In today ‘s article we will focus on an innovative model of brief group therapy based on the work of psychiatrist Irvine Yalom (1983) , included in the Program Employed for Persons (PEP ) for patients with addiction problems, carried out at Eagleville Hospital ( Pennsylvania) , a hospital facility that offers different levels of assistance ranging from acute psychiatric hospitalization to specialized residential addiction treatment (Weiner, 1987).
What is the Employed for Persons (PEP) Program?
The Program Employed for Persons (PEP) is a program that has adopted a new format of group therapy suitable for people who are on short-term stays at Eagleville Hospital. The model was used with over five hundred patients who had successfully completed treatment for two years already.
How is it different from a traditional group therapy model?
Traditional hospital group therapy is unstructured , involves periodic patient participation, focuses on past events, and has a longitudinal time period with no scheduled end . Furthermore, the therapist is a facilitator who, in general, expects patients to appropriately address some issues useful for group discussion and analysis.
How does group therapy based on Yalom’s model proceed?
Yalom ‘s new short-term model uses the time frame of a single session (group life is a single session) and involves structured participation of all patients in each session. The focus of the therapy is centered on the “here and now” and the work allows the therapeutic process to be completed even without the cohesion of the group. Therapy structured in this way promotes a sense of mastery and efficacy in patients who formulate concrete activities to be performed related to specific problems.
What is the role of the therapist in this form of therapy?
Yalom’s model foresees a structured intervention in which the therapist together with the co-therapists actively lead the group, coordinating the participation of each patient. Therapists’ interventions are always positive and supportive , aimed at emphasizing strengths and positive outcomes rather than weaknesses and deficiencies. The overall purpose of the group is to help each member explore and improve interpersonal relationships that relate to their addiction and their recovery .
To which patients is it preferable to propose this type of intervention and for which problems?
This format of therapy is designed for patients who are higher functioning , are more verbal , are not cognitively impaired, and have a supportive social network . The same problems brought by the patients must not be of an urgent nature and can be worked through through other forms of therapy (e.g. individual and/or family sessions).
Now let’s see how a single group therapy session is structured!
Each session lasts 90 minutes and is divided into the following phases:
- Group orientation and preparation (5 minutes).
At the beginning of the intervention, the purpose of the group, the structure and the way of proceeding are introduced. This happens every session and is especially useful for new members.
- Agenda agenda (30 minutes).
Each member briefly formulates a problem to address in that meeting. Personal agenda items should be related to the patient’s addiction and recovery and should involve one or more of the following areas:
- interpersonal issues
- social functioning
- professional concerns
- management of psychosocial stress (i.e. anxiety and/or depression).
As the patients formulate their problem, the therapist writes them on a large pad next to the patient’s name. This serves as a visual reminder of each patient’s agenda item for that session.
- Filling the Agenda (35 minutes).
Patients are called one at a time, in this way the leaders facilitate the work and it is possible to focus on more points on the agenda. Once the patient has stated why she thinks his problem is important, the leaders invite other group members to provide input.
Inputs can be of two types:
- relating to personal experiences that may be of help to the patient who is facing the same problem;
- comments on the patient’s behavior and interactions in the group or on the unit, which concern the more hidden issue.
- Review and conclusion (20 minutes).
The group ends with an elaboration that foresees the contribution of both the therapists and the patients, who choose a concept or a general theme that represented that group. The guiding question is “What did you learn in this session?” . The essay is then written by each patient in his logbook.
In this article we have addressed for the first time the single-session intervention in the context of group therapy . This, in addition to showing us once again how the TSS method can be applied to different therapeutic approaches, allows us to grasp some of its advantages .
The first concerns the temporal aspect . The time interval of the single session makes the group tool more flexible which, while remaining a constant of the intervention, can change its composition and allow new people to join it.
The second concerns the sense of self-actualization that patients experience every time they participate in the session, formulating a point on their personal agenda, feeling helpful to others and carrying out a specific task to be accomplished in a defined time.
Finally, the third concerns the opportunity that the structured form of therapy offers to each patient, giving him the opportunity to identify the issues that will also have to be addressed after the therapy.
Team Psychotherapist of the Italian Center
for Single Session Therapy
Weiner, D., H. (1987). An Innovative Short-Term Group Therapy Model for Inpatient Addiction Treatment. Employee Assistance Quarterly, 2:4, 27-30.
Yalom, I. (1983). Inpazient Group Psychotherapy. Basic Books.
Yalom, I. (1985). The Theory and Practice of Group Psychotherapy. Basic Books.
Brown, S. & Yalom, I. (1977). Interactional group therapy with alcoholics. Journal of Studies on Alcohol, 38(3).
Mavcs, P. & Schulz, J. (1985). Inpatient group treatment on short-term acute care units. Hospital and Communiy Psychiatry. 36(1, Jan.).