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APA Task Force Report: ENCOUNTER GROUPS AND PSYCHIATRY

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heretik:

--- Quote from: "Ursus" ---
--- Quote from: "seamus" ---Interesting arguement! however the subjuct of SELF DETERMINATION is never mentioned..and the audience that those seminars are directed to are ADULTS. this having been said,how much of it has to do with the therapy via coercion that so many of us suffered,as children. I think we digress here.Didnt certain adults PAY to go to "encounter groups". What happened to free will? its one thing to pay,and go oneself. And quite another to sign a child in and write a check while sayin' bon chance,mon frer. Would one expect a child to take away the same message as an adult? Exactly what would be the most probable outcome of such a situation?
--- End quote ---
Yep. I totally agree with your take on how encounter groups can potentially really mess with concepts of free will and self determination, certainly more so when you are an adolescent. Opting for an encounter group experience implies that one can opt OUT as well. Not so when you're stuck in a program!


--- Quote from: "seamus" ---So just take the idea of this half assed therapy leading to a well, short term , fleeting and tempoary change. Hmmm.....once the shine wares off a subject will most likly be left with,huge self doubt,a feelin that he/she had been given a "bum steer",a certain amount of introspection, and x amount of anger.so one might say a certain emotional pendulum has gone both to,and fro. Where does it REALLY leave a subject? Could one suppose how a body could be confused at the prospect of finding out,that the truth had feet of clay?Or angry.....or depressed......
--- End quote ---
Personally, I tend to think a good part of that "shine" is due to all the endorphins and adrenalin released into your bloodstream during circumstances of crisis. Seriously, I think some folks can get "addicted" to that!  :D
--- End quote ---

This can be very true, Ursus.

Ursus:
From the above section, "5 - Dangers of Encounter Groups":

"Furthermore, many non-clinically trained leaders reject the medical or psychiatric definition of adverse effect; they may assert that the stressing of members to the point of experiencing such extreme discomfort that they require professional help is not a danger but an accomplishment of the encounter group and that these individuals, although they may temporarily appear worse, have in fact undergone a growth experience and will, in the long run, be more fully integrated individuals."[/size]
Gawd. What morons.

heretik:
Most encounter groups I had either been involved with or have discussed with others were temporary but the effects lasted a long time afterward. I guess I could compare it to being trampled by a herd of elephants. My identity (self) was being crushed.
 
The self: core identity or social creation?
A theme of modernism is the dichotomy between the universal and the individual. Although the construction of self is seen as an illusion by Eastern religions, the Western notion of self is that of an individualistic true self. This is reflected in the ancient Greek dictum "to thine own self be true". The foundation of psychoanalytic work rests on uncovering layers to reach deeper, more fundamental features of the individual. Most psychotherapy is based on this Westernized notion of the individual self, and in this psychotherapy is a child of modernism (Parry, 1991).

Excerpt from this article; http://apt.rcpsych.org/cgi/content/full/6/6/450

Ursus:

--- Quote from: "heretik" ---Most encounter groups I had either been involved with or have discussed with others were temporary but the effects lasted a long time afterward. I guess I could compare it to being trampled by a herd of elephants. My identity (self) was being crushed.
--- End quote ---
My guess is that the degree of damage also depends in part on how much choice you have in the matter of participating or not. When you can opt to walk away, both physically as well as psychologically, you can accept or not accept whatever is dished out on your terms. Of course, coercion kinda messes with whether that "choice" is truly volitional.

I also don't see how someone who isn't an adult can be said to "consent" to this. There's an implied informed perspective that can really only be acquired by living on one's own for a while. Imo, of course!

Ursus:
Next installment:

American Psychiatric Association Task Force Report No. 1 - 'Encounter Groups and Psychiatry', continued...

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The Promise of Encounter Groups: Applicability to Clinical Practice

Many have considered the fact that if the intensive group experience is so powerful and has so much potential for harm, then it is likely it must also have a great inherent potential for constructive change. As Carl Rogers has pointed out, whatever else one may say for face-to-face encounter groups, one must recognize their potency; individuals are intrigued by them and strongly drawn to the groups. Disregarding for a moment the question of enduring change, we must recognize that with great regularity participants describe the experience as a powerful and moving one.

The National Training Laboratories has, for two decades, had the problem of designing a well balanced laboratory which included a T-group and various other exercises designed to teach theory, to integrate the T-group experience into the total laboratory exercise, to focus the participants' attention on the application of his learning to back-home problems, etc. Almost invariably, however, the T-group has tended to eat up the entire laboratory; its attraction is so great that, unless strong precautions are taken, every other exercise is turned into another type of T-group. The American Group Psychotherapy Association, a large organization composed primarily of psychiatrists, clinical psychologists and psychiatric social workers, has had a similar experience. For many years the AGPA has sponsored a two-day institute immediately preceding its annual convention which was originally designed to consist of small group seminars with the mandate of exploring in depth some designated topic. These small groups have with such regularity evolved into encounter groups (despite the best efforts of the institute directors) that the sponsoring organization has made concessions in the format of the institute which allow their development in the experiential direction.

The source of the potency and attraction of the group is problematic: perhaps the groups offer a unique socially sanctioned opportunity for regressive behavior and impulsive expression; perhaps, too, participants are intrigued by the opportunity to explore themselves and to risk new and different behaviors.

Until recently the group therapy and encounter group fields represented two separate parallel streams of knowledge and practice. There has been of late, however, an increasing amount of cross fertilization. A few psychiatrists have been heavily involved in the National Training Laboratories and have led T-groups in NTL laboratories and a large number have been participants in T-groups. Furthermore, some psychiatrists have been leaders or participants in some of the newer forms of encounter groups; a few (the actual number is unknown) have been active in the organization and operation of growth centers. Many of these psychiatrists have introduced techniques they have learned in encounter groups into their psychotherapeutic work. In addition, many group therapy patients have had some encounter group experience and have attempted to introduce different approaches and techniques in their therapy groups. Consider the example of the "here-and-now". Long a well established technique in both individual and group psychotherapy and dating back to such theoreticians as Reich, Ferenczi, Strachey, Ezriel, Klein and