GROUP THERAPY AND

FAMILY THERAPY
PREPARED BY- MS. DHAIRYA ARORA,
MSC 1ST YEAR,
MHN DEPT.
GROUP THERAPY

It is less time-consuming procedure in which 10 people can be treated at one time.

Joseph Pratt uses it first in 1905 on tuberculosis patient. Group therapy may utilize
psychoanalytic, supportive, transactional or behavioral approaches. over the years many
types of group therapies have emerged like self help groups(alcoholics anonymous for
alcoholics, weight watchers for obese) transactional analysis groups, psychodrama,etc.
DEFINITION:It is a form of treatment in which carefully selected, emotionally ill
persons are placed into groups ,guided by a trained therapist for the purpose of changing
the maladaptive behavior of the individual member.
 PURPOSES:

To intervene in psychopathology.

To reveal ,examine and resolve distortions in
interpersonal relationships.
To improve the skill of relating to others.
To learn coping styles.
CHARACTERISTICS
THERAPEUTIC
FUNCTIONS
 SETTINGS
Therapeutic milieu of a psychiatric in-patient unit or ambulatory psychiatric
Partial hospitalization (also known as Day Hospital treatment)
Group-based expressive therapies such as drama therapy, psychodrama,
art therapy, and non-verbal types of therapy such as music therapy.
Group psychotherapy is a key component of Milieu Therapy in a
Therapeutic Community, are explored in daily or weekly community meeting.
 A form of group therapy has been reported to be effective in psychotic
adolescents and recovering addicts. Patient groups read a novel or collectively
view a film. They then participate collectively in the discussion of plot, character
motivation and author motivation.
 PHYSICAL CONDITIONS INFLUENCING
GROUP DYNAMICS

• Seating • Disliked member

• Size • The silent member
• Membership • Group conflict
• Dealing with challenging
group behaviour
• Monopolizer
• Yes, but
 TYPES OF GROUP THERAPY:

• Task groups • Intensive problem-solving

• Self help group groups
• Educational group • Multidisciplinary team
• Suportive therapy group • Activity group
• Psychotherapy group • Peer support group
• Brief therapy group
 TYPES OF GROUP ACCORDING TO
PURPOSE
• Psychoanalytic group therapy • Psychodrama group
• Transactional analysis • Encounter groups
• Rational emotive therapy • T- groups
• Gestalt therapy • Community support groups
• Interpersonal group therapy • Marathon group
PHASES OF GROUP
DEVELOPMENT
 PHASE 1 INITIAL OR ORIENTATION PHASE:
• Group activities:The leader and member works together to establish the rules
that will govern the group .
• Leader expectations: The leader is expected to orient members to specific group
processes, encourages members to participant without disclosing too much too
soon , promote environment of trust and ensure that rules established by the
group do not interfere with fulfillment of the goals.
• Member behavior:members have not yet established trust and will respond to
this lack of trust by being overly polite. There is a fear of not being accepted by
the group . they may try to get on good side of the leader with compliments and
confronting behaviors. A power struggle may ensue as members compete for
their positions in the pecking order of group.
 PHASE 2: MIDDLE OR WORKING PHASE:
• Group activity: Cohesiveness has been established has been established with in the
group. Problem solving and decision making occur within the group .In the mature
group , cooperation prevails and differences and disagreements are confronted and
resolved.
• Leader expectations: The role of leader diminished and become more one of facilitator
during the working phase. Some leadership functions are shared by certain members of
the group .The leader help to resolve conflict and continues to foster cohesiveness
among the members ,ensuring that they do not deviate from the intended task .
• Member behavior:At this point trust has been established among the members. They
turn more often to each other and less often to the leader for guidance . they accept
criticism from each other using it in a constructive manner to create change.
 PHASE 3 FINAL OR TERMINATION PHASE:
• Group activity:The longer a group has been in existence ,the more difficult termination is
likely to be for the members. Termination should be mentioned from the onset of group
formation. A sense of loss that precipitates the grief process may be evident particularly in
the groups that have been successful in their stated purpose.
• Leader expectations: The leader encourages the group members to reminisce about what
has occurred within the group to review the goals and discuss the actual outcomes and to
encourage members to provide feedback ,& encourages members to discuss feelings of
loss associated with termination of the group.
• Member behaviors: Members may express surprise over the actual materialization of the
end . this represents the grief response of denial which may then progress to anger . anger
toward other group members or toward the leader may reflect feelings of abandonment.
Successful termination of group may help members develop the skills needed when losses
occur in the other dimensions of their lives.
 PREPARATION OF PATIENT

