Clinical Psychology

CHAPTER SUMMARY

KEY TERMS

WEB SITES OF INTEREST

O

ne could argue that most of the problems that

bring patients to therapy are acquired and

maintained in a social context. It is very likely

that current emotional and behavioral problems

have been influenced, to some degree, by past

interpersonal dysfunction. A marital conflict, by

definition, involves two people. An unassertive

salesperson manifests his or her problem in interac-

tions with customers. Children’s disruptive behav-

ior often occurs in the context of family

relationships. Therefore, inasmuch as the strands

of human misery are woven so tightly into the fab-

ric of social relationships, should we not consider

forms of therapy that take place in a group or

dyadic setting?

In addition, proponents maintain, group and

family therapies are more economical. Seeing

patients individually for therapy is, they argue, sim-

ply not a rational response to the mental health

needs of society (Kazdin & Blase, 2011). The eco-

nomics of health care has led many insurers to

demand more efficient and less costly forms of

mental health treatment. Whatever the reasons, a

variety of methods for treating a number of patients

at one time, including group therapy, family ther-

apy, and couples therapy, have become increasingly

popular. In this chapter, we discuss group therapy,

family therapy, and couples therapy in some detail.

Group Therapy

A Historical Perspective

For many years, group therapy was practiced as a
method of choice by only a handful of dedicated
therapists. Others used it primarily because their
caseload was so heavy that group therapy was the

only means by which they could deal with the

overload. Still other therapists used group therapy

as a supplementary technique. During individual

therapy, for example, a therapist might work

toward getting a patient to achieve insight into his

pathological need to derogate women; then, during

a group session, other members of the group might

reinforce the therapist’s interpretation through their

reactions to the patient. Instead of being seen as a

second choice or supplementary form of treatment,

however, group methods have now achieved con-

siderably more visibility and respectability.

One of the earliest formal uses of group meth-

ods was Joseph H. Pratt’s work with tubercular

patients in 1905. This was an inspirational approach

that used lectures and group discussion to help lift

the spirits of depressed patients and promote their

cooperation with the medical regimen. A major

figure in the group movement was J. L. Moreno,

who began to develop some group methods in

Vienna in the early 1900s and, in 1925, introduced

his psychodrama to the United States. Moreno also

used the termgroup therapy. Trigant Burrow was a

psychoanalyst who used the related termgroup anal-

ysisto describe his procedures (Rosenbaum, 1965).

In the 1930s, Slavson encouraged adolescent

patients to work through their problems with con-

trolled play. His procedures were based on psycho-

analytic concepts. These and other figures have

been identified as pioneers of the group movement

(American Group Psychotherapy Association, 1971;

Lubin, 1976).

As was true for clinical psychology generally, it

was the aftermath of World War II that really

brought group methods to center stage. As we

have observed before, the large number of war

veterans sharply increased the demand for counsel-

ing and therapy. The limitations of the existing

agency and hospital facilities made it necessary to

use group methods to cope with the immediate

demand. Once these methods had gained a foot-

hold in the terrain of pragmatism, respectability

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