therapeutic factors represent different parts of t
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NRNP 6675
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NRNP 6675 Week 5: Therapeutic value of
groups
11 primary factors of the therapeutic experience - ANS 1. Instillation of hope
2. Universality
3. Imparting information
4. Altruism
5. The corrective recapitulation of the primary family group
6. Development of socialising techniques
7. Imitative behaviour
8. Interpersonal learning
9. Group cohesiveness
10. Catharsis
11. Existential factors
Therapeutic factors - ANS Therapeutic change is an enormously complex process that occurs
through an intricate interplay of human experiences
therapeutic factors represent different parts of the change process. - ANS Interpersonal
learning - cognition
Socializing techniques - behavioural change
Catharsis - emotion/affect level
Cohesiveness - precondition for change
1. Instillation of hope - ANS - The installation and maintenance of hope is crucial in any
psychotherapy.
- Hope is required to keep clients in therapy - don't believe in something, it won't work.
- Faith in a treatment can in itself be therapeutically effective. A high expectation of help before
the start of therapy is significantly correlated with a positive therapy outcome.
- Selection of diverse clients along the coping-collapse continuum.
- A positive outcome à more likely when the client and therapist have similar expectations
2. universality - ANS - Many individuals enter therapy with the thought that they are unique in
their wretchedness.
- To some extent this is true for all of us, but many clients, because of their extreme social
isolation, have a heightened sense of uniqueness.
- Their interpersonal difficulties stop them from being validated and accepted by others.
- Disconfirmation of a client's feelings of uniqueness is a powerful source of relief.
- Clients express great relief at discovering that others share the same problems.
, - consensual validity: Establishing consensus between observers about the validity or objectivity
of an observation or perception - what we are going through is not that abnormal.
o H.S. Sullivan: The process whereby patients/ clients compare their own feelings and
responses to certain life experiences with the feelings and responses (behaviours) of other
individuals who have had similar experiences.
- Patients can experience heightened self-efficacy and confidence when they establish that
others, who have
had similar experiences, reacted similarly to those situations.
3. imparting information - ANS 1. Didactic Instruction
2. Direct advice
1. didactic instruction - ANS - Many group therapy approaches have made use of
psychoeducation (formal instruction) as an
an important part of the program.
- NB! Learning takes place in a group environment.
- Ideal context = one of partnership and collaboration.
- These groups offer clear instruction about the nature of the client's illness or life situation and
examine the client's misperceptions and self-defeating responses to their illness.
- Group settings are the best place to teach mindfulness- and meditation-based stress reduction
approaches.
- The first step towards control is the explanation of a phenomenon.
2. Direct advice - ANS - Direct advice from members occur in every therapy group.
- In dynamic interactional therapy groups, it is invariably part of the early life of the group and
occurs with such regularity that it can be used to estimate a group's age.
- Advice-giving may reflect a resistance to more intimate engagement in which the group
members attempt to manage relationships rather than to connect.
- The process of giving advice, rather than the content of the advice, may be beneficial, implying
and conveying mutual interest and caring.
- Direct suggestion = the least effective form of advice.
4. Altruism - ANS - Members gain through giving.
- Many psychiatric patients beginning therapy are demoralised and possess a deep sense of
having nothing of value to offer others.
- Group therapy is the only therapy that offers clients the opportunity to benefit others.
- Encourages role versatility - requiring clients to shift between roles of help receivers and help
providers.
5. Corrective recapitulation of the primary family group - ANS - Majority of clients who enter
have a background of a highly unsatisfactory experience in their 1st and most important group
primary family.
- A therapy group resembles a family.
- Enactment of familial patterns of interaction
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