1. GROUP PSYCHOTHERAPY
Ms Sharika Ratish
Assistant Professor(Mental Health Nursing)

2. CONCEPT:
 Group psychotherapy is a treatment in which carefully
selected people who are emotionally ill meet in a group
guided by a trained therapist, & help one another effect
personality change.
 In other word, Group psychotherapy is a treatment of
psychological problems in which two or more patients
interact with each other on both an emotional &
cognitive levels in the presence of one or more
psychotherapists who serve as catalysts (the person who
can be related to or who can understand the other’s
point of view), facilitators or interpreters.

3. Three major kinds of groups are:
 Group Therapy
 Therapeutic Groups
 Adjunctive Groups
 Group Therapy:
Group Psychotherapy members gain a
personal insight, improve their interpersonal
relationship, change destructive behavior & make a
necessary alteration in their behavior.

4.  Therapeutic Group:
• It is a group of patients who meet
under the leadership of a therapist to work
together to improve mental & emotional
health.
• Example; Groups of expectant mothers, people
who have just lost their husband or wife.
Group of people with a chronic illness.
• - Therapeutic groups are self-help like
Ashiana, Saheli in Delhi, who conduct these
groups for drug addicts.

5.  Adjunctive Groups:
Adjunctive groups deal with selected
needs of a group.
For Example; for sensory stimulation allow them to
have music therapy, for self-expression art
therapy, for expression of feelings & emotions
through dance therapy. These are a few examples
which can be used for adjunctive groups

6. CONTRAINDICATION
 Antisocial patients
 Actively suicidal or severely depressed
patients
 Patients who are delusional & who may
incorporate the group into their delusional
system.

7. GROUP SIZE
 Optimal size for group therapy is 8 to 10
members.
FREQUENCY AND LENGTH OF SESSIONS
 Most group psychotherapist conduct group
sessions once a week; each session may last for
45 minutes to 1 hour.

8. TYPES OF PSYCHOTHERAPY GROUPS
1. Traditional Groups
2. Encounter Group or T. Group
3. Homogeneous or heterogeneous groups
4. Open or close groups
5. Groups for psychosis or neurosis

9. 1. TRADITIONAL GROUPS:
Traditional groups includes mainly the patients with mental
illness & are from the hospital inpatient department. In
the didactic group therapy, lecture is given to the
patient along with some filmshow, like in the case of
excessive drinking or use of drugs
- Psychodrama is a technique of psychotherapy in which a
patient acts out his feelings in front of a group of
patients. The therapist guides & directs the patient &
interprets the actions of the patient. This type of acting
out provides an insight into the patient about his faulty
patterns of learning which he can eliminate

10. PSYCHODRAMA
• Created in mid 1930s by J.L. Moreno and later developed by his
wife, Zerka Moreno.
• An action approach to group therapy in which clients explore
their problems through role playing, enacting situations using
various dramatic devices to gain insight, discover their own
creativity, and develop behavioural skills.
• Scenes are played in the here-and-now, even though they might
have originated in a memory or anticipated event.

11. BASIC COMPONENTS OF
PSYCHODRAMA
• The protagonist-The person
who is the focus of the
enactment. Protagonist selects
the event to be explored
• Auxiliary egos -Other
members who take part in the
enactment
• The audience -Others in the
group who observe and
participate.
• The stage -The area where the
psychodrama enactment
occurs.
• The Director

12. PHASES OF PSYCHODRAMA
WARM UP -Initial activities to increase
involvement of entire group
SHAPING AND PRESENTATION- Involves
the enactment and working through of a past or
present situation or of an anticipated event.
Protagonist is encouraged to move into action
SHARING AND DISCUSSION- Sharing
involves statements about oneself. Discussion of the
process comes after personal sharing

13. TECHNIQUES OF PSYCHODRAMA
• Self-presentation – protagonist gives a self-portrait to
introduce the situation
• Role reversal – protagonist takes on the part of another
personality portrayed in the drama; involves looking at oneself
through another individual’s eyes
• Double – stands to the side of protagonist and says the words
that aren’t spoken
• Soliloquy – verbalize thoughts or feelings
• Empty chair – talk to someone not there

14. TECHNIQUES OF PSYCHODRAMA
• Mirror technique – another member mirrors the protagonist’s
postures, gestures, words; fosters self-reflection; must be used
with discretion
• Future projection – increases awareness of available options
for future encounters
• Magic shop – exchange one characteristic for another one
already possessed
• Role training – experiment with new behaviours in the safety of
the group

15. CONTRIBUTIONS AND STRENGTHS OF PSYCHODRAMA
• An action-oriented approach
• Active techniques that foster direct experience
• Provides alternative ways of dealing with life’s problems
• Can be integrated with other therapies
• Promotes catharsis, healing, and self-understanding
LIMITATIONS OF PSYCHODRAMA
• Need to exercise caution in using techniques
• Essential that group leader receives training and supervision
• Leaders need to know themselves

16. 2. ENCOUNTER GROUP OR T. GROUP:
Encounter group is a form of small group in which
an individual learns how his feelings & behavior
affect him & others. This group is not necessarily a
group of people with mental illness. The individual
may have some coping difficulty which he would
like to resolve at the right time

17. 3. HOMOGENEOUS OR
HETEROGENEOUS GROUPS:
Homogeneous groups are composed of patients
of the same age, race, sex, socioeconomic level
& similar category of illness.
Heterogeneous groups vary on all these
aspects.

