Preface
Introduction
1. Beginnings
The Parable of the Long Spoons
Demystifying the Group Experience
Considerations in Starting a Group
How Group Can Add Value to Individual Treatment
How Group Can Free Up the Therapist
Introducing Group
Clarifying How Group Can Help
2. Theory that Has Informed My Group Perspective
Wilfred Bion
Melanie Klein
Otto Kernberg
D. W. Winnicott
Margaret Mahler
Rene Spitz
Yvonne Agazarian
3. Things to Keep in Mind When Introducing Group
Translating Symptoms, Presenting Problems, and Complaints into Therapeutic Goals
Differentiating Self-Esteem from Self-Image
Character: Patterns of Behavior that Endure Over Time
4. A General Approach to Facilitating Group
Continuing to Do What They Do or Trying Something Different
Engaging Role Locks
5. General Considerations in Facilitating Group
The Support Trap
Patients in the Victim Position
Trauma
Self-Disclosure of the Therapist
Countertransference
Approaching Dreams in Group
6. Frames of Reference
All Behavior Has a Purpose
Me/Not Me
Empathic Attunement
Know Your Chickens
Disbelieving the Patient
There Is No Objective Reality
Look-Alike Events
Making the Relationship More Important than the Content
Should We Care about Our Patients?
Support Groups
What Didn't Work in Your Last Therapy?
7. Therapeutic Stance with Patients
Your Nickel in the Dime
Observing Self/Experiential Self
Differentiating the Therapeutic Alliance from a Positive Transference 48
Establishing Mutual Assumptions
General Therapeutic Posture and Interventions
Reinforcement of Perspectives, Patterns, and Mutual
Assumptions
Initial Consultation
General Interview Questions
8. Practical Considerations
To Zoom or Not to Zoom: Dealing with Technology
Fees, Payments, and Other Practicalities
9. Preparing the Patient for Group
The Parallel Process in the Here-and-Now Experience
Group Norms and Agreements
Importance of Not Taking Feedback Personally
Finding Leverage in Dealing with the Secondary Gains of Dysfunctional Behavior
Goodness of Fit
Adding New Members
The Group Contract
10. Establishing A Group Therapy Culture
Useful Interventions in Developing a Group Culture
Challenging Moments: Using a Group-as-a-Whole Perspective
Framing an Experience
Ambivalence Framed as Competing Parts of the Patient
Helping Patients Shift Their Communication Pattern from Explaining to Relating Effectively: Using Agazarian's "Explain vs. Explore"
Helping Patients Move from Intellectualization
Helping Patients Identify Their Feelings
Dysfunctional Roles that Emerge in Group
11. Character Styles that Are Common in Group
Borderline Personality Disorder and Tendencies
Splitting
Bipolar Symptoms and Borderline Tendencies
Narcissistic Personality Disorder and Tendencies
Confusing a Narcissist's Need for Love with Love for the Patient
Witnessing a Rupture and Repair in Group
Projection and Projective Identification
Recognizing and Addressing Dysfunctional Roles and Role Locks
12. Common Clinical Issues Encountered in Group
Working with Depression
Happiness Cannot Be Pursued—It Must Ensue
Boredom
Working with Anger
Reminding the Group to Stay in the Here and Now
Using Present-Focused Language
Patients Who Have Difficulty Accessing Feelings
Patients Who Feel Nothing
Chitchatting
A Goldilocks Moment
Addressing Avoidance and Distraction
13. Common Challenges in Group
Scapegoating
Handling Enactments
Member Dropping Out Abortively
The Silent Group
Making a Group Member the Identified Patient
Dysregulated Patients
Addressing the Protest of "Blaming the Victim"
The Parable of the Sixteenth Dragon
Conflict vs. Deficit
Flooding
Addressing Breakdowns in Communication
The Defensive Use of Asking Questions
14. The Use of Fables
Kissing the Frog
The Three Little Pigs
Sleeping Beauty
Icarus
The (Other) Parable of the Sixteenth Dragon
15. Challenging Moments in Group
Addressing Potentially Explosive Topics
Useful Interventions in Challenging Moments
Dealing With the Elephant in The Room
Witnessing Repair in Group
Tolerating Guilt and Shame
Recognizing Cognitive Dissonance in Group
Dealing with Cognitive Dissonance
The Good Fortune of Being in a Group with Members You Can't Stand
The Experience of Safety in Group
Exploring the Experience of Safety
16. Group Snapshots
A Solution to Being Lost in the Woods
Reinforcing "What Do You Need from the Group Right Now?"
Witnessing in Group
Defensive Styles in Group
Process vs. Content
The "Don't Ask, Don't Tell" Group
Group Member Bolts Out of the Session
Tendencies to Blame and Complain
Addressing Nonverbal Provocations
Using the Patient's Words
17. Endings
Reframing "We're Going Around in Circles"
The Process of Termination
It's All Grist for the Mill
References
Index
