Methods and procedures used in group therapy

The main methods of group psychotherapy traditionally carry a panel discussion, psychodrama, psycho gymnastics, projective drawing and music therapy. Each of these methods can be used in therapy, and as an independent method. All methods of group psychotherapy conventionally divided into: basic and auxiliary, verbal and nonverbal. By verbal methods include group discussion and psychodrama, a non-verbal - psycho gymnastics, projective drawing and music therapy.

Group discussion is the basic reference method of psychotherapy. What is the subject of a group discussion? Usually there are a discussion of the patient's biography, certain themes and interpersonal interaction in the group (interactions). Thus, the determined orientation of the three main types of group discussion: biographical, thematic and Interactional. Interactional orientation focused on the analysis of features of interpersonal interaction in the group and situations that arise in the course of the group process. Biographical orientation is a discussion of the history of life of the patient, the individual episodes and events of his biography, his problems, conflicts, relationships, attitudes, characteristics of behavior throughout life. Thematic focus group focuses on relevant topics for the majority of participants in the group. Pivots group discussion: introduction of group members; discussion of patients' expectations, their fears and concerns, their experiences in connection with the beginning of work of the group and interact with other participants; experience and discussion group voltage associated with a mismatch between the expectations of patients and group reality, behavior therapist and what is happening in the group; resistance buildup and aggression towards the therapist to relate these experiences from the past experiences; autopsy true feelings to a therapist, their awareness, understanding their causes and processing, development of group norms in relation to the therapist; opening problems associated with autonomy, responsibility and activity, attitude to authority; the formation of an adequate attitude to the disease and treatment, motivation to participate actively in the work of the group; development of psychotherapeutic group norms and group culture, the adoption of its team members; dominance interactional perspective, the analysis of the dynamics of the group with access to the problems of individual patients - actually "working phase" group psychotherapy, during which solved its main task (correction and attitudinal, inappropriate reactions and behaviors, reinforcement and generalization of positive changes); discussion of the treatment of the results, conclusions.

Psychodrama can be considered as a method of group psychotherapy, which is a role-playing game, in which the necessary conditions are created for the spontaneous expression of emotions associated with significant patient issues. Psychodrama as a medical psychotherapeutic method was created and developed by Moreno based on the experience of his theatrical experiment "spontaneous theater", the original purpose of which was not associated with psychotherapy and was in the development and implementation of human creativity, his work in the "theater of life". In the course of playing situations arise spontaneity, creativity, genuine emotional connection between the situation of the participants, catharsis, promote the development of creative activity and the achievement of insight. All this creates a favorable basis for creative rethinking of their own problems and conflicts, development of deeper and more adequate self-understanding, to overcome the non-constructive behavior patterns and ways of emotional response, formation of a new, appropriate behavior and new ways of acting out emotional. psychodrama procedure assumes that the following participants: the protagonist, therapist, physician assistants, spectators. The protagonist - a patient (subject), Chief Executive, presenting the problems. Therapist (director, conductor, facilitator) - the organizer of the role-play to help the patient to explore their problems. therapist functions of the organization PD action, space, build confidence, encourage participants to spontaneity, the preparation of the protagonist and the entire group to the role-playing game ("warming up"), the identification of problems and patient experiences, commenting, the inclusion therein of the subsidiary characters, organization of discussion, emotional sharing, analysis, interpretation of what is happening. Therapist assistant - koterapevt patients and performing supporting roles in psychodrama and enhancing the function of the therapist. The audience - is the other group members not directly involved in the psychodramatic action, but to discuss the situation after its completion. Another "participant" is a psychodrama scene - the living space, a place where psychodramatic action unfolds. psychodrama process includes three main phases: an initial or preparatory ("warm-up" phase); in fact, psychodramatic action; discussion (giving the protagonist of various feedback and interpretation). Psychodramatic procedures are widely used in the conduct of humanistic-oriented psychotherapy, Gestalt therapy, training methods.

