الفهرس 
HISTORY OF group THERAPYOnly 14 pages are availabe for public view
Abstract
group therapy is a treatment modality involving a small group of members and one or more therapists with specialized training in group therapy. It is designed to promote psychological growth and ameliorate psychological problems. group therapy seeks to effect psychological change and to alleviate psychological suffering through the cognitive and affective exploration of the interactions among members, and between members and the therapist who must be a mental health professional skilled in intervening both within the group and on an individual level.
The first therapy group was conducted for individuals with physical illness. The term group therapy was coined by Jacob Moreno. group therapy was first used with children and adolescents. The sociocultural context in which group therapy is embedded has over the years critically influenced the course of its development. For example, as Anthony (1972) noted, World War I provided a context for the development of group psychology, whereas World War II created the environment for group therapy to emerge as a major treatment modality. Also, the value of self-liberation created a context in which the encounter or growth group movement in the United States could occur. Today, group therapy is a treatment modality that is widely used across different psychological problems, populations, and settings.
There exists a rich array of group therapy models; interpersonal, psychodynamic, social system approaches, cognitive-behavioral, psychodrama, redecision therapy, and existential therapy. Although these models are highly variable in their goals, they share important commonalities. Perhaps the most crucial is their use of the process of the group to move members toward their goals. For some models, such as cognitive-behavioral group therapy, the focus upon group process is a more recent development. These approaches differ from one another in terms of their degree of empirical support. For example, the effectiveness of the cognitive-behavioral model is well established for a variety of symptom conditions. Other models, such as psychodrama and psychodynamic group therapy, have a more limited base of empirical support, largely because a thoroughgoing investigation of effectiveness has yet to be undertaken.
Mindfulness is about present moment awareness. It can be thought of as moving away from a `doing’ mode into a `being’ mode, in which we focus on accepting and allowing what is in our current experience to emerge, with no need to suppress, judge, or immediately change it. Rather than focusing on the past or the future, the present moment in its full richness is the focus.
According to SAMHSA, the United States mentioned 27 different types of group therapy that were categorized under 5 main groups. Psycho-educational groups are designed to educate clients about substance abuse, and related behaviors and consequences, and to motivate the client to enter the recovery‐ready stage. Psycho-educational groups are highly structured and follow a manual or a preplanned curriculum. Skills development groups operate from a cognitive–behavioral orientation, incorporating psycho-educational elements into the group process, though skills development may remain the primary goal of the group. Coping skills training groups attempt to cultivate the skills people need to achieve and maintain abstinence. Skills development groups usually run for a limited number of sessions and has to be small enough for members to practice the skills being taught.
Cognitive–behavioral therapy groups work to change learned behavior by changing thinking patterns, beliefs, and perceptions and to develop social networks that support continued abstinence. It is a well‐established, relatively a low‐cost modality, and early recovery–oriented with a homogeneous membership. The most effective CTAG facilitators strike a balance between being task-oriented and process-oriented. Support groups attempt to help people with dependencies sustain abstinence without necessarily understanding the determinants of their dependence. These groups are also used to improve members’ general self‐esteem and self‐confidence. Groups may continue indefinitely, with new members coming in and old members leaving, and occasionally, returning.
Interpersonal process groups use psychodynamics, or knowledge of the way people function psychologically, to promote change and healing. It focuses on the here-and-now in the group, an establishment of group cohesion and therapeutic norms, and the interaction between members. It encourages involvement in complementary 12-step programs.
There are a variety of therapeutic groups that may be employed in substance abuse treatment settings. Some of these specialized groups are unique to substance abuse treatment (like relapse prevention) and others are unique in format, group membership, or structure (like expressive therapy groups). Relapse prevention groups focus on helping a client maintain abstinence or recover from relapse. Expressive groups includes a range of therapeutic activities that allow clients to express feelings and thoughts that they might have difficulty communicating with spoken words alone. Play and art therapies enable these clients to work through their trauma and substance abuse issues using alternatives to verbal communication. The problem‐focused group is a specific form of cognitive–behavioral group used to eliminate or modify a single particular problem, such as shyness or substance abuse. Problem‐focused groups are short (commonly 10 or 12 weeks), highly structured groups of people who share a specific problem. Self-help groups are special kinds of therapeutic groups. Alcoholics Anonymous has been the most widely observed self-help group
Several qualitative reviews suggest the efficacy of group therapy for the treatment of Substance Abuse and other forms of addiction. Several individual studies suggest that persons with Substance Abuse derive as much benefit from participating in a group of members with heterogeneous diagnoses as individuals with other diagnoses. In a study comparing relapse prevention for cocaine abuse delivered in group and individual formats. Clients treated in groups reported fewer cocaine‐related problems than those treated in individual sessions. Further, Carroll (1996) found that 6 months after intensive outpatient treatment for cocaine abuse, subjects treated in a group setting displayed higher rates of sustained abstinence than those treated individually. Research studies have demonstrated for decades that attendance at AA/NA is associated with long-term abstinence.
Groups are a useful and effective means of doing `something’. This `something’ can be multifaceted, from the delivery of information to the exploration of feelings, to the teaching of skills, and so forth. Curative group processes are instillation of hope, universality (individuals are not alone in their struggles),imparting of information, altruism (individuals can give something of value to others and feel useful),the corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior (Groups offer a chance to observe helpful behaviors by others), Interpersonal learning, group cohesiveness (individuals feel that what they say and do is important to others, and what others say is important to them), Catharsis (group is a space to vent and explore feeling and gain relief). The therapeutic factors emphasized in any one group format depend upon the patient population, goals of the group, setting, time frame, and a host of other contextual variables.
The features that characterize good leadership in all types of groups include an optimistic attitude about group, healthy ways of relating to others, the capacity to develop a stable therapeutic frame, skill in helping members find meaning in their reactions, an ability to use their own reactions, and optimal use of the leadership format (solo or co therapy). Several features that may influence leadership style include theoretical orientation, time frame, and developmental status.
It is useful to view behaviors associated with co-morbidity not as `intentional’, disruptive behavior to be `punished’, but more as useful information about where the client is and their complex needs. Facilitators can hold this information in mind, safely hold the client and group, and feedback pertinent information into ongoing treatment systems. Client presentation during the group will add useful information to individual work and specific needs that arise, particularly changes in behavior or mood. For example, exhibiting signs of paranoia or hallucinations may indicate a deterioration of their mental state and may require medication to be reassessed. Furthermore, some information disclosed within the group may not be appropriate for the group and should therefore be discussed on an individual basis. Clients with co morbidity are likely to be grappling with complex and long-standing difficulties, both in their internal and external worlds. This struggle becomes magnified within a group context. Ambivalence about changing substance misuse is expected among clients without mental health difficulties; ambivalence can also be anticipated from clients with dual diagnosis, clients for whom the prospect of `giving-up’ long-standing, well-used coping strategies may induce deep fear and uncertainty about their ability to cope.
Substance misuse can lead to varying types and degrees of neuropsychological dysfunction, which have immense psychological and social importance in the process of rehabilitation and recovery. Clinical experience suggests that cognitive deficits in attention, memory, and executive functioning compromise engagement in rehabilitation, treatment efficacy, and recovery. Although very motivated to change, clients with cognitive impairments are vulnerable to experiencing poorer functioning and may be more vulnerable to relapse. Integrating individuals with varying levels of cognitive ability into recovery groups can be achieved with minor modifications and adjustments. This can help improve the function of impaired clients without adversely affecting less-impaired clients.