Therapeutic focusing in time-limited group psychotherapy.

Abstract

The degree to which treatment outcome is related to therapeutic focusing, leader skill, and positive aspects of the therapeutic relationship was examined in time-limited group psychotherapy. Measures tapping each of these domains were assessed at Sessions 3,8, and 14 in 15-week therapy groups led by 4 expert professional group therapists and 4 "natural-helper" nonprofessionals. Significant differences were found on process measures for both the leader skill condition and time factors. In addition, both the quality of the therapeutic relationship and the degree of therapeutic focusing independently predicted client improvement. Specifically, the results indicate mat therapist focusing occurs differentially and is only predictive of improvement in professional groups, whereas a positive therapeutic relationship is only predictive of early positive improvement in nonprofessional groups.

Therapeutic applications of groups: From Pratt's "thought control classes" to modern group psychotherapy.

“…ers (Barlow et al, 1997;Burlingame & Barlow, 1996) studied a number of these factors, corroborating this relatively complex picture. Although outcome may have been the same for the natural helpers and expert leaders in Burlingame & Barlow's (1996) study, the nonprofessionals tended to get to the end of the group in one way, whereas the professionals quite another, clearly indicating a complex process that led to an outcome.…”

An application of the competency model to group-specialty practice.

“…in Table 2) that track group norms, stages, roles, all at the group level. Group therapists must also attend to individual needs by delivering targeted interventions based upon each individual group member's pregroup interviews, where target complaints have been discussed, which according to research, can lead to positive outcomes (Barlow, Burlingame, Harding, & Behrman, 1997).…”

“…For instance, group-as-a-whole interventions (i.e., focusing upon the group of individuals who maintain multiple alliances with each other and the group leader) require group leaders to apply intervention competencies (as found in Table 2) that track group norms, stages, roles, all at the group level. Group therapists must also attend to individual needs by delivering targeted interventions based upon each individual group member's pregroup interviews, where target complaints have been discussed, which according to research, can lead to positive outcomes (Barlow, Burlingame, Harding, & Behrman, 1997).…”

“…Once it has been determined that the client may indeed benefit from an appropriate referral to a carefully selected group type, the therapist can enhance the client's chances for success by introducing the soon-to-be group member to the group-member role, including engaging in reciprocal functioning (that the client will both give and receive help), avoiding advice, giving appropriate feedback, and being willing to appropriately disclose. In addition, helping the client identify two or three target complaints (on a scale from 1–5, from less to more intense) appears to lead to better outcomes when the group leader then focuses on those concerns during actual group sessions (Barlow et al, 1997). Such pregroup preparation is also part of the functional competency subsumed within group intervention (see Table 2).…”

Group psychotherapy specialty practice.

“…Ironically, however, it appears from the research that fewer group courses are being offered in graduate programs (Taylor et al, 2001). In a number of studies, group outcomes rival and sometimes exceed outcome gains in individual therapy (Burlingame, MacKenzie,& Strauss, 2003).This is especially true if leaders utilize group interventions to enhance the powerful cohesive alliances that form between member-member and member-leader through clearly researched leader methods (Barlow, Burlingame, Hardman, & Behrman, 1997;Burlingame & Barlow, 1996), and if the lack of trained leaders seriously compromises the chances for those unique qualities of group to be present (Barlow, Burlingame, Nebeker, & Anderson, 2000;Stein & Lambert, 1995). Contributions from the group psychology literature undergird these issues (Kivlighan & Shaughnessy, 2000).…”