Psychoanalytically oriented short-term groups for outpatients: Unsettled issues

Abstract

The psychoanalytic approach to short-term Increasing interest in providing short-term groups for outpatients reflects both economic and conceptual developments in the mental health field. Economic factors include an interest in providing cost-effective treatments and the growing necessity of accommodating to limits set by third-party payment sources. Conceptual factors include the idea that time pressure accelerates the pace of therapeutic work and the idea that a time limit prevents long-term dependency by the patients. Consideration of such conceptual factors suggests that shortterm group therapy may be the treatment of choice for certain types of patients, for example, patients who work better under time pressure and patients who tend to form long-term dependent relationships. Positive clinical reports have frequently described the use of short-term groups with specialized populations such as patients with deficient social skills or those with child-rearing problems. These groups have typically utilized client-centered, behavioral, or cognitive-behavioral approaches.This article will focus on the less prevalent, psychoanalytic approach to short-term group therapy (STG). The objective of this approach is to help patients solve their presenting problems by achieving insight into how their difficulties are related to unresolved intrapsychic conflicts and by initiating a process of working through that will continue beyond the treatment sessions.

Dropping out from short-term group therapy.

“…Personal objectives often included overcoming difficulties associated with loss, for example, loneliness, or ambivalence concerning the establishment of new relationships. Conceptually, loss patients represented a population whose problems might be particularly conducive to work and resolution within STG ( McCallum & Piper, 1988). Patients manifesting problems of suicidal intent, psychosis, addiction, sexual deviation, or sociopathic behavior or who were currently involved in another form of psychotherapy were excluded from the study.…”

The Psychological Mindedness Assessment Procedure.

“…All patients had been assessed as experiencing a prolonged or delayed grief reaction following the loss of a person or persons. Conceptually, loss patients represented a population whose problems might be particularly conducive to work and resolution within STG (McCallum & Piper, 1988). The average length of time since the losses identified by the patient was 7 years (range: 3 months–20 years).…”

Integrating group dynamics and cognitive-behavioral groups: A hybrid model.

“…Closed groups tend to have a preset number of sessions and an explicit termination date. McCallum and Piper (1988)…”

“…Closed groups tend to have a preset number of sessions and an explicit termination date. McCallum and Piper (1988) maintain that closed-group time pressures accelerate the pace of group work and decrease dependency on group leaders. In contrast, open groups allow new members to join the group as spaces open due to member “graduation” or attrition.…”