Compatibility - the key to group therapy?

Day-hospital programmes are often recommended for people suffering from eating disorders. They often use group therapy to treat people but there has been little research into which aspects of this are the most important for people's recovery. One aspect of this that researchers are particularly interested in is group cohesion - the 'forces acting on the members of the group to remain in the group.' Group cohesion is, in turn, made up of components such as commitment to the group, compatibility of the group and the extent to which the content of the programme stimulates members. Researchers from Westmead Hospital in New South Wales looked into this issue in a study of 36 women going through an eating disorders day treatment programme. They found that the programme did lead to an improvement in the women's condition and of the aspects of group cohesion it was compatibility that was associated with attendance and treatment response.

Crino, Natalie and Djokvucic, Ivana - Cohesion to the group and its association with attendance and early treatment response in an adult day-hospital program for eating disorders: a preliminary clinical investigation Clinical Psychologist, July 2010, 14(2), 54-61

Self-esteem in the sandtray

Adolescence is a troublesome time for many people and adolescent girls tend to be more vulnerable than boys. In particular adolescent girls tend to have a lower self-esteem than boys; this is important as a high self-esteem is considered to be a protective factor for mental-health problems. Many girls between 11-14 are still in the concrete operational stage of development and often have difficulty in expressing their feelings adequately in words so group activity therapy may be more appropriate in this group. Group sandtray therapy is an intervention in which "group members build small worlds with miniature figures in individual trays of sand and share about their worlds as they are willing." Sessions are facilitated by a trained therapist who explores some of the psychological and interpersonal issues raised by participants. A U.S. study of 37 girls found that after nine sessions of sandtray therapy self-esteem was improved in the areas of: scholastic competence, social acceptance, physical appearance, behavioural conduct and global self-worth.

Shen, Yu-Pei and Armstrong, Stephen A. - Impact of group sandtray therapy on the self-esteem of young adolescent girls Journal for Specialists in Group Work June 2008, 33(2), 118-137

Group work for fathers

Research and theories about child-rearing have tended to concentrate on the role and influence of mothers rather than fathers. However, in the last few years there has been much more research into fatherhood, pointing to its importance in exerting a positive influence on areas such as academic performance, ego and moral development, communication, individual well being and relationships. Involvement of fathers has been found to promote healthier adaptation in adolescents, prevent the development of stereotypical attitudes, problems with substance abuse and sexual activity and involvement with the police. This has led to the development of fathering programmes. The Re:Membering Fatherhood programme is designed to strengthen a father's capacity, self-awareness and confidence in performing the nurturing dimensions of fatherhood and to strengthen families as a whole by preparing them to play a more meaningful and active fathering role. A study of 29 fathers using the programme found that it led to significant improvements for fathers and their participation within the family including role performance, involvement, communication, task accomplishment within the family, self-esteem, a sense of increased competence and decreased stress in parenting.

Gearing, Robert Edward ... [et al] - Re:membering fatherhood: evaluating the impact of a group intervention on fathering Journal for Specialists in Group Work March 2008, 33(1), 22-42

Psychosocial interventions for relapse in bipolar disorder

Although drugs are the main method of treating bipolar disorder psychosocial interventions are also important to address issues such as medication adherence, awareness and understanding of the disorder, early identification of symptoms and coping skills. When combined with drug treatment they enable individuals to take a more active role in the management of their disorder and lead to improvements in mood stability, occupational and social functioning and quality of life. A review of psychosocial interventions found that cognitive behaviour therapy or group psychoeducation may be effective in relapse prevention in stable individuals. Family therapy was no more or less effective than individual psychosocial therapy or crisis management. There was no evidence that care management or integrated group therapy were effective in the prevention of relapse.

Beynon, Suzanne ... [et al] - Psychosocial interventions for the prevention of relapse in bipolar disorder: systematic review of controlled trials British Journal of Psychiatry 192: 5-11

Personality and leaving therapy

How people leave group psychotherapy is often as important as what goes on in the sessions. Drop-out is characterized by frequent absences from group sessions and avoidance of the therapist's solicitations. In evasion into health the member resists the group's successful penetration of his/her defences and denies the need for further help claiming that all his/her problems have been solved. In ending of a phase the group member feels that he/she has completed a successful piece of work and is unwilling to proceed further. In saying goodbye, the best possible outcome, the group member announces his/her departure in advance, works towards the definitive date, freely discusses his/her feelings and anticipates the after-therapy period. A Swiss study of 24 older people suffering from depression looked into the links between people's personalities and the quality of their termination from group therapy. The researchers found that neuroticism was not related to the quality of the termination but agreeableness and openness to experience were strongly associated with a successful ending to therapy.

Canuto, Alessandra ... [et al] - Impact of personality on termination of short-term group psychotherapy in depressed elderly outpatients International Journal of Geriatric Psychiatry January 2008, 23(1), 22-26