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What the Group Can Do

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What the Group Can Do

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  1. The Importance of Group Therapy in the Treatment of Sex AddictionDon Mathews, MFT, founder & directorGraeme Daniels, MFT, assistant directorJoan Gold, MFT, director of women’s programsIMPULSE TREATMENT CENTERNorthern California’s Oldest and Largest Sex Addiction Treatment Centerwww.SexAddictTreatment.net

  2. “These basic principles – the importance of the emotional experience in therapy and the client’s discovery, through reality testing, of the inappropriateness of his or her interpersonal reactions – are as crucial in group therapy as in individual therapy, and possibly more so because the group offers far more opportunities for the generation of corrective emotional experiences.” Irvin D. Yalom, The Theory and Practice of Group Psychotherapy, 5th Ed.

  3. What the Group Can Do • Reduce shame: Group speaks from lived experience. Therapist is paid to be empathetic. • Intervene in transference and projection: Effectiveness of peers at interrupting transference and projection processes • Increase motivation for change: “What the group thinks of me” more motivating than what the therapist may think • Offer feedback: Clients get to explore the effectiveness of their communication and how they impact others • Increase accountability: Group holds client to treatment goals -- “You paid for this”

  4. What the Group Can Do • Offer 24/7 support: Group members move out of isolation and learn to ask for help • Highlight defensive structure: Group interaction gives therapist a much clearer picture of defenses in action • Expand problem-solving abilities: More psychologically-minded clients work with more concrete thinkers and at different paces • Reality Testing: Group process offers continuous reality testing • Modeling: Less defensive group members model vulnerability and emotional risk taking for more defensive  

  5. ITC’s Primary Treatment: Group Therapy Assessment and Preparation • Usually done in three individual sessions • When characterological issues emerge • Increased preparation time • Concurrent individual therapy mandated • Other issues that alter the three session A&P • Client in crisis • Legal issues • Appropriate group availability

  6. Stages of Group Development • Initial stage: • Members get to know each other • Begin defining goals, both personal and group • Roles, norms, and responsibility begin to be defined • Group depends on the leader for direction • Working stage: • Members start defining/attempting to solve problems • Communication of feelings begins • Differences become apparent • Conflict and cooperation develop

  7. Stages of Group Development • Mature: • Development of a group culture • Conflicts able to be resolved • Differences accepted without judgment • Personal responsibility increases • Termination Stage: • Evaluation of group experience • Exploration of feelings about group experience

  8. Principles of Group Therapy • Universality • Instillation of hope • Imparting information • Altruism • Imitative behavior • Group cohesion • Interpersonal learning • Development of socializing techniques • Recapitulation of the family • Catharsis • Existential Factors Irvin D. Yalom, The Theory and Practice of Group Psychotherapy, 5th Ed.

  9. Guidelines for Healthy Groups (Sex Addicts) • The Four Circles (three from SAA) • Group feedback system • Group as antidote to isolation; the sharing of fantasy and acting out • Facilitation of group disclosures: setting tone, empathy, providing an “open mike” • Reality testing and containment of projections

  10. Guidelines for Healthy Groups (Partners) • Boundaries, boundaries, boundaries • Identification of feelings; separating feelings from thoughts • Direct versus indirect communication • Personal experience, not intellectual ideas or advice • Body sensations and present awareness • Limit interruptions to process • Notice incongruence  

  11. ITC Group Rules • Three month commitment required • Regular attendance and punctuality necessary • Four weeks notice is required on leaving the group • Payment requested at beginning of the month • No reimbursement for missed sessions • Confidentiality: All personal information disclosed in group stays in group • Advice among group members is discouraged, unless specifically requested • No recreational drugs/alcohol use 24 hours before sessions

  12. Contact Outside of Group • Connection outside of group for personal support only. Clients agree to no talking about group (including feelings about what goes on in group), other group members and/or group leader • If something comes up outside of group that is actually "group business," it is brought back to the group. This keeps the group free of secrets and/or triangulation

  13. Differences between SA & Partner Groups Central Characteristics of Addicts Central Characteristics of Partners • shame • impulsive behavior • lack of empathy • denial of consequences • loss of self • ineffective boundaries • lack of voice • denial of feelings and/or needs

  14. Differences between SA &Partner Groups Addict’s Group Process Partner’s Group Process • generallyconfrontational in style • aids in reducing denial • increases accountability • heightens awareness of consequences • identifies triggers • encourages use of sober resources • generally supportive in style • increases self-awareness • heightens understandingof feelings and needs • models direct communication • encourages use of self-care resources

  15. Growth in the Group • Absenteeism, lateness, termination • Preparing a member for group, selecting out • Confrontation and avoidance • Confidentiality as a matter of group ethics

  16. ITC: A Collaborative Model

  17. Resources • Bion, Wilfred (1961) “Experiences in groups and other papers” New York: Basic books. Disorders of Self, New Therapeutic Horizons (1995) Edited by James F. Masterson, MD, and Ralph Klein, MD. Brunner/Mazel, Inc. • Fischer, R.E (1995). “Group Psychotherapy and Disorders of the Self”. Disorders Of The Self: New Therapeutic Horizons. Edited by James Masterson, M.D. and Ralph Klein, M.D. Brunner/Mazel, Inc. • Science and Services Task Force (2007) “Practice Guidelines for Group Psychotherapy”. American Group Psychotherapy Association. Edited by Robert H. Klein, Ph.D.

  18. Resources • Yalom, Irvin (2005) The Theory and Practice of Group Psychotherapy. Fifth Edition. Basic books • International Journal of Group Psychotherapy, N.Y: The Guilford Press, published by The American Group Psychotherapy Association www.AGPA.org • The Association for Specialists in Group Work: www.asgw.org • The International Association for Group Psychotherapy and Group Processes: www.iagp.com

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