was but a short distance away. As a result, nearly
every school or approach to individual psychother-
apy now has its group counterpart. There are group
therapies based on psychoanalytic principles, Gestalt
therapy principles, behavior therapy principles, and
many other types as well.
Approaches to Group Therapy
Different approaches to group therapy have ema-
nated from different theoretical origins, and the
descriptions of group therapy are couched in a
variety of theoretical languages. However, as we
saw with individual psychotherapy, experienced
group therapists of the same theoretical persuasion
often use quite different methods. Because of this
poor fit between what therapists do and where
they come from theoretically, it is difficult to
evaluate the similarities and differences among
approaches and, indeed, to describe in any
coherent way the methods used in a particular
approach. Nevertheless, the following approaches
seem fairly typical of the general group therapy
movement.
Psychoanalytic Group Therapy. As with indi-
vidual approaches to treatment, much of the work
in group therapy began from a psychoanalytic tra-
dition, Most forms of psychoanalytic group therapy
are basically psychoanalytic therapy carried out in a
group setting. Although there are obvious differ-
ences from individual psychotherapy (e.g., multiple
transference effects, modified therapist–patient
transference, and influences from one member to
another), the focus is still on phenomena such as
free association, transference, interpretation of resis-
tance, and working through. Although one can
hardly argue that group processes do not exist,
their role is viewed as secondary to that of individ-
ual processes. The group becomes a vehicle
through which the individual can express and even-
tually understand the operation of unconscious
forces and defenses and thereby reach a higher
level of adjustment. In general, this approach to
group therapy is considered “nondirective,” and
group processes may transpire with only subtle
input from the therapist. As will be seen below,
this approach deviates from more contemporary
group therapy strategies.
Wolf (1975) has emphasized that psychoanaly-
sis can occur in groups as well as on the individual
couch. Wolf believes that the dynamics of the
group are secondary to the individual analysis and
that the role of the therapist is key. In contrast to
individual psychotherapy, group therapy can permit
a deeper analytic experience because individuals can
“lean”on the group and thus increase their anxiety
tolerance. In addition, group members react to one
another, to the therapist, and to relationships of
authority and intimacy. By observing how others
in the group communicate with one another, by
participating in a situation in which the individual
is not the sole object of the therapist’s attention, and
by both receiving help from others and giving help
to them, the individual can achieve an analysis that
is more effective than it might be in the individual
therapy setting.
Typically, these groups consist of eight to ten
members (equal numbers of men and women) who
meet for 90 minutes three times a week. Sometimes
the group meets once or twice a week without the
therapist to facilitate the working through of trans-
ference relationships. Patients often free-associate to
their feelings about other members, report dreams,
and analyze resistance and transference feelings
toward both the therapist and other group mem-
bers. The following excerpts illustratepsychoanalytic
group psychotherapy.Psychodrama. Another historic approach to
group therapy involved“psychodrama.”This is a
form of role-playing that was developed by
Moreno (1946, 1959). The patients act out roles
much as if they were in a play. This acting is said
to bring about a degree of emotional relief (cathar-
sis) and spontaneity that heightens insight and self-
understanding. Patients may be asked to play
themselves or another role. At times, they may be
asked to switch roles in the midst of a dramatiza-
tion. The drama may involve an event from the
patient’s past or an upcoming event toward which
the patient looks with trepidation.GROUP THERAPY, FAMILY THERAPY, AND COUPLES THERAPY 433