Psychoanalytic therapists tend to be very careful in the constitution of a group. Thus, they tend to require that its formation follow three important steps, which will be explained below.
1. Routing
In this step, the therapist tries to give knowledge about the group, in order to achieve a minimum number of members that make it able to work. It’s important, since the very beginning, to have well defined goals, so you can know the kind of patients you want in your group.
2. Selection
This is the second step and it occurs for two main reasons.
The first one is to try to avoid the risk of unpleasant surprises during therapy, such as the countertransferential discomfort or a patient’s economic impossibility or lack of motivation for the treatment, the latter being the primary cause for treatment abandonment.
The second reason is related with the issues of the indications and contraindications of belonging to a therapeutic group. You can check out the examples below:
Indications:
1. Priority for a teenager in a group dedicated to them.
2. When the patient shows preference for this kind of treatment.
Contraindications:
1. Lack of Motivation (some patients are just looking for some social support, rather than treatment)
2. The pathology (some pathologies require more attention and show a higher level of aggressiveness, so a patient excessively depressed, paranoid or narcissistic isn’t usually a good option for this kind of treatment)
3. Intellectual deficiency (a case where it will become too difficult or even impossible to follow along with the development of the rest of the group)
4. Patients in a severe crisis
5. Risk of breaking the secrecy within the group (people that for professional or political motives represent a risk of breaking the secrecy in the group)
6. Therapy abandonment (history of several instances of therapy abandonment in the past)
3. Grouping
In this third step, the therapist should anticipate the interaction between the individuals and the resulting viability for therapy. He or she should do this accordingly to the age group, the eventual relationship between members when outside of the group, their personalities, moments of crisis and any other situation which may end up interfering with the good development of said therapy group.
He should also establish the group rules, not only for the beginning but for the patients who will be inserted into the group at some later stage.
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