Interactive Group Therapy: Integrating, Interpersonal, Action-Orientated and Psychodynamic Approaches

369 Pages·1999·40.03 MB·English

by  Jay Earley

INTERACTIVE GROUP THERAPY

INTERACTIVE
GROUP THERAPY
Integrating Interpersonal,
Action-Oriented, and
Psychodynamic
Approaches
jay Earley, Ph.D.
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INTERACTIVE GROUP THERAPY: Integrating Interpersonal, Action-Oriented, and
Psychodynamic Approaches
Copyright © 2000 Taylor & Francis. All rights reserved. Printed in the United States of
America. Except as permitted under the United States Copyright Act of 1976, no part of this
publication may be reproduced or distributed in any form or by any means, or stored in a
database or retrieval system, without prior written permission of the publisher.
2 3 4 5 6 7 8 9 0
Printed by Edwards Brothers, Ann Arbor, MI. 1999.
A CIP catalog record for this book is available from the British Library.
0 The paper in this publication meets the requirements of the ANSI Standard Z39.48-1984
(Permanence of Paper).
Library of Congress Cataloging-in-Publication Data
Earley, Jay, 1944-
Interactive group therapy : integrating interpersonal. action-oriented, and
psychodynamic approaches I Jay Earley.
p. em.
Includes bibliographical references and index.
ISBN 0-87630-984-8 (case : alk. paper)
l. Group psychotherapy. 2. Group psychotherapy Case studies.
I. Title.
RC488.E224 1999
616.89'152-dc21 99-44316
CIP
ISBN: 0-87630-984-8
CONTENTS
Preface vii
Acknowledgments xi
1
Chapter Introduction 1
2
Chapter Access 9
3
Chapter Healing Response 18
4
Chapter Experimenting 37
5
Chapter Inner Healing 44
6
Chapter Transcript 50
7
Chapter How to Structure a Group 61
8
Chapter Therapeutic Group Norms 80
9
Chapter Responsibility, Motivation, and Direction 94
1 0
Chapter Self-Exploration-Awareness and Insight 103
11
Chapter Interactive Work 118
1 2
Chapter Presence and Contact 129
1 3
Chapter Transcript 136
v
VI Contents
1 4
Chapter Defenses and Resistance 149
1 5
Chapter Problem Ownership 158
1 6
Chapter Aggression 168
1 7
Chapter Intervention Choices 174
1 8
Chapter The Group Leader's Attitude 185
1 9
Chapter The Leader-Client Relationship 197
2 0
Chapter Outside Contact Between Group Members 210
21
Chapter Developmental Stages of Group Process 219
22
Chapter Termination 236
23
Chapter Group Roles and Positions 243
24
Chapter Difficult Group Members 251
25
Chapter The Group as a Whole 260
26
Chapter Gender and Diversity 275
27
Chapter Other Issues 282
28
Chapter Specialized Groups 296
29
Chapter Societal Issues 310
Glossary 321
Appendix 325
References 339
Index 343
PREFACE
In a recent survey (Dies, 1992), the American Group Psychotherapy Association di
vided group therapists into three categories: psychodynamic, interpersonal, and ac
tion-oriented. The psychodynamic approaches (Rutan & Stone, 1993) are those de
rived from psychoanalysis where the primary emphasis is on uncovering symbolic
material related to the childhood origins of defenses and symptoms. Interpersonal
approaches, as exemplified by Yalom's (1995) classic text, focus primarily on the per
sonal interactions and relationships among the group members. Action-oriented ap
proaches include cognitive/behavioral, Gestalt, Transactional Analysis (TA), and psy
chodrama-the common element being a commitment to action in addition to self
exploration. This not only includes action on the part of group members (e.g., behav
ioral experimentation or role playing) but also an active leadership stance from the
group therapist that may include suggestions, questions, and structured activities in
addition to interpretations.
This book presents a new approach that draws from all three of these orienta
tions to form a creative whole of its own, which I believe represents an advance in the
field. Like interpersonal approaches, it sees the interactions between group members
as the primary means for therapeutic change, focusing on contact and intimacy be
tween group members as an important aspect of therapeutic healing. Like psychody
namic groups, my approach emphasizes insight about unconscious processes and child
hood origins of current problems. Finally, like Gestalt therapy (Perls, Hefferline,
& Goodman, 1951), it uses an active leadership style that focuses on responsibility,
spontaneity, and vitality, and helps members heighten awareness of their moment
to-moment experience.
Action-oriented groups tend to be leader-centered groups, where the group mem
bers interact primarily with the leader rather than with each other, and less attention is
paid to the relationships among group members and the unfolding of the group pro
cess. As a result, this valuable aspect of group work is usually not fully utilized in
action-oriented groups. The approach described in this book changes that because it is
both action-oriented and group-centered. It encourages experimenting with new be
havior and an active leadership stance, while focusing primarily on group process and
interpersonal interactions between group members. In addition, my action-orientation
prompts me to have a different viewpoint on some crucial group issues such as healing
responses from group members, the role of touch, and contact between members out
side of group.
VII
VIII Preface
Therefore, this book will be of special interest to action-oriented group leaders
who want to move beyond leader-centered or structured groups toward a greater em
phasis on interpersonal and group process. Because of my background in Gestalt therapy,
many Gestaltists and other action-oriented therapists have attended my training pro
gram to learn how to lead interactive, group-centered groups.
This book begins with a discussion of the therapeutic change process in group
therapy, which then forms the background for the presentation of method and tech
nique. The bulk of the book is devoted to providing practical guidelines for leading
groups. I offer detailed suggestions for structuring groups, making interventions, un
derstanding difficult clients, adopting the best leadership attitude, following group pro
cess, and a host of other clinical issues. In addition to rich clinical examples and case
histories, the book also contains transcripts of group sessions, annotated to illustrate
both theory and technique.
D
Unique Features of This Approach
Therapeutic Change Process. This book contains a new perspective on the thera
peutic change process that emphasizes those interpersonal aspects of change that are
particularly important in therapy groups. In addition to helping clients achieve greater
insight and access to their feelings, it demonstrates the value of experimenting with
new, healthy behavior and receiving healing responses from other group members and
the leader.
Active Leadership Stance. Though the style of leadership advocated here is ac
tive, it is empowering for group members. As a leader, you ask questions to elicit
clients' awareness of their experience in the moment and the deeper issues that under
lie their reactions. You also sometimes make suggestions about new behavior or atti
tudes that clients can try experimentally. When necessary, you actively intervene to
make sure that the group is safe enough for members and is moving in a therapeutic
direction. However, group members themselves are responsible for their own thera
peutic direction and initiate the details of the work. When an interaction or explora
tion is proceeding appropriately, you may be silent for long stretches of time. In sum
mary, the leader is active in ensuring that the work is advancing in a therapeutic man
ner, but this activity is often oriented toward encouraging client responsibility. This
book contains a discussion of the internal shift that action-oriented leaders often must
make in moving from a leader-centered to a group-centered mode.
The Interactive Norm. This method actively promotes the norm that the primary
focus of the group is the interpersonal interactions between group members. They are
expected to initiate work on their relationships with each other and to explore their
feelings about being in the group. Rather than waiting for this work to emerge gradu
ally, the leader actively encourages it.
Presence and Contact. In this approach, we are not only interested in behavior
and its unconscious meaning, but also the quality of presence and contact as group
members explore themselves and interact with each other. When is a client being purely
Preface IX
intellectual? When is she distracted? When is a group member inhabiting her body and
feeling her emotions? Is a client taking in the support and caring she is receiving? Is she
allowing herself to be touched by others?
Intimacy and Relational Healing. This method pays special attention to the rela
tionships that develop between group members. These not only activate transferential
material, but also have the potential for helping clients heal. When two people work
through the transferential difficulties between them and develop a deep connection
with each other over time, they can both experience enormous growth.
D
My Experience
I have been leading therapy groups for two decades and training group therapists for
nearly one. Groups have become the major focus of my professional life, igniting my
passion and providing fulflllment. As a leader, trainer, and participant, I love therapy
groups-the excitement of the here-and-now encounters between people; the inten
sity of the work; the caring and love that develop among group members over time;
the profound therapeutic changes that clients achieve; those special moments of group
bonding and the overall sense of community that develops. It is very satisfying to par
ticipate in a group that creates the equivalent of a healthy extended family or tribe. I
hope that, in addition to educating you about therapy groups, this book will help you
appreciate the group therapy experience and perhaps inspire you to include more of
this kind of relating in your own life.
D
Larger Social Issues
My interest in group therapy goes beyond a desire to help group members reduce their
suffering and lead happier lives. I am also interested in group work as a way of promot
ing healthier ways of being and relating to others in our society. The world is in such a
serious crisis at this time in human history (Earley, 1997) that we can't afford to focus
only on the narrow goals of our profession. We must be interested in changing our
culture and society in fundamental ways or the world may be facing serious ecological
and social breakdown. This is not just my belief or that of a narrow group. In 1993, a
group of 1,600 of the world's leading scientists-including half of all living Nobel lau
reates in science-published the World Scientists Warning to Humanity, which contained
the following statement, "We the undersigned, senior members of the world scientific
community, hereby warn all humanity of what lies ahead. A great change in our stew
ardship of the earth and the life on it is required, if vast misery is to be avoided and our
global home on this planet is not to be irretrievably mutilated.''
Group therapy, of course, can only play a small role in the social transforma
tion that is needed, but that role can be important nonetheless. We have an opportu
nity to not only alleviate symptoms of mental illness and foster healthy character change,
but also to promote empathy, self-reflection, community, appreciation of diversity,
healthy ways of dealing with power, and other new ways of being. As a result, group
therapy can help us to create a healthier culture and surmount the current planetary
crisis.