Chapter 1:Therapeutic Factors The Theory and Practice of Group Psychotherapy Irvin Yalom, Ph.D

Therapeutic Factors What are the actual factors in group therapy that make it therapeutic? What one thing or virtue or factor must a patient experience in order to continue with therapy?

Therapeutic Factors 1.Instillation of Hope 2.Universality 3.Imparting Information 4.Altruism 5. the corrective recapitulation of family unit 6.Development of Socializing Techniques 7. Imitative Behavior 8. Interpersonal Learning 9. Group Cohesiveness 10. Catharsis 11. Existential Factors

This an arbitrary construct or cognitive map Therapeutic Factors Divided in the text into clusters that are arbitrary. First 7 Interpersonal learning Group Cohesiveness Existential Factors This an arbitrary construct or cognitive map They went with pt reports or what is called a slightly more phenomenological approach to some extent.

Therapeutic Factors Research with therapists wasn't the best approach because it would be biased based on their theoretical inclination. Also, what therapists valued wasn't at times what pts valued. Correlational studies of the therapy variables that lead to successful outcomes can be a methodological issue when applied to group therapy

Instillation of Hope a. crucial in any therapy b. several research studies talk about high expectation highly correlated with positive therapy results; consider faith healers and placebo c. we able to use this in group therapy by helping them understand how group can help (preparation) d. others doing testimonials or improving assist others e. many groups have a testimonials component to them AA etc. 1. In AA, many of the leaders are previous alcoholics 2. In our group we occasionally bring someone that is a veteran. CONSIDER DRAWBACKS

Universality a. Many pts, as they suffer become self absorbed. As that happens they may seek isolation. Is this a human condition? 1. Subsequently, the person may feel that are unique and they are have unacceptable problems. a. Of course, there is some truth to that idea since we all have a unique constallation of variables in our lives. b. This + most problems have an interpersonal factors = causing others problems

Universality b. Typically, there is no human deed or thought that is outside of the experience of other people however YOUR REACTION MAY MAKE IT SEEM THAT WAY. c. NOTE: This also corresponds with some of the data collected by Yalom over the years regarding secrets that pts harbored " the most common secret is a deep conviction of basic inadequacy -a feeling that one is basically incompetent, that one glides through life on a sleek intellectual bluff."

Universality Next in frequency is a deep sense of interpersonal alienation - that, despite appearances, one really does not, or cannot, care for or love another person. The third most frequent category is some a variety of a sexual secret. d. This factor can be affected by multicultural issues.

Imparting Information a. Didactic instruction- In addition to offering support, information provided influence our cognitive maps. As such, you educate pt's on their condition and study their misconceptions. b. Humans have always hated uncertainty. c. Direct advice -focuses on providing content. However, indirect advice focuses on the process and the content. 1. The least effective was direct suggestion or advice; most effective was systematic operationalized advice or instruction

Altruism - the story of the rabbi a. This focuses on pt empowering him/herself by giving and being less self absorbed or be self absorbed in an empowering manner. Further, they focus on an objective problem. It gives a sense of significance and connectedness b. Yalom agreed with Victor Frankle that a sense of life meaning ensues but can't be deliberately self consciously pursued: a derivative phenomenon that materializes when we have transcended our selves, when we have forgotten ourselves and become absorbed in someone outside ourselves.

Corrective Recapitulation of Family unit a. they repeat the experience they have had with a primary family unit (i.e. issues with authorities, dependency)

Development of Socializing Techniques a. development of social skills is important and an inherent part of dealing with problems remember we have said that each problem has an interpersonal style

Imitative Behavior act as if a. research has demonstrated that it is effective b. in the short term helps someone unfreeze certain behaviors and explore new behaviors.