approaches, the therapist in group behavioral ther-
apy often plays a very active, almost didactic role,
providing lessons, skills training, and homework
assignments.
Behavioral and cognitive-behavioral groups are
usually time limited (e.g., 12 sessions) and are com-
prised of patients with similar problems. As in most
behavior therapy treatments, these group members
complete a number of assessment instruments
before, during, and after treatment to monitor
progress. Rose (1991) provides a number of exam-
ples of how reinforcement, modeling, problem
solving, and cognitive interventions are imple-
mented in behavior therapy groups. Research has
supported the efficacy of behavioral and cognitive-
behavioral group interventions for the treatment of
depression, social skills deficits, pain, agoraphobia,
and other conditions (Rose, 1991).
For example, a group approach is usually the
treatment of choice for assertiveness training.
Groups provide nonassertive individuals with an
excellent environment in which to confront their
problems, reduce their fear of being assertive, and
learn acceptable methods of self-expression. Such
groups typically involve direct teaching, with the
therapist describing the group’sgoalsandthe
problems that nonassertiveness can generate for
people. Assertiveness training groups are usually
also characterized by such features as cooperative
problem solving, honesty, and acceptance among
group members. Group members are provided
with opportunities to comment and to criticize
the manner in which they present themselves.
New assertiveness skills are demonstrated and
practiced, and homework assignments are often
given, followed by group discussion of their
success.
Another example is cognitive-behavioral group
therapy for social phobia. Heimberg and Becker
(2002) present a detailed description of this treat-
ment. Briefly, group members are first introduced
to a cognitive-behavioral model of social phobia
that incorporates cognitive, behavioral, and physio-
logical components. After the basics of cognitive-
behavioral therapy are introduced, the group sessions
focus on exercises concerning in vivo or simulated
exposure to feared situations, cognitive restructuring,
and the development of skills that involve identifying
and modifying cognitive biases that serve to produce
and maintain symptoms of social phobia. This treat-
ment approach to social phobia has proven effica-
cious (Burlingame, MacKenzie, & Strauss, 2004)
and, due to the nature of social phobia, is arguably
the treatment of choice.
Group therapy also is popular in working with
young children and adolescents. Because youth are
often comfortable with a classroom-type setting,
the use of a group approach can be a nice fit for
work on reducing aggressive behavior, anxiety, or
the development of social skills, for instance. In
some cases (e.g., groups of youth with pervasive
developmental disorders, such as high-functioning
autism), the group setting allows for immediate
practice of skills that may be otherwise hard to
obtain.
Group behavioral therapy meetings, like other
time-limited approaches, typically take place on a
weekly basis for a predetermined number of sessions
(e.g., eight sessions for a group consisting of mem-
bers dealing with a life crisis). Often, the group has
been comprised following a careful pregroup prep-
aration and screening to ensure that potential group
members have similar issues and the requisite skills
to contribute to the group.
Box 15-1 describes the application of this
approach to patients with personality disorders.The Arrangements
Because of the wide variety of group approaches
used by clinicians, it may be somewhat misleading
to give a general description of the arrangements for
group therapy. Despite the diversity of techniques,
however, there are some general similarities. For
example, most groups consist of five to ten patients
who meet with the therapist at least once a week
for 90-minute to 2-hour sessions. The members are
often seated in a circle so that they can all see each
other. Sometimes they are seated around a table,
sometimes not.
The composition of the group may vary
depending both on the therapist’s convictions andGROUP THERAPY, FAMILY THERAPY, AND COUPLES THERAPY 437