18. 4. OPEN GROUPS & CLOSED GROUPS:
In open groups members may join & leave the
group at anytime. Closed groups have a
specific number of people, specific time to start
& close the group sessions; the duration is three
to four weeks. Inpatients & outpatients both
are included in this group.
Open & closed groups are used
extensively in the hospital.

19. 5. GROUP ACCORDING TO MENTAL
ILLNESS:
Neurotic group or patient suffering from
psychotic illnesses come under this
category.

20. APPROACHES TO GROUP THERAPY
 The therapist’s role is primarily that of a facilitator; he
should provide a safe, comfortable atmosphere for self-
disclosure.
 Focus on the “here and now”.
 Use any transferences situations to develop insight into
their problems.
 Protect members from verbal abuse or from
scapegoating.
 Whenever appropriate, provide positive reinforcement,
this gives ego support & encourages future growth.

21.  Handle circumstantial patients, hallucinating &
delusional patients in a manner that protects the self-
esteem of the individual & also sets limits on the
behavior so as to protect other group members.
 Develop ability to recognize when a group member is
“fragile”, he should be approached in a gentle,
supportive & non-threatening manner.
 Use silence effectively to encourage introspection &
facilitate insight.

22.  Laughter & a moderate amount of joking can act as
a safety valve & at times can contribute to group
cohesiveness.
 Role-playing may help a member develop insight
into the ways in which he related to others.

23. THERAPEUTIC FACTORS INVOLVED IN
GROUP THERAPY:
1. Sharing experience
2. Support to & from group members
3. Socialization
4. Imitation
5. Interpersonal learning

24. 1. SHARING EXPERIENCE
 This helps the patients to realize that they are
not isolated & that others also have similar
experience & problems
 Hearing from other patients that they have
shared experiences is often more convincing &
helpful than reassurance from the therapist.

25. 2. SUPPORT TO AND
FROM GROUP MEMBERS
 Receiving help from other group members can
be supportive to the person helped.
 The sharing action of being mutually
supportive is an aspect of the group
cohesiveness that can provide a sense of
belonging for patients who feel isolated in
their everyday lives.

26. 3. SOCIALIZATION:
 It is acquisition of social skills (for example,
maintaining eye contact) within a group
through comments that members provide about
one another’s deficiencies in social skills.
 This process can be helped by trying out new
ways of interacting within the safety of the
group.

27. 4. IMITATION
 It is learning from observing & adopting the behaviors
of other group members.
 If the group is run well, patients imitate the adaptive
behaviors of other group members.
5. Interpersonal learning:
 It refers to learning about difficulties in relationships by
examining the interaction of individuals with the other
members of the group.

28. STEPS OF GROUP THERAPY
1. Selecting group Members
2. Developing contact
3. Selection of group leaders

29. 1. SELECTING GROUP MEMBERS:
 It is very important function of a group therapist.
 She has to decide based on the condition of the
patient who all can be included in the group.
 A very depressed patient may lead to
withdrawal of other members of the group,
whereas too many excited patients included in
the group may lead to unsuccessful group
therapy.

30. 2. DEVELOPING CONTACT:
 The purpose should be made clear to all the members in
the group.
 Time, length & place of the meeting should be
announced.
 Starting & ending time & how frequently the group
sessions will be conducted.
 Attendance of members.
 Confidentiality to be maintained within the group.
 Role of the members is; to report punctually, maintain
confidentiality & interact freely.

31. 3. SELECTION OF GROUP LEADERS:
 Role of the therapist – the therapist acts as a facilitator & helper.
I.
III.
VII.
VIII.
To provide information to the group.
II. Allow emotional catharsis.
Share members’ perception.
IV. Share feelings of fear, loneliness & frustration.
V. Improve communication skills
VI. Provide a role model.
Help to know what is reality.
Set limits for some patients.
IX. Make observation of all the non-verbal techniques being used by
the patient.

32. SOME TECHNIQUES USED IN GROUP
THERAPY:
 Reflecting or rewarding comments of group
members
 Asking for group reaction to one member’s
statement
 Asking for individual reaction to one member’s
statement
 Pointing out any shared feelings within the group
 Summarizing various points at the end of session.

33. THANKYOU