the ability of thinking the group by the shared experience and the learning that has been established.

 

Institutional Groups

Groups formed inside companies and lead by an organizational psychologist, in view of promoting a work optimization and an increase of production inside the company.

 

Community Groups

This kind of group is formed in specific communities with the goal of promoting mental health. They are very specific and their goals widely change depending on the group in question.

 

Therapeutic Groups

This kind of group is formed according to its members’ pathology and it’s main goal is to control it. One of the most famous examples of this kind of group are the self-help groups.

There are plenty of them and they reach very different people, having experienced an amazing expansion in the field of medicine. In this case, the operative group provides a considerable psychotherapeutic benefit.

 

REFERENCES
ZIMERMAN, David E., OSORIO, Luiz Carlos & Col. (1997). Como Trabalhamos com Grupos. (How to work with groups) Porto Alegre: Artes Médicas.

THE GROUP FIELD AND ITS ELEMENTS

A group is a structure that goes far beyond the sum of all its members. All its elements are linked to each other and a change to any one of them will impact all the others.

Each group develops a huge psychic energy potential, where the cohesive and disruptive forces face off, creating an overall balance.

Main aspects present in the group field (analytical view)

(Zimerman & Osorio, 1997)

1. Interaction between the working group and the basic assumptions

There is a permanent oscillatory interaction between these two assumptions, based on the previously mentioned forces of cohesion and disruption of the group.

2. Presence of Drives

We can verify the presence of libidinal drives in any group. These drives can be aggressive or narcissistic and they will manifest in many different ways.

3. Anxiety

Within any group, some anxieties will always arise, caused not only by the group’s internal conflicts, aswell as the internal conflicts of each one of its members, but also by the series of frustrations that external reality to the group will likely impose.

4. Defensive Mechanisms

The group will develop these mechanisms, in many different ways, in response to the anxieties mentioned above. In a therapeutic group, these are of vital importance and should not be ignored.

5. Active Game of Identification

This is a very important aspect of the so-called group field, since it’s at the core of these projected identifications formed within the group, that the sense of the group’s identity will be created.

6. Communication

Fundamental within any group, either in its verbal, or nonverbal form.

7. Roles

The roles played, especially those that are repeatedly performed by the same people, should be the subject of careful observation by the group leader.

8. Links

The way the links emerge in the group, aswell as the way these tend to manifest and relate with each other, is increasingly valued within the group therapy.

9. Resonance

Resonance is a typical phenomenon within the group field. It consists of the way in which the communication from a group member will “resonate” in another member, which will then send a relevant emotional response to the group aswell, despite having a completely different story to tell. It is a phenomenon equivalent to “free association of ideas.”

10. Mirror Gallery

Where each one reflects himself and is reflected in the other, providing a possibility to discriminate, affirm and consolidate its own identity.

11. Containment Function

A cohesive, well-built group will play an important role in the containment of the anxieties and needs of each of its members.

It is important to notice that many aspects of the group field are still hidden and enigmatic. We should never forget that shame, fear of rejection, and the culture in which each individual is inserted, will always interfere with his or her development within the group and, therefore, with the others’ aswell.

REFERENCES

ZIMERMAN, David E., OSORIO, Luiz Carlos & Col. (1997). Como Trabalhamos com Grupos. (How to work with groups) Porto Alegre: Artes Médicas.

WHAT’S A GROUP?

The human being is a product of his relationships and interactions and these tend to form or occur within certain groups, of which the individual is a part and which allow his socialization. Throughout our lives, the groups we belong to are always changing and this change helps us adapt to new and different situations. We are integrated and belong into different groups, which interact with each other and help us form our personality. But after all, what is a group?

1. An entity with its own laws and specific mechanisms

A group is not a mere sum of the different individuals composing it. To be considered a group, these people must have common interests that shape them into a new entity, a group, with implicit rules.

2. Common Goal

The members of a group all have a common goal which should be achieved by the group entity.

3. Communication

The communication is important within a group and should be understood as its whole and its various aspects. Thus, the size of a group (therapeutic or not) must not exceed the limit, which would endanger the communication skills of its members.

4. Physical Environment

The group gathers around a certain physical space, which could be a formal institution, or some specific point in a neighborhood, for example. This space will allow them to define and delimit goals, schedules and even some of the rules or guidelines of said group.

5. The Group is a unit

The group behaves as a whole, giving its members a sense of belonging.

6. A unique and genuine identity

The group has its full identity, but each of the individuals has its own identity, personality and goals that are their own and may not be connected to the group at all. This reality should always be respected by the group.

7. Cohesion and disintegration

In every group, these two forces coexist and help maintain its balance.

8. Group dynamics

The dynamics of each group deals with two contradictory forces, which are struggling to find the balance, as referred in the previous point (no.7). These are, according to Bion (quoted by Zimerman & Osorio, 1997): the conscious intentionality and the influence of unconscious factors.

9. Affective Interaction

Group members interact with each other and the development of relationships and affectivity is inevitable, assuming the most varied and multiple ways.

10. Group Hierarchy

In any group there is a clear hierarchy, more or less explicit, which allows the distribution of the roles that each member will have within it.

11. Group Field

The group field develops (concept developed in The group field and its elements), and in it will most likely be inserted the respective fantasies, anxieties, defense mechanisms, among others, of the group and its members.

REFERENCES

ZIMERMAN, David E., OSORIO, Luiz Carlos & Col. (1997). Como Trabalhamos com Grupos. (How to work with groups) Porto Alegre: Artes Médicas.