International Journal of Group Psychotherapy最新文献

The American Group Psychotherapy Association (AGPA) Practice Guidelines helped inspire the Dutch Group Therapy Association (NVGP) to develop the Dutch Practice Guidelines for Group Treatment. In this article, we provide a short review of the history of Dutch group psychotherapy. We discuss socioeconomic developments in the Netherlands and their consequences for health care in general and group psychotherapy in particular. After that, we introduce the procedures of the NVGP Dutch Task Force in developing their Practice Guidelines including their process to reach expert consensus. We then elaborate on the similarities and differences between the American and the Dutch Practice Guidelines. We end by presenting future directions and thoughts on international cooperation in the development of evidence-based practice guidelines for group treatment.

Law enforcement violence has emerged as a leading public health concern, and law enforcement officers are themselves at greater risk for a range of psychiatric disorders. Drawing on the significant empirical support for mentalization-based treatment (MBT), this paper explores the use of MBT as a transdiagnostic psychotherapy for law enforcement professionals. By helping patients to mentalize-that is, to "read," access, and reflect on mental states in oneself and other people-MBT could be useful as a dual-focus treatment, able to simultaneously impact psychiatric illness among law enforcement officers while also indirectly impacting the problem of law enforcement violence in the broader society. The core psychotherapeutic principles of MBT are reviewed, along with common vulnerabilities in mentalizing likely to arise for law enforcement professionals in the context of high emotional and interpersonal intensity. The authors outline a novel application of MBT which has implications for psychiatric treatment as well as police training: the single-session psychoeducation and psychotherapy group, where law enforcement officers practice both self-reflection and empathy in situations of relational conflict. Utilizing group process from a residential treatment program for first responders with mental health and substance use disorders, a case example is offered to illustrate this intervention.

The identification of relationship ruptures in group therapy coupled with repair efforts by the group leader are addressed from a measurement-based care (MBC) perspective. Several MBC systems are now recognized as evidence-based treatments, and these systems typically use self-report assessment of both outcome and relationship measures. After laying a brief foundation of alliance rupture and repair from an individual therapy perspective, the complexity of applying alliance and repair across the multiple therapeutic relationships and constructs found in the group treatment literature is considered. The Group Questionnaire (GQ) is an empirically derived measure designed to capture the multiple relationship structures (member-member, member-leader, and member-group) and constructs (alliance, cohesion, climate, and empathy) in group therapy. Similarities and differences between the GQ and alliance rupture and repair measures are considered, followed by algorithms used to identify rupture and repair in group therapy on the three GQ subscales-positive bond, positive work, and negative relationship. MBC clinical reports are used to illustrate how rupture is identified at both a group and individual member perspective along with information to support repair interventions. Finally, both clinical and empirical reasons for using the MBC approach are considered along with clinical observations.

The article explores ideas about the role of group mentalizing-the experience of joint attention and shared intentionality-as a process that can support the emergence of more collaborative and salutogenic social functioning. This is based on developmental and evolutionary thinking about the importance of joint attention in human social cognitive development and functioning. The importance of experiencing rupture and repair as part of the process of thinking together-while also working with the separate nature of our thoughts-is described, emphasizing that it is through an understanding of the complex and inevitably uneven and challenging nature of joint attention and social cooperation that such cooperation is itself made possible.

As a theory-based practice, systems-centered therapy (SCT) posits that integrating differences is essential for development and transformation. Ruptures over differences that are "too different" are inevitable in groups. Importantly, when ruptures are not repaired, groups fixate in survival. SCT groups use functional subgrouping to develop a secure context for repairing ruptures in the here-and-now and integrating differences. This article presents theory, examples, and transcripts demonstrating how functional subgrouping repairs ruptures and how SCT's person-as-a-system theory guides its work with ruptures by weakening past survivor roles as they are repeated in the present: enabling ruptures to be repaired within and between the person, group members, leaders, and the whole group, rather than repeating past roles that if not undone inhibit development and lead to ruptures in the present.

In group psychotherapy, there will inevitably be empathic ruptures with individual members or the whole group. Self psychologists define ruptures as breaks in empathy regarding selfobject needs, and they address how ruptures can be repaired in very specific ways. Since exploring and working with empathic ruptures was basic to Kohut's theory, his ideas are very applicable to working with groups where there are multiple opportunities for empathic ruptures. A case example in which there is a major disruption between two group members and ultimately with the entire group is explored. The clinical material will demonstrate the usefulness of Kohut's understanding/explaining sequences, the importance of groupobjects, and the role of the group therapist when addressing empathic ruptures in group therapy.

The therapeutic alliance is the bedrock upon which psychotherapy rests. Therapists need be aware of ruptures in the alliance, especially those caused by the therapist. Much important therapeutic work occurs in repairing alliance ruptures.

The group climate, cohesion, and alliance with the leaders are critical elements of effective group psychotherapy. Although there has been significant attention to these curative mechanisms, there has been less attention to ruptures in the group relationships or the repair of them. The current special issue is devoted to theory, research, training, and practice regarding ruptures and repairs in group treatment. Contemporary and more traditional theorists describe how ruptures facilitate change in group therapy. Researchers apply the empirical findings on ruptures in individual therapy to group therapy and describe how ruptures can be measured. Group therapists also address how group leaders can contribute to ruptures and their subsequent repair. This introduction to the special issue concludes with the implications for practice and a call for future research that will help us fully understand how ruptures affect group process and outcomes in group work.