Group therapy

Jessica Friedman, M.S.W., and Kathy Rayman, M.S.W., helped conduct outpatient group therapy. Geoffrey Smith and Brian Derrick performed the PCP assays. Alan Forsythe, Ph.D., and Denise Paz,... 

Group therapy for substance abuse/dependence includes more than three people (ideally 8 to 10) who interact in the same room for 90 to 120 minutes. Group therapy provides patients with the opportunity to bond with others and the advantages of this can be mutual identification dealing with... 

Interpersonal, family, or group therapy with a licensed psychiatric nurse practitioner/clinical nurse specialist, psychologist, social worker, or counselor assists individuals with bipolar disorder to establish and maintain a daily routine and sleep schedule and to improve interpersonal relationships.3,20 These therapies may help treat and protect against manic episodes. 

Psychotherapies for PTSD include anxiety management (e.g., stress-inoculation training, relaxation training, biofeedback, distraction techniques), CBT, group therapy, hypnosis, psychodynamic therapies, and psychoeducation. Psychotherapy may be used in patients with mild symptoms, those who prefer not to use medications, or in conjunction with drugs in those with severe symptoms to improve response. 

Teaching clients is an important part of therapy within any treatment model. Teaching often is referred to as psycho education in therapy and treatment. Psychoeducation can take place in a number of forums, from individual therapy sessions to classroom settings and group therapy. The content and emphasis of psychoeducation varies across the different treatment models, as you will see. 

Hayward, C., Varady, S., Albano, A.M., et al. (2000) Cognitive-behavioral group therapy for social phobia in female adolescents results of a pilot study. / Am Acad Child Adolesc Psychiatry 39 721-726. 

This type of program should offer cognitive-behavioral group therapy and individual therapy. It should be able to provide medication if necessary, structured meals, and nutritional counseling and meal planning. Group therapies, e.g., social skills training, are also useful. 

Antipsychotics versus combined antipsychotic therapy and psychotherapy (five studies). Here, too, the results were clearly in favor of drug therapy because there were virtually no relevant differences between patients receiving antipsychotics alone and those treated with antipsychotics phis psychotherapy. Three of the five studies involved group therapy and the other two individual psychotherapy neither of these forms of psychosocial treatment augmented the effect of the simultaneously administered antipsychotics to any demonstrable extent. 

Despite these limitations, the following conclusions can be drawn from the Boston New Haven Study and two other, similarly extensive studies published at the same time one with analytically orientated group therapy (Covi et cd.t 1974) and one with family therapy (Friedman. 1975) ... 

Malm, U. The influence of group therapy on schizophrenia. Acta Psvchiatr. Scarnl. 65, (Suppl. 297), 1-65, 1982. 

A group of clinical researchers in New Hampshire, USA, who are highly experienced in the treatment of substance abuse in the severely mentally ill have identified certain key principles of management (Drake et al. 1993, 2001), which are shown in Table 7.4. They consider that a special approach is necessary because the severely mentally ill do not identify problems in the same way, they typically have difficulty with addiction treatment approaches such as group therapy, and there is an ever-present danger that this group fall between two sets of services. Their work is in a unit specifically for dual diagnosis patients. 

The same New Hampshire group have described continuous treatment teams (Drake et al. 1996), who treat the dual diagnosis patients, with 24-hour responsibility for case management. There is a flexible approach to individual and group therapy, the latter being either educational or treatment-oriented in the case of those committed to abstinence. There is a practical focus on social situation, social skills and aspects of daily living. 

Aggressive psychosociai therapies (e.g., family therapy, group therapy, cognitive-behavioral therapy, and various rehabilitation programs)... 

Martinsen EW, Olsen T, Tonset E, et al. Cognitive-behavioral group therapy for panic disorder in the general clinical setting a naturalistic study with 1-year follow-up. J Clin Psychiatry 1998 59 437-442. 

Putting relapse on the map was an important move forward at a time when little attention was paid to the problems of maintaining changed behaviours, when a dose of detoxification treatment followed by more or less intensive, but still loosely defined, counselling or group therapy was deemed to be the treatment for addiction problems. 

With the exceptions of methadone maintenance, LAAM maintenance, and nicotine substitution therapy (and probably naltrexone for alcohol addiction and bupropion for nicotine addiction), no clearly effective pharmacotherapy for drug addiction exists. Certainly, no broadly effective pharmacotherapy exists (effective for addictions to drugs of different chemical classes and pharmacological categories). Therapeutic strategies based on psychotherapy, group therapy, behavior modification, economic incentives, and aversion deconditioning have proven limited. 

This sequence is very seldom allowed to occur, because we are so busy "treating" the patient, whether by chemotherapy, shock therapy, milieu therapy, group therapy, psychotherapy, family therapy... (p.85). 

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