The psychoanalytic group situation.

This article explores the theoretical and clinical underpinnings of a specific form of group-centered psychotherapy. In this modality, the nature of the phenomena developing in the clinical situation are related to the prevailing levels of the therapeutic regression occurring in the group. It is suggested that the most regressive phenomena tend to be experienced as groupwide phenomena with individual members assuming the position of part objects, whereas lesser degrees of regression center on the experience of whole-object relations. Five dimensions of the therapeutic situation are explored: regression, the group as a setting, the nature of anxiety, the creation of objects, and symbolization. This model allows for a differentiated exploration of therapist-centered and peer-centered transferences. A session is discussed in detail.

The context of transference interpretations in analytical group psychotherapy.

Transference interpretation varies with the underlying understanding of the concept of transference. We view the phenomena of transference in its multiple connections; its relationship to countertransference, its relationship to a particular kind of remembering that unfolds in sequence rather than in representation and its relationship to working through. The transference is expressed in the context of a "total situation" and in order to unfold, requires a time-space frame which variation will modify the nature of the transference available for interpretation. The analytical frame applied to a group situation creates an environment that promotes rapid and sometimes massive regression. We have introduced the notion of levels of transference to account for the state of self/object differentiation present in the group. This varies with the amount of regression, and depends on the severity of splitting, projection and projective identification. In terms of transferential objects available in the group, we recognize the analyst, other members and the group as a whole. The latter carries the more primitive transference and the underlying phantasy structure of the group transactions. We briefly described some possible errors in the interpretation of transference and their potential consequences.

On the concept of psychoanalytic work.

A set of criteria for psychoanalytic work that can be used to define various forms of psychoanalytic therapy is proposed. Four patients who were involved in short-term individual psychotherapy with the same therapist, but who evidenced considerably different therapy process and outcome, are used to illustrate the criteria. Implications for practice and research are cited.

Relationships between the object focus of therapist interpretations and outcome in short-term individual psychotherapy.

The relationships between the object (person) focus of therapist interpretations and outcome were examined for 21 patients who received short-term individual psychotherapy. Percentages of single objects and linked objects, e.g. therapist-parent link, were derived from an analysis of the therapy sessions. Patients, therapists and an independent assessor provided pre-therapy, post-therapy and six-month follow-up outcome scores. Contrary to other reports in the literature little evidence was found to support the hypothesis of a direct linear relationship between object focus and favourable outcome. Several explanations for the findings are discussed.

Pretraining for group psychotherapy. A cognitive-experiential approach.

Pretherapy training for group psychotherapy is conceptualized in terms of learned conditions of preparedness (objectives) and in terms of methods of preparation (procedures). Controlled studies of pretraining for group psychotherapy were reviewed in reference to these two dimensions and their effects. A controlled study of pretraining involving five outpatient therapy groups that used a new cognitive-experiential approach to pretraining was performed. Pretrained groups had significantly higher patient attendance and significantly fewer dropouts than nonpretrained groups.

An outcome study of group therapy.

Outcome research in a group therapy program was conducted with therapists in training who had little prior experience with group therapy. Significantly greater improvement over an initial three-month period was found for treated patients when compared with control patients on a multivariate combination of five outcome criteria. Some, but not all, of the five separate criteria indicated such a difference. Only slight, nondifferentiating improvement was found for target symptoms. Significantly greater improvement over the three-month period on the multivariate combination was also found for treated patients who had begun therapy during the second year of the program when compared with treated patients who had begun therapy during the first year of the program. Finally, significant improvement over the three-month period on the multivariate combination was found for both treated and control patients.