What exactly is a psychotherapy process group? Both therapists and clients alike are sometimes unsure and may have limited information and exposure to process groups. During initial group screenings often clients refer to the Bob Newhart Show (a famous sitcom in 70's satirizing therapy and in particular, group), wondering if the group they are considering will be as over the top and wacky. It is also not uncommon for potential group members to refer to bad experiences they or friends have had in groups. Thus, it is of extreme importance to both educate and inform the potential group member as to what they might expect in a process group.
The assessment session, usually the first contact made with clients interested in group, explores the specific rationale for group, including how it operates and some of the salient qualities that differentiate group from individual work. My assessment includes communicating potential group scenarios that help clients anticipate what may (or may not) be challenging in group.
As a whole, process groups vary depending on theoretical orientation and subjective leader style. What follows below are common characteristics that will help frame an initial understanding of the process group. Note the next newsletter will cover other techniques named briefly here at the end of the article.
Clients work on interpersonal relationships in group with an emphasis on "here and now" experiences. The here and now focus continually asks group members to connect "outside" experiences to how they play out currently in group. Such explorations are reflected in questions such as: How is the experience you are talking about now also happening in the group? Who in the group is most like your husband?
Just as it is helpful to connect outside experience to what is arising in group it is also useful when clients key into to their momentary experience in group and share what is going on for them. This may not always have an "outside" context, but can clearly help focus and forward their progress.
Despite its benefits there can be much resistance to "here and now" suggestions. A common example is when someone expresses anger toward someone outside of the group but is hesitant to suggest whom they are angry with in the group. As the group leader, making yourself available as a recipient of anger can make room for anger and generally creates greater ease surrounding an often difficult subject. A group leader must be both patient and observant of group members, often returning to the here and now until it feels integral to how members utilize the group.
The "there and then" can be described as simply details of important experiences in a group member's outside life. The "there and then" can be helpful in two ways. Firstly, if you want to obtain more information about a valued experience outside of the group, this exploration will support that endeavor. For example, Chloe, share with us some of the details about how your mom was frustrating and how you weren't seen growing up. As Chloe details, with an excellent memory, how her mom has failed her, the group leader and members will be on the lookout for how we fail her similarly. Secondly, the "there and then" is a valuable technique when an escalation or conflict is not being resolved, or is too "intense" to offer immediate understanding, especially by the members most directly involved. Exploration of familiar stuck and difficult circumstances in group members' lives will potentially add a layer of poignancy to their struggles, help elucidate how important and impactful they are, and hopefully help other group participants understand why the interaction they just witnessed is so challenging for their fellow group member. For example, when John says, this conflict with Bob reminds me of how my Father never listened to me and I kept trying to get him to pay attention to me. At times, without the "there and then" group members not directly involved in a struggle could be less empathic and patient with what is being worked on.
This topic of process groups will expand into the next newsletter and cover the following group therapy techniques:
(a) Exploring group norms.
(b) Identifying stages of group development.
(c) Naming group roles and how they are playing out in particular sessions.
(d) Awareness of empathic failures and repairs.
(e) Looking for and encouraging "joining," thus connecting group members and reduces both stigma and isolation.
(f) Exploring manifestations of safety and trust.
(g) Utilizing "bridging" techniques.