Michele Graffam, LCSW

October 15, 2014

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What is a Group
— A group is a collection of individuals whose
association is founded on commonalities of interest,
norms, and values. Membership in the groups may
be by chance, by choice, or by circumstances

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History of Groups
— Originally found successful in treating patients with
TB in the early 1900’s
— Later used during WW II for treating those with
emotional reactions
— Lewin’s Systems Theory: The group as a whole is
greater than the sum of its parts

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The Elements of an Interpersonal Group
— The model represents that the interpersonal
dynamics are kept at the forefront of member’s
attention by the therapist. The interpersonal
approach places the therapist among the other
members of the group without giving him or her a
distinctive identity or any formal differentiation for the
boundaries of the group as a whole.

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Effective Group Therapy
Yalom Identified 11 Characteristics that make Effective Group Therapy
— Universality (“I’m not alone nor have unique
problems”)
— Group Cohesiveness Altruism (unselfish giving)
— Instillation of Hope Imparting Information
(educational)
— Interpersonal Learning Development of Socializing
Techniques
— Imitative Behavior Corrective Recapitulation of the
Primary Family Group Catharsis Existential Factors

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Group Types
— Group: Two or more patients may participate in therapy
at the same time. Patients are able to share experiences
and learn that others feel the same way and have had
the same experiences.
— Marital/Couples: This type of therapy helps spouses and
partners understand why their loved one has a mental
disorder, what changes in communication and behaviors
can help, and what they can do to cope.
— Family: Because family is a key part of the team that
helps people with mental illness get better, it is
sometimes helpful for family members to understand
what their loved one is going through, how they
themselves can cope, and what they can do to help

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Psychotherapy
— Group psychotherapy, like individual psychotherapy, is
intended to help people who would like to improve their ability
to cope with difficulties and problems in their lives. But, while
in individual therapy the patient meets with only one person
(the therapist), in group therapy the meeting is with a whole
group and one or two therapists.
— Group therapy focuses on interpersonal interactions, so
relationship problems are addressed in groups.
— The aim of group psychotherapy is to help with solving the
emotional difficulties and to encourage the personal
development of the participants in the group.
— The therapist (called conductor, leader, or facilitator) chooses
as candidates for the group people who can benefit from this
kind of therapy and those who may have a useful influence on
other members in the group.
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ROLE OF NURSE IN GROUP THERAPY
— In psychiatry nurses may lead various types of
therapeutic groups such as client education, assertiveness
training, support, parent, and transition to discharge groups
among others. To function effectively in the leadership capacity
for these groups, nurses need to be able to recognize various
processes that occur in the groups such as phases of group
development. They also should be able to select appropriate
leadership styles for the type of groups being lead. Nurses
may develop these skills as a part of their training or they may
pursue additional studies.
— Leading therapeutic group is within the realm of nursing
practice because group work is such a therapeutic approach.
Nurses working in this field should continuously strive for
expanding their knowledge and use of nursing process for the
effective therapeutic approach.

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Group Rules
— Group sessions are confidential. Members and leaders
are bound ethically and legally not to disclose the
contents of the sessions in any way that could identify
members of the group. Remember, we are building trust
and safety.
— Use "I" statements: Speak from your own experience by
using "I" instead of “we," "you," and "us". We can only
speak for how we feel, not how others feel.
— Be on time: Being on time shows respect for the process
and others.
— Tolerance: Tolerance is acceptance. We must be
accepting of our differences in order to grow and learn.
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Group Rules
— No bombshells: No dramatic, scintillating topics
introduced just before the break or end of group process.
It is disrespectful to others' recovery. Breathe: Breathing
allows us to feel our feelings and live. Balance, pause,
and meditate.
— Listen: We have two ears and one mouth so listen twice
as much as you speak. Effective communication requires
both listening and sharing.
— Do not give advice: Do not tell anyone what to do or how
to feel. Let them discover their own process.
— No war stories: Do not get stuck in euphoric recall,
glamorize, or romanticize about your addiction. If it were
so great, we wouldn't be here.

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Group Rules
— No cross talk: Do not talk when someone else is sharing.
Share your own experience when it is your time to do so.
— No power plays: Be respectful. Do not get up and leave or use
negative body language (roll the eyes, shake the head, etc.)
when someone is sharing.
— No rescuing: No touching, offering tissue or comfort when
someone is sharing. Letting someone feel is a part of healing.
— No intimacy between group members: It is unhealthy to the
group if there is coupling between members.
— No secrets: If someone is having a craving or is in relapse
mode, please share it with the group. It takes the power out of
it.
— Expect and respect moments of silence: Quiet is a form or a
process of seeking an answer.

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Successful Groups
— Start with an introduction topic for group and rules
— Have informational handouts
— Allow others to discuss their concerns and ask questions
— Keep group on topic
— Know who will and will not benefit from group setting, this
can be difficult when dealing with those who are
inpatient.
— Allow individuals to share as they feel comfortable
— At the end of group, summarize the progress made
during group

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Questions

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References
— http://psychology.about.com/od/psychotherapy/f/grou
p-therapy.htm
— http://www.goodtherapy.org/group-therapy.html
— http://www.nursingplanet.com/pn/group_therapy.html

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Survey Monkey Evaluation
— https://www.surveymonkey.com/s/ConductingSucces
sfulGroups10-15-2014

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