Social Work and Human Services

For this discussion, you will need to watch the following four (4) Group Therapy Demonstration Video Clips, taken from the series Understanding Group Psychotherapy: Outpatients, with Dr. Irving Yalom (2006 Psychotherapy.net, LLC).

There are four vignettes (two in each video). The videos will start from the beginning.

It is recommended you watch the “pre-session commentary” but can then go to the right of the video screen, under “Chapters”, and select “First Group Session” and then “Third Group Session”. You can then just focus on viewing the specific sessions, however it is recommended that you view the pre/post session discussion for the vignettes.

For the next two vignettes, select “Fifth Group Session” and “Eighth Group Session” as well if you wish to bypass the commentaries.

To view, click the link below and if prompted, enter your ESC Moodle log-in.

M4 Group Therapy with Outpatients, Vignettes 1 and 2 [length 1:117 and 17:11 minutes each] Starts 8;11 and 28:00
Vignette #3 and 4 presents Understanding Group Therapy: Vol 1, Part 2. This covers Sessions 5 and 8 (vignettes 3 and 4) with commentary in between the two vignettes and after the 4th vignette. This video will open with the fifth session (vignette 3). To view the eighth session” (vignette 4) , go to “Chapters”, then click “Eighth Session”. It is recommended that you view the pre/post session commentary for each video to gain insight into the co-leaders’ theory and philosophy of group therapy.

To view, click the link below and if prompted, enter your ESC Moodle log-in.

M4 Group Therapy with Outpatients, Part 2, Vignettes 3 and 4 length [16:57 and 18:11 minutes each]
As you watch the videos, consider that the problems presented and addressed commonly apply to groups struggling with substance use disorders or related recovery issues. Once you have viewed all four vignettes, submit a New Post and address the following:

Identify at least 3 specific group interventions/strategies used by Dr. Yalom and his co-leader. (Note: that group interventions are not exactly the same as those used in individual counseling).
How could these group therapy interventions/strategies be applied to a group where members are being treated for an addiction disorder or substance use disorder?
Assuming a group of people with addiction/substance use disorders, what modifications would you suggest for the group rules/expectations? How would you address group task and group maintenance issues? How you would open and close each session?
Reply to the main posts of at least two (2) other students.

Optional Videos on Inpatient Group Therapy
For anyone interested in group therapy within an inpatient or residential setting, there are additional videos you can view. Note these are not required for this discussion. The first is entitled Inpatient Group Therapy Volume 2, Part 1. This is based on a 1:15 minute group session. After starting Part 1, it is advised to go to Chapters and view the 6 minute “Introduction” to gain an understanding of the group members then click “Orientation” to view the first 4 minutes of the session. The second vignette of this session is “Agenda Formation” and runs for about 23 minutes (minute 13:55 to 37:00) – this provides a more complete demonstration of this session.

The second is entitled Inpatient Group Therapy Volume 2, Part 2 To see the rest of the session go to the Chapter titled “Agenda Filling”. This runs till 28:20 and will lead to a session conclusion. This is followed by a commentary and then a discussion with a group of observers of the group.

ANSWER

Group Interventions/Strategies by Dr. Yalom

One key strategy is constancy, where both Dr. Yalom and the group leader understand that to recovering patients, consistency in a way that provides a stable and safe environment is vital. It is fundamental that many factors are kept both predictable and constant, even for simple things like the group leader’s sitting position in each session. The doctor and the group leader also learn to respond the same way to particular behaviors. The second key strategy is active listening. Any effective therapy has to have active listening as a crucial strategy. The doctor has to both be able to perceive and understand verbal and nonverbal cues to mean and metaphorical meaning. Comprehension of timelines is also crucial where the group leader has to be able to tell apart feelings from the past and the current once. Lastly, both the doctor and the co-leader need to be able to exude confidence even when operating between uncertainties, where they cannot rely on scientific methodologies to come up with solutions. From self-knowledge and intent clarity while at the same time attentive to each member of the group and their experience, doctors and group leaders must come up with a way to securely grounding stability in the group.

How these Strategies can be Applied to Members Recovering from Addiction

When managing a group of recovering addicts, the first application from Dr. Yalom’s recommendations would be for a group leader to be active, responsive, and lively and keeps the group meaningfully engaged with each other. Consistency in the most basic things like the mode of dressing, sitting position, greetings, and introductions must be maintained. The group leader will also have to have superior listening skills and understanding of the group to respond effectively to questions and concerns. This skill comprises the ability to evolve with the group in their different recovery phases. For instance, at the beginning of treatment, more activity will be left to the group leader to provide guidance and layout a recovery foundation. However, through the progressive journey of recovery, both the doctor and the group leader could offer less support and gratification in order to keep the group at an optimal level of anxiety. Lastly would be the ability to be a source of strength to the patients throughout the journey. The mode of response to queries must come out as both confident and true, which is why it is helpful that the group leader is an initially struggling addict who has now recovered.

Modifications for Group Rules and Expectations

To effectively manage a group recovering from addiction, first, I would ensure that I inform the patients of options. For instance, the group would be free to discuss with the group leader forms of treatment or leadership, which they thought would be effective or ineffective. Secondly, I would ensure appropriate management of group emotion by protecting the patients and their will to get or not get involved, protecting boundaries by ensuring a patient is not pressured to give up information they are not ready to give, and lastly, regulation of effect to ensure the group function is effective in its purpose which is recovery. Group tasks and maintenance would be systematic, constant, and optional to members. Maintaining an opportunity to form some kind of control for the patients is important in retaining or recovering bits of their dignity. The opening and closing of every session would be a chant designed to be a motivational anthem aimed at reminding each member of the group of their purpose in life and what they seek to accomplish by the end of the therapy to become effective functional members of society.