The patient is prepared for the group therapy sessions by

explaining the processes to which the patient will exposed
,emphasizing the need to be open and honest with co- patient and
finally ,alerting the patient to the possibility that he may likely be
questioned by group members explicitly share his problem to
develop self knowledge about illness.
CRITERIA OF PATIENT TO BE INCLUDED IN
GROUP THERAPY:

• Ability to communicate .
• Willingness to share his problems with others.
• Motivation to change.
• Patient with authority anxiety .
• Patient using defense mechanism of projection, repression,
denial, suppression, transference reactions.
 FACTORS CONTRIBUTING TO GROUP
THERAPY:
• Faith in the treatment procedure.
• Universality (similar problems are seen in • Imitative behavior (imitation of a healthy
the others) behavior ,especially therapist is identified as
a role model and patients imitates the
• Direct guidance for the problem.
therapist.)
• Altruism (patient offer each other support
• Conflict resolutions.
,reassurance, suggestion, and insight)
• Acceptance of the reality
• Development of socializing skills.
• Group cohesiveness
• Catharsis (ventilation of emotion)
• Interpersonal learning.
 THERAPEUTIC TECHNIQUES USED IN GROUP
THERAPY:
• Approval • Reassurance • Teaching
• Acceptance • Identifification • Silence
• Clarification • Support • Structuring
• Exploration • Intervention • Limit setting
• Interpretation • Understanding • Transference and
• Giving information • Reflection counter transference

• Encouraging expression • Listening • Themes

of feelings
 ADVANTAGES OF GROUP THERAPY:
Members profit by hearing other members discuss
their problems to decrease the feeling of isolation
alienation and encourages to share feeling and
problems.
Opportunity to explore specific styles of
communication in a safe atmosphereto receive
feedback and undergo change.
Learns multiple way of solving problems from other
group members and group exploration to discover
new ways of solving problems.
The group provides for its members understanding,
confronting and identification, with more than one
individual.
Allows to receive the support and encouragement of
the other members of the group which can help them
feel less alone.
Group members can serve as role models to other
members of the group by seeing someone who is
successfully coping with a problem
Group therapy is very cost effective. Instead of
focusing on just one client at a time, the therapist can
devote his or her time to a much larger group of
people.
Group therapy offers a safe haven. The setting allows
people to practice behaviors and actions within the
safety and security of the group.
By working in a group, the therapist can see first-hand
how each person responds to other people and
behaves in social situations,the therapist can provide
valuable feedback to each client.
DISADVANTAGES

• Individual privacy is destroyed.

• Resistance and reluctant to change.
• Therapist at times dominant or as if he is giving
individual therapy.
NURSE’S ROLE IN GROUP
THERAPY
FAMILY THERAPY
 INTRODUCTION
• Family is the most powerful primary social system • Restructuring of maladaptative family behavioral
or primary social group, to which a person ever styles and
belongs. • A strengthening of family problem solving
• Family therapy is a form of group therapy in which behaviors
the client and his or her family members • Family therapy works through social negotiation.
participate.
• Therapist enters the family at relationship level not
• Family therapy is a form of psychotherapy at the individual level.
designed to assess and treat various psychiatric
disorders through-
• An understanding of how the interactional
dynamics of the family relates to individual
psychopathology
• Mobilization of the family's inherent strengths and
functional resources.
 DEFINITION
Family therapy may be defined
as any psychotherapeutic endeavor
that explicitly focuses on altering
the interactions between or among
family members and seeks to
improve the functioning of the
family as a unit, or its subsystems,
and/or the functioning of
individual members of the family.
STAGES OF FAMILY DEVELOPMENT