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Chapter 5: Therapist Basic Tasks

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Chapter 5: Therapist Basic Tasks The Theory and Practice of Group Psychotherapy Irvin Yalom, Ph.D Basic Tasks 1. Creation and maintenance of the group 2. – PowerPoint PPT presentation

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Title: Chapter 5: Therapist Basic Tasks


1
Chapter 5 Therapist Basic Tasks
  • The Theory and Practice of Group Psychotherapy
  • Irvin Yalom, Ph.D

2
Basic Tasks
  • 1. Creation and maintenance of the group
  • 2. Culture Building
  • 3. Activation and illumination of the here-and-now

3
Basic Tasks
  • Creation and Maintenance of the Group
  • Transitional object ????
  • You need to create a physical entity
  • Occasionally, you may need to focus on not
    meeting everyones needs.

4
Basic Tasks
  • Culture Building
  • Shaping the energy/dynamics into a therapeutic
    social system.
  • The group that is the agent of change.
  • They set the therapeutic factors in motion.
  • The group therapist functions far more
    indirectly, than individual therapist in which
    the clinician is the agent of change.
  • Like the game of chess, therapist sets up the
    situation.

5
Basic Tasks
  • In this process it is important to demonstrate
  • Capacity for empathy and caring (Rogers, 1957
    Traux Carkhuff,1967)
  • In Lieberman, Yalom Miles (1973) work with
    encounter groups, they found that the members
    perception of the leader as genuinely concerned
    and caring was the most important factor.
  • It contributes to the culture of a safe place.
  • Self Reflection in order to manage adverse
    reactions to the group.

6
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
8 dimensions
  • Directive vs.. Nondirective
  • Transparency vs.. Opaqueness
  • Group as a whole/subgroup/interpersonal/individual
  • Past/resent/Future
  • Inside/Outside the group
  • Content/ Process
  • Understanding/ Corrective Emotional experience
  • Confrontation/exploration vs. support

7
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
  • Directive vs. Nondirective
  • Self explanatory
  • Nondirective allows for the members to take on
    greater responsibility
  • Focus on each other instead of the leader as the
    transitional object
  • Allows leader to see their natural (supposedly)
    form of relating
  • Directive
  • Efficient use of time
  • Insures greater participation by more members
  • Keeps group on track but possibly influencing too
    much

8
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
  • Transparency vs. Opaqueness
  • The extent the leader shares information about
    themselves
  • What might you expect if a therapist is
    completely transparent?

No boundaries Loss of the dual role of a leader
9
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
  • What if the leader isnt transparent at all?
  • Therefore, Judicious self disclosure
  • Know the intent and its dynamic influence

Unsafe place Cold Little spontaneous interaction
10
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
  • Group as a whole/subgroup/interpersonal/individual
  • Represents the different layers or degree upon
    which a leader can intervene
  • Group level focus members responding to the
    same stimuli
  • Subgroup level focus - two members form alliances
    and explore the differences or focus on conflict
    resolutions between subgroups
  • Individual level focus the group is directed to
    examine ones members issues

11
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
  • Past/present/Future
  • as related to the groups life
  • Inside/Outside the group
  • Now this one can combine with the above to create
    a matrix
  • Content/ Process
  • The communication dynamics between members
  • NOTE As you focus on the process of an
    individual, he/she may feel more vulnerable
    because you are often addressing more unconscious
    material

12
Dimensions of the Leaders Role As per
Brabender, Fallon, Smolar (2004)
  • Understanding/ Corrective Emotional experience
  • Increase understanding via providing insight
    which suggests that there is a conflict to be
    addressed
  • Or provide the basic foundation that they may
    have not had in their previous relationships a
    corrective experience suggesting that there is a
    lack of something
  • Confrontation/exploration vs. support
  • Raise the level of emotional stimulation
  • Or consolidate the gains acquired through support

13
Basic Tasks
  • Construction of Norms
  • Constructed via from expectations for their group
    and from the explicit and implicit directions of
    the leader
  • If members expectations are not firm, then the
    leader has even more opportunity to design a
    group culture.
  • The leader cannot not influence norms.
  • What one does not do is often as important as
    what one does do.

14
Basic Tasks
  • Norms are shaped both the expectations of the
    members and by behavior of the therapist.
  • The leader shape norms via
  • The technical expert role
  • The model setting participant
  • -The technical expert understands the dynamics
    and is able to explain to the group and reinforce
    appropriately.
  • Page 113 good examples

15
Basic Tasks
  • E.G. asking members to mention their opinions on
    each others comments.
  • Hence, this role includes significant social
    reinforcement persuasion.
  • Among certain theoretical frameworks or
    clinicians, this is a controversial issue.
  • Consider this, that it tends to be inevitable
    that a clinicians overt and covert responses act
    as a reward-punishment.

16
Basic Tasks
  • The model setting participant
  • Bandura has demonstrated in studies that
    individuals may be influenced to engage in more
    adaptive or less adaptive behaviors through
    observing and assuming the therapists behavior.
  • A clinician model the difference of their a self
    esteem and public esteem. Therefore, they
    demonstrate how the integrity of their self
    esteem is not threatened but rather can be
    improved.
  • Appropriate disclosure can also be modeled.
    Sometimes pts dont understand how to moderate
    such behavior.
  • The therapist models honest with appropriate
    restraint.

17
Basic Tasks
  • A leader that presents a infallible doesnt allow
    for members to present their flaws and encourages
    a norm of being always being right.
  • NOTE A patient issue with you may related to
    his/her past but may have some validity to it in
    your reality. In other words, check its validity
    within and through ???______ validation.
  • For example an overly cautious leader may lead
    to a guarded and lifeless group. How does this
    work in the individual therapy format.
  • A clinicians transparency relates to the amount
    of a clinicians disclosure.

18
Basic Tasks
  • Therapeutic Norms
  • Self Monitoring group
  • They are the main event instead of waiting on you
  • Self Disclosure
  • There is a subjective aspect of disclosure.
  • What you consider superficial may be profound to
    another.
  • The other issue is when to disclose avoiding
    premature.
  • Vertical vs. horizontal disclosure
    (metadisclosure)

19
Basic Tasks
  • Be aware not to have a pt punished for
    disclosure.
  • Procedural norms
  • The patterns of behavior in the group may not be
    appropriate. (i.e. An appropriate one is checking
    in at the beginning but inappropriate one would
    be to continue the session in a sequential
    method.)
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