Psycho gymnastics refers to a non-verbal methods of group psycho-therapy, which is based on the use of motor expression. Psycho gymnastics involves expression of feelings, emotional states, the problems with the help of movements, facial expressions, pantomime. Psycho gymnastics allows patients to express themselves and to communicate without words. Psycho gymnastic lesson consists of three parts - the preparatory, pantomime and final. Pantomimic part of psycho gymnastics is the most important. Patients suggest topics that they play without words. Topics may be offered and the therapist, and by the members of the group. Content for the pantomime is not limited and can be focused both on the individual patient's problems and the concerns of all members of the group at the same time and the group as a whole, that is touching interpersonal interaction in the group. Psycho gymnastics in the process of group psycho therapy is usually conducted as a separate exercise. However, at the beginning of the panel discussion with the therapist need to offer some psycho gymnastics task group.

Projective drawing. The main objective of the projective drawing is to obtain additional information about the problems of individual patients or the group as a whole. As psychodrama and psycho gymnastics, projective drawing facilitates the identification and understanding of difficult problems verbalized and patient experiences. Occupation is usually constructed as follows: each patient receives a sheet of paper, crayons (you can also use colored pencils and inks), and draws on a given topic. For projective drawing quality is not significant. The topics for the drawing, can be very diverse and relate to both the individual problems of individual patients, and the common group problems. Topics for drawing typically cover three areas: 1) the past, present and future patients (who I am, what I would like to be, how I appear to others, I am among the people, my family, my work, my most pleasant or unpleasant memories); 2) The general concepts that reflect certain values ​​and events (love, hate, illness, fear, health, relationship, responsibility, and 3) the relationship in the group (I group eyes, my position in the group, our group). Use also free themes (each member of the group draws what he wants) or co-drawing (the whole group at one large sheet of paper drawing, for example, a portrait of the group). On the drawing usually has 30 minutes. The group then went on to discuss each patient's drawings. Projective drawing can be carried out as a separate class, but sometimes it is useful at the beginning of the panel discussion.

Music therapy - a psychotherapeutic method that uses music as a healing agent. Considering the basic direction of the therapeutic effect of music, providing 4 aspects: 1) the emotional activation during verbal psychotherapy; 2) the development of interpersonal skills - communication functions and abilities; 3) regulating effect on the psycho-vegetative processes; 4) the development of aesthetic needs. As the mechanisms of therapeutic action of music therapy indicate: catharsis, emotional discharge, emotional state regulation, facilitating awareness of one's own experiences, the confrontation with life's problems, increasing social activity, the acquisition of new means of emotional expression, facilitating the formation of new relationships and attitudes. Music therapy exists in two main forms: active and receptive (passive). Active music therapy is a therapeutic approach, an active musical activity: playing, fantasy, improvisation using your voice or musical instrument selected. Receptive music therapy involves the process of perception of music for therapeutic purposes. Patients in the group will hear a specially selected music, and then discuss their own experiences, memories, fantasies (often projective nature) arising from them during the hearing. One lesson is heard, usually three pieces or complete musical passages (every 10-15 minutes). The first piece should form a certain atmosphere for the whole class, to show the mood of patients, develop contacts and enter into music classes, to prepare for further listening. This quiet work, characterized relaxing effect. The second product - a dynamic, dramatic, intense. It carries most of the load, its function is to stimulate intense emotions, memories, associations projective nature of the patient's own life. Third, the product should relieve tension and create an atmosphere of peace. It can also be calm, relaxing, or, on the contrary, vigorous, giving cheerfulness, optimism and energy. In group therapy is used and an active version of music therapy. This requires a set of simple musical instruments or objects make sounds. Patients are invited to express their feelings or to conduct a dialogue with any member of the group with the help of selected musical instruments. Alternatively, the active music therapy may be considered choral singing. Performance music therapist or a group of participants (together or individually) also has a therapeutic effect, contributing to the creation of a trust, a warm atmosphere.

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