PART 15: Therapy

44.6 Group and Family Therapies

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44-7 What are the aims and benefits of group and family therapies?

Group Therapy

group therapy therapy conducted with groups rather than individuals, permitting therapeutic benefits from group interaction.

Except for traditional psychoanalysis, most therapies may also occur in small groups. Group therapy does not provide the same degree of therapist involvement with each client. However, it offers many benefits:

It saves therapists’ time and clients’ money, often with no less effectiveness than individual therapy (Fuhriman & Burlingame, 1994).
It offers a social laboratory for exploring social behaviors and developing social skills. Therapists frequently suggest group therapy for people experiencing frequent conflicts or whose behavior distresses others. For up to 90 minutes weekly, the therapist guides people’s interactions as they discuss issues and try out new behaviors.
It enables people to see that others share their problems. It can be a relief to discover that you are not alone—to learn that others, despite their composure, experience some of the same troublesome feelings and behaviors.
It provides feedback as clients try out new ways of behaving. Hearing that you look poised, even though you feel anxious and self-conscious, can be reassuring.

Family Therapy

family therapy therapy that treats the family as a system. Views an individual’s unwanted behaviors as influenced by, or directed at, other family members.

One special type of group interaction, family therapy, assumes that no person is an island. We live and grow in relation to others, especially our families, yet we also work to find an identity outside of our family. These two opposing tendencies can create stress for both the individual and the family.

Family therapy This type of therapy often acts as a preventive mental health strategy and may include marriage therapy, as shown here at a retreat for military families. The therapist helps family members understand how their ways of relating to one another create problems. The treatment’s emphasis is not on changing the individuals, but on changing their relationships and interactions.

John Moore/Getty Images

Unlike most psychotherapy, which focuses on what happens inside the person’s own skin, family therapists work with multiple family members to heal relationships and to mobilize family resources. They tend to view the family as a system in which each person’s actions trigger reactions from others, and they help family members discover their role within their family’s social system. A child’s rebellion, for example, affects and is affected by other family tensions. Therapists also attempt—usually with some success, research suggests—to open up communication within the family or to help family members discover new ways of preventing or resolving conflicts (Hazelrigg et al., 1987; Shadish et al., 1993).

Self-Help Groups

More than 100 million Americans belong to small religious, interest, or support groups that meet regularly—and 9 in 10 report that group members “support each other emotionally” (Gallup, 1994). One analysis of online support groups and more than 14,000 other self-help groups reported that most such groups focus on stigmatized or hard-to-discuss illnesses (Davison et al., 2000). AIDS patients were 250 times more likely than hypertension patients to be in support groups. People with anorexia and alcohol use disorder often join groups; those with migraines and ulcers usually do not.

The grandparent of support groups, Alcoholics Anonymous (AA), reports having 2.1 million members in 115,000 groups worldwide. Its famous 12-step program, emulated by many other self-help groups, asks members to admit their powerlessness, to seek help from a higher power and from one another, and (the twelfth step) to take the message to others in need of it. Studies of 12-step programs such as AA have found that they help reduce alcohol use disorder at rates comparable with other treatment interventions (Ferri et al., 2006; Moos & Moos, 2005). In one eight-year, $27 million investigation, AA participants reduced their drinking sharply, as did those assigned to cognitive-behavioral therapy or an alternative therapy (Project MATCH, 1997). In one study of 2300 veterans who sought treatment for alcohol use disorder, a high level of AA involvement was followed by diminished alcohol problems (McKellar et al., 2003). The more meetings members attend, the greater their alcohol abstinence (Moos & Moos, 2006). Those whose personal stories include a “redemptive narrative”—who see something good as having come from their experience—more often sustain sobriety (Dunlop & Tracy, 2013).

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With more than 2 million members worldwide, AA is said to be “the largest organization on Earth that nobody wanted to join” (Finlay, 2000).

To review the aims and techniques of different psychotherapies, and assess your ability to recognize excerpts from each, visit LaunchPad’s PsychSim 6: Mystery Therapist.

In an individualist age, with more and more people living alone or feeling isolated, the popularity of support groups—for the addicted, the bereaved, the divorced, or simply those seeking fellowship and growth—may reflect a longing for community and connectedness.

* * *

For a synopsis of these modern psychotherapies, see TABLE 44.2.

Table 15.2: TABLE 44.2
Comparing Modern Psychotherapies

Therapy	Presumed Problem	Therapy Aim	Therapy Technique
Psychodynamic	Unconscious conflicts from childhood experiences	Reduce anxiety through self-insight.	Interpret patients’ memories and feelings.
Client-centered	Barriers to self-understanding and self-acceptance	Enable growth via unconditional positive regard, genuineness, acceptance, and empathy.	Listen actively and reflect clients’ feelings.
Behavior	Dysfunctional behaviors	Learn adaptive behaviors; extinguish problem ones.	Use classical conditioning (via exposure or aversion therapy) or operant conditioning (as in token economies).
Cognitive	Negative, self-defeating thinking	Promote healthier thinking and self-talk.	Train people to dispute negative thoughts and attributions.
Cognitive-behavioral	Self-harmful thoughts and behaviors	Promote healthier thinking and adaptive behaviors.	Train people to counter self-harmful thoughts and to act out their new ways of thinking.
Group and family	Stressful relationships	Heal relationships.	Develop an understanding of family and other social systems, explore roles, and improve communication.

RETRIEVE IT

Question

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ANSWER: humanistic therapy—specifically Carl Rogers' client-centered therapy

Question

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