LEAVING THERAPY PARTICIPANTS FROM THE GROUP. PART 1

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

For many leading psychotherapy groups, especially beginners, there is no problem as disturbing as leaving the group. However, leaving the group is not only inevitable, but also a necessary part of the sifting process that accompanies the formation of group cohesion.

A certain mechanism of decompensation should function in the group: mistakes in the selection process are inevitable; unexpected events occur in the life of newcomers; incompatibility develops in the group.

Some intensive training or meeting groups that last a week and are held in geographically isolated locations lack this very opportunity to leave. According to I. Yalom, in such situations, psychotic reactions can develop due to the forced stay in a group with which the participant was incompatible.

Participants who prematurely leave the group are characterized (according to I. Yalom):

-decreased motivation;

- weakly expressed positive emotions;

-use of drugs and alcohol;

-high somatization;

-intense anger and hostility;

-lower socioeconomic class and social efficiency;

-decreased intelligence;

-insufficient understanding of the principles of group work;

- less attractive (in the opinion of therapists).

It is useful to approach the phenomenon of premature leaving a group in terms of the interaction of three factors: the participant in the therapy, the group, and the therapist. In general, the participant's contribution is due to the problems caused by deviance; conflicts in the sphere of close relationships and self-disclosure; external stress; complications associated with the simultaneous passage of individual and group therapy; the inability to “share” the leader with other group members and the fear of “emotional contamination”. Added to all of these reasons is the stress that accompanies the early stages of being in a group. Participants with maladaptive interpersonal patterns find themselves in situations that require them to be close and open. They are often confused about the procedure, suspect that the group's work is not directly related to their problem, and at the first meetings do not feel the support that would help them save hope.

The most important methods of preventing premature withdrawal of participants from the group are careful selection and comprehensive pre-therapy preparation. During the preparation, it is important to make it clear to the participant in the therapy that during the psychotherapeutic process he will inevitably have to endure despondency and discouragement. Participants are less likely to lose faith in the therapist if the therapist is able to make predictions based on their experience. It is helpful to emphasize that the group is a social laboratory. The therapist can tell the participant that they are faced with a choice: make their participation in the group another example of failure, or experiment with new behaviors in a low-risk situation. However, with all the efforts and professionalism of the group leaders, there will definitely be members who will think about leaving the group. When a participant informs the facilitator that he wants to leave the group, the traditional tactic is to try to convince the participant to attend the next meeting and discuss their intentions with other participants. Behind this tactic is the assumption that the group members will help the member work through their resistance, thereby convincing them not to abandon the group. I. Yalom, examining 35 participants who dropped out of nine treatment groups, found that each of the dropped out was persuaded to attend another meeting, but this never prevented early interruption of therapy. From this, Yalom concludes that attending the last class is an ineffective use of group time. Not having as much experience as the esteemed Dr. Yalom, I still would not be so categorical and use the strategy of persuading a participant who wants to leave the group to attend another meeting. Many years ago, while still a member of a psychotherapy group, I had the opportunity to take part in the work of a group that one of its members wanted to leave. As a result of persuasion from the leaders, the participant agreed to attend another meeting, during which the reasons for his desire to leave the group were discovered, which resolved his conflict and allowed him to work effectively in the group in the future.

Leaders of groups can reduce rates of premature leaving by paying close attention to the problems of the first stage of the group. Therapists should try to balance the self-disclosure of group members, as overly active and overly passive members are at risk of leaving the group prematurely.

Negative feelings, anxieties, and fears about the group should be addressed rather than hidden away. In addition, the therapist should strongly encourage the expression of positive emotions and, if possible, set an example.

It is very important for group leaders to control their fearful thoughts about the fact that one by one the participants will leave the group, and one day they will come to the meeting room and find only themselves there. If this fantasy is allowed to take over completely and completely, the therapist ceases to be the therapist for the group members. He will begin to cajole, seduce the participants in order to ensure their further participation in the work of the group.

The words of Yalom seem very important to me in order to quote them in full:

“By changing my own personal attitudes, I have ensured that therapy participants no longer refuse to join the group. But now I refuse that the participant would go to the group! I do not mean that I often ask therapy participants to leave the therapy group. However, I am quite ready to do this if the person does not work in a group."

Convinced that group therapy is a highly effective form of therapy, finding that the participant is unlikely to benefit from it, each therapist understands that it is preferable for such a participant to be removed from the group by offering him another, more suitable form. …