with confidentiality, punctuality, attendance, and so-
cial contact between members outside of group time.
There are two types of groups: open groups and
closed groups. Open groupsare ongoing and run
indefinitely, allowing members to join or leave the
group as they need to. Closed groupsare structured
to keep the same members in the group for a speci-
fied number of sessions. If the group is closed, the
members decide how to handle members who wish
to leave the group and the possible addition of new
group members (Yalom, 1995).Family Therapy.Family therapyis a form of group
therapy in which the client and his or her family
members participate. The goals include understand-
ing how family dynamics contribute to the client’s
psychopathology, mobilizing the family’s inherent
strengths and functional resources, restructuring mal-
adaptivefamily behavioral styles, and strengthening
family problem-solving behaviors (Gurman & Lebow,
2000). Family therapy can be used both to assess
and treat various psychiatric disorders. Although
one family member usually is identified initially as
the one who has problems and needs help, it often
becomes evident through the therapeutic process that
other family members also have emotional problems
and difficulties.Family Education.The National Alliance for the
Mentally Ill (NAMI) has developed a unique 12-week
Family-to-Family Education course taught by trained
family members. The curriculum focuses on schizo-
phrenia, bipolar disorder, clinical depression, panic
disorder, and obsessive-compulsive disorder (OCD).
The course discusses the clinical treatment of these
illnesses and teaches the knowledge and skills that
family members need to cope more effectively. The
specific features of this education program include
emphasis on emotional understanding and healing in
the personal realm, and power and action in the so-
cial realm. NAMI also conducts Provider Education
programs taught by two consumers, two family mem-
bers, and a mental health professional who is also a
family member or consumer. This course is designed
to help providers realize the hardships that families
and consumers endure and to appreciate the courage
and persistence it takes to reconstruct lives that
must be lived, through no fault of the consumer or
family, “on the verge” (NAMI, 2002, p. 1).Education Groups.The goal of an education group
is to provide information to members on a specific
issue—for instance, stress management, medication
management, or assertiveness training. The group
leader has expertise in the subject area and may be
a nurse, therapist, or other health professional. Edu-
cation groups usually are scheduled for a specific
number of sessions and retain the same members for
the duration of the group. Typically the leader pre-
sents the information, then members can ask ques-
tions or practice new techniques.
In a medication management group, the leader
may discuss medication regimens and possible side
effects, screen clients for side effects, and in some
instances actually administer the medication (for in-
stance, depot injections of haloperidol [Haldol] deca-
noate or fluphenazine [Prolixin] decanoate).Support Groups.Support groupsare organized
to help members who share a common problem cope
with it. The group leader explores members’ thoughts
and feelings and creates an atmosphere of acceptance
so that members feel comfortable expressing them-
selves. Support groups often provide a safe place for
group members to express their feelings of frustration,
boredom, or unhappiness and also to discuss common
problems and potential solutions. Rules for support
groups differ from those in psychotherapy in that
members are allowed—in fact, encouraged—to contact
one another and socialize outside the sessions. Confi-
dentiality may be a rule for some groups; the members
decide this. Support groups tend to be open groups in
which members can join or leave as their needs dictate.
Common support groups include those for cancer
or stroke victims, persons with AIDS, and family
members of someone who has committed suicide.
One national support group, Mothers Against Drunk
Driving (MADD), is for family members of someone
killed in a car accident caused by a drunk driver.Self-Help Groups. In a self-help group,members
share a common experience, but the group is not a
formal or structured therapy group. Although pro-
fessionals organize some self-help groups, many are
run by members and do not have a formally identi-
fied leader. Various self-help groups are available.
Some are locally organized and announce their meet-
ings in local newspapers. Other groups are nation-
ally organized, such as Alcoholics Anonymous, Parents
Without Partners, Gamblers Anonymous, or Al-Anon
(a group for spouses and partners of alcoholics), and
have national headquarters and Internet websites
(see Internet Resources).
Most self-help groups have a rule of confidential-
ity: whoever is seen at a meeting or what is said at the
meetings cannot be divulged to others or discussed
outside the group. In many 12-step programs, such
as Alcoholics Anonymous and Gamblers Anonymous,
people use only their first names so their identities are
not divulged (although in some settings, group mem-
bers do know one another’s names).3 PSYCHOSOCIALTHEORIES ANDTHERAPY 65