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Here-and-Now

Group Psychotherapy
by

Maria Dsouza

on 25 April 2013

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Transcript of Here-and-Now

Presented by: Maria Swan The Therapist: Working in the Here-and-Now Timing of Group Intervention One tier is an experiencing one.
The group lives in the here-and-now. 2 Tiers in the here-and-now focus: The process focus is what makes an experiential group different from other therapies.

In process exploration, group members are encouraged to actively participate in discussions about the relationships between people in the group and the here-and-now behavior.

In normal social settings, process commentary can be disrespectful and awkward due to socialization anxiety, social norms, fear of retaliation, and power maintenance. Process Focus: The Power Source of the Group Activating Stage- Therapist moves the group into the here-and-now.
Focus on the relationships with one another. Therapist's Tasks in the Here-and-Now An issue critical to the existence or functioning of the entire group always takes precedence over narrower interpersonal issues.

Group-as-a-whole forces are continuously in play in group therapy.
Therapists need to be aware of them and harness them in the service of therapy. Group members develop strong feelings towards one another and the therapist.
It is ahistorical meaning the present events of the meeting are the focus and will lead to opening up each group member's social microsm. The second tier is the illumination of process: The group must understand itself and apply itself to the experience.
The group reflects and examines their behaviors that just happened. Process refers to the nature of the relationship between interacting individuals-members and therapists.

Therapists must guide the group into the self reflective loop and help members examine the here-and-now interactions that took place during the meeting. First Stage: Process Illumination- identify and share as it's unfolding.
The therapist is an observer-participant.

Clients must recognize what they are doing with other people.
They must appreciate the impact of this behavior on others and how it influences others' opinion of them.
They must decide whether they are satisfied with their habitual interpersonal style.
They must exercise the will to change.
They must transform intent into decision and decision into action.
They must solidify the change and transfer it from the group into their life. Therapist's Tasks Second Stage: 1. Therapist must think here-and-now.
2. Therapist teaches members how to receive and give proper feedback through modeling.
3. Therapist must keep group focused on here-and-now and be able to interrupt content flow.

Working through individuals resistance to change is the key to success. Common Group Tensions Tensions are always in a group. There is a certain struggle for dominance. Primary Task and Secondary Gratifications Primary task of the client is to achieve their original goals:
relief of suffering
better relationships with others
living more productively and fully
-primary task can change as therapy progresses Secondary gratification can divert client's pursuit of their primary goal.
a relationship with another member
an image a client wished to project
a group role in which the client was the most desirable, influential, wise or superior Therapist's Feelings Therapists feelings of trust grow through experience.

When expressing feelings to group members, the therapist must be reliable and accurate while being confident.

Objective countertransference-reflecting on the client's characteristic interpersonal impact on you and others.
Subjective countertransference-idiosyncratic reactions that reflect on what you, personally, carry into your relationships. Helping Clients In Process Orientation Often the therapist does not want to point out certain observations or insights so that the individual or group will arrive at the solution on their own.
Therapists should teach through modeling their own process orientation by discussing observations they saw in the meeting of spoken and unspoken process observations. In Process-Illuminating Comments It is important for clients to facilitate the assimilation of new information.
The therapist should make sure delivery of feedback to clients is accepted or it is not useful.
Clients are more receptive to supportive observations.
Make sure observations are not categorizing or limiting (dependency, narcissism, arrogance) because it causes clients to be defensive. Process Commentary Develops through experience.

Comments progress from simple observations of sense-data and grow more complex to sequences of behavior, interpersonal patterns, fantasy, and dream material.

Therapist guides clients through the sequence:
Here is what your behavior is like
Here is how your behavior makes others feel
Here is how your behavior influences the opinions others have of you
Here is how your behavior influences your opinions of yourself
Once the sequence has been developed and is fully understood by the individual, the client has entered the antechamber of change.

The therapist may then ask: Are you satisfied with the world you have created?

The therapist's goal is to guide the client to accept:
1. Only I can change the world I have created for myself.
2. There is no danger in change.
3. To attain what I really want, I must change.
4. I can change, I am potent. Group-as-a-Whole Process Commentary Inherent forces in a group significantly influence behavior.
Individuals act differently in a group and it is important to view the whole of an individual by observing them with others.

Group-as-a-whole influences the group by:
1. They can act in the service of the group (cohesiveness).
2. They can impede effective group therapy.
-The purpose of a group-as-a-whole interpretation is to remove some obstacle that obstructs progress of the group.
*Anxiety-Laden issues- when an issue arises that the group refuses to confront leads to group flight which is a regression from the group's normal functions.
*Antitherapeutic Group Norms- when a group "takes turns". This discourages free interaction in the here-and-now. A group can also devote all its time to the first issue discussed or "can you top this?" format. Reference Yalom, Irvin D. & Leszcz, Molyn (2005). Theory and Practice of Group Psychotherapy (Fifth edition). New York, NY: Basic Books.
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