Prior to starting in the group it may be useful to know that group therapy has a long and well proven record as a highly effective and useful form of psychotherapy. It is as helpful, and in some cases more helpful, than individual therapy, particularly in those situations where social support and learning about interpersonal relationships are important objectives of treatment. The vast majority of individuals who participate in group therapy benefit from it substantially. However, group therapy can at times be stressful and may transiently increase mood and anxiety symptoms.

Some Goals of Group Psychotherapy

Many individuals seeking therapy feel isolated and dissatisfied in their particular life situation. They may have difficulties establishing and maintaining close, mutually gratifying, and meaningful relationships with others. They are frequently interested in learning more about how they relate to others.

Group therapy offers an opportunity to:

	receive and offer support and feedback gain insight and understanding into one’s own thoughts, feelings, and behaviors by looking at relationship patterns both inside and outside the group gain understanding of other peoples’ thoughts, feelings and behaviors improve self-confidence, self-image, and self-esteem improve interpersonal relationships and communication experiment with new interpersonal behaviors talk honestly and directly about feelings undergo personal change inside the group with the expectation of carrying that learning over into one’s outside life
Confidentiality

All statements by participants in psychotherapy must be treated with the utmost respect and confidentiality. It is an essential part of ethical, professional conduct.

Therapists

Group therapists are pledged to maintain complete confidentiality except in one situation: when there is an immediate risk of serious harm to a group member or to someone else.

If you are in concurrent individual treatment, we request your permission to communicate with your individual therapist at regular intervals. Your therapists are your allies and it is important for your therapy that they communicate with one another.

Group Members

Confidentiality is similarly expected of all group members. Group members must maintain confidentiality to create a safe environment for the work of therapy and to develop trust within the group. Most individuals in therapy prefer to keep the therapy a private place and refrain from any discussions with others. If, however, in discussions with friends or family, you wish at some point to refer to your group therapy, you should speak only about your own experience, not about any other member’s experience. Never mention any other member’s name or say anything that might inadvertently identify any group members.

What Do You Do?
How Are You Expected To Behave?

Generally, there will not be a prescribed agenda for each session. Participants are encouraged to talk about any personal or relationship issues relevant to the problems and goals that lead them to therapy. Participants are encouraged to offer support, to ask questions, to wonder about things said or not said, to share associations and thoughts. A lot of emphasis will be placed on examining the relations between members — that is, the “here-and-now.” Members will often be asked to share their impressions of one another — their thoughts, fears, positive feelings and well as some characteristics of the other that creates distance. The more that we are able to work in the here-and-now of the group, the more likely we are to be effective.

Disclosure about oneself is necessary to profit from group therapy but at the same time members should choose to disclose at their own pace. There are no pressured confessions.

The work of the therapy group is expressed verbally and not in physical action.

In order to keep the group environment a therapeutic place, we ask that members always try to say things to other members in a way that is constructive. Helpful feedback focuses on what is happening in the here-and–now; does not blame; is relevant; and, connects the member receiving the feedback with the member offering the feedback. This kind of direct feedback and engagement is often novel; rarely in our culture do individuals speak so honestly and directly. Hence, it may at first feel risky, but also deeply supportive and meaningful.

Direct advice — giving amongst group members and from group therapists is not a large part of how the group helps. Neither are general discussions such as sports or politics helpful unless there is something about a current event which has particular relevance to one’s personal or interpersonal issues.

It is important for participants to know that being a part of a therapy group is different in some ways from being a part of a support group. One of the ways in which it is different is that socializing with other group members outside of this group is generally discouraged whereas in many support groups it is often expected and encouraged.

This difference exists primarily because this therapy group’s goal is to explore and understand interpersonal relationships in the group with the expectation that this understanding will, over time, be helpful in developing more satisfying relationships outside of group. We think of the group as a microcosm of each person’s fuller world at large and the group as a kind of relationship laboratory.

At times group participants develop strong positive feelings towards other group members or therapists. We expect these feelings be discussed in the group, just as other feelings, such as anger or disappointment should be discussed.

Sometimes group members run into one another outside of group. Each group must come to some agreement about how to deal with such meetings. Since the goal of the members is to understand as much as possible about their relationships with each other member, it is best that the group is privy to all interchanges between members. Therefore if members interact between meeting they should share all information with the group. Any type of secrecy regarding relationship between members impedes the progress of therapy.

Group Therapists

Your group therapists are not going to “run the show.” Their role is more that of a participant/facilitator rather than that of an instructor. Therapy is most productive when it is collaborative and a shared enterprise. Keep in mind that the input from other members may often be as important, or even more important, than the leaders’ comments. When deemed appropriate the therapists may make observations about group interactions and behavior, or about what particular individuals say or do in the group. They might also comment on progress or obstructions within the group.

As much as possible we hope that if you have something to ask of or say to the group therapists, that you do so in the group sessions. However, if there is something urgent you must discuss with the group therapists outside of group, between sessions, this can be arranged. But it is useful to bring up in the next group meeting what was discussed with the therapists. Even relevant material from your individual or couples therapy with another therapist should be shared. We hope that there are really no issues that cannot be talked about within the group. At the same time, we recognize that trust develops only over time and that some personal disclosures will be made only when one feels sufficiently safe in the group.

Anticipated Length Of Therapy
And Initial Length Of Commitment

Group therapy does not generally show immediate positive benefit to its participants. Because of this fact, participants sometimes find themselves wanting to leave therapy in the beginning if it becomes stressful for them. We ask that you suspend your early judgments of the group’s possible benefits and continue to attend and to talk about the stresses involved and your doubts about group therapy.

We ask that you make an initial commitment to attend and participate in your therapy group for at least 12 sessions. By then you will have a clearer sense of the potential helpfulness of the group.

Attendance and Group Cohesion

The group works most effectively if it is cohesive, reliable and predictable. Regular attendance is a key part of that and we therefore request that you make it a priority in your schedule. Group therapy progresses best when each member values and respects the commitment and work of each participant. Regular attendance and active participation in the meetings is an important way to demonstrate that respect and valuing.

Arrival on time to each session, as well as regular attendance is expected. If you know that you are going to be late or absent, we ask that you call the group therapists, as far ahead of time as possible, with the reason for your lateness or absence, so that they can let the group know at the beginning of the session.

If you know a week or more ahead of time of a lateness or absence, inform the group at an earlier session. We ask that you let the group know your vacation plans well ahead of time, if at all possible. The group therapists will do the same.

There may be times when the group is the last place you want to be, because of the difficult emotions that may be generated by therapy. These times may in fact be unusually productive opportunities to do the work of psychotherapy. In the same vein, you can anticipate that some of the difficulties that you have experienced in the world at large will express themselves in the group. Don’t be discouraged by this. It is in fact a great opportunity because it means that you and the group members are truly tackling the important issues that concern you.

You have decided, by agreeing to participate in group therapy, to begin a process of giving and receiving support and working towards needed changes in your personal and interpersonal life. We look forward to the opportunity of working together with you in this group.

(The previous is from Irvin Yalom, The Theory and Practice of Group Psychotherapy, 5th edition, Fall, 2005.)

To request more information, e-mail: kimivesbailey@sbcglobal.net, or call: 650-737-1818