factorsisneededtobetterunderstandwhyand
how group therapy works (Bednar & Kaul, 1994;
Burlingame et al., 2004; Rose, 1991).
The Future of Group Therapy
Despite the economy and efficiency of group treat-
ments, they appear to be underutilized. One major
reason is that clients and therapists alike tend to
view group therapy as a second-choice form of
treatment. Fewer clients are referred for group ther-
apy as compared with other forms of treatment, and
even those who are referred may not follow
through and join a group. However, there is evi-
dence that the demand for group therapy may be
increasing (Burlingame et al., 2004).
Managed behavioral health care is likely to
make group therapy a more viable option in the
future (Steenbarger & Budman, 1996). Group ther-
apy is attractive to therapists and managed care
organizations because it can save staff time (and ulti-
mately money) in the care of less severely disturbed
patients (MacKenzie, 1994), and it offers an
alternative to inpatient treatment in some cases
(Steenbarger & Budman, 1996). However, to take
advantage of these opportunities, group therapists
need to better educate the public and health care
professionals about this mode of treatment, aggres-
sively lobby governments and managed behavioral
health care companies to financially support group
therapy as a service, and better educate themselves
about managed care and the health care needs that
remain unfulfilled (Steenbarger & Budman, 1996).
Family Therapy
Generally, when a member of a family develops a
problem, everyone in the family is affected. Increas-
ingly, families are going into therapy as units in an
attempt to fathom the nature of their difficulties and
the means by which to deal with them. Family ther-
apy is a burgeoning field, as indicated by the numer-
ous handbooks and overviews of the field that appear
every year. Further evidence of this interest is the
special sections on the treatment of families that
appear frequently in clinical journals such as the
Journal of Consulting and Clinical Psychology.
However, it is important to note that family ther-
apy differs somewhat from simply involving family
members in treatment. Indeed, it is quite common to
involve parents in the treatment of youth, or sporadi-
cally to involve spouses, siblings, or additional support
members in the treatment of patients more generally.
In fact, most therapeutic approaches with children
involve substantial interaction with parents to help
change the context in which children are raised.
Some therapists may even refer to these instances as
“family therapy sessions.”Yet, true“family therapy”
often is characterized by a unique approach to treat-
ment involving the conceptualization of psychological
symptoms as arising from the family system.The Development of Family Therapy
Fruzzetti and Jacobson (1991) trace the origins of
family therapy to the 19th-century social work
movement. However, family therapy did not
immediately gain prominence. It was not until the
mid-20th century that family therapy became a
popular form of treatment. Some of the delay had
to do with the long-standing dominance of psycho-
analysis. The perspectives of behaviorism and
humanism paved the way for an alternative treat-
ment like family therapy to become a viable option
for clinicians. The problems of individuals were
conceptualized in systemic terms, as a manifestation
of some type of family dysfunction. This new per-
spective on clinical problems was most evident in
some of the conceptualizations of severe mental
disorders such as schizophrenia.
In trying to understand schizophrenia, a Palo
Alto research group (Bateson, Jackson, Haley,
Satir, and others) approached the problem from a
communication point of view. To influence a fam-
ily member, one must deal with the entire family
system (Jackson & Weakland, 1961). Related to the
idea of the family as a unit is the concept of the
double-bind(Bateson, Jackson, Haley, & Weakland,
1956). For example, a child might be told by a
father,“Always stand up for your rights, no matter
who, no matter what!”But the same father tells the440 CHAPTER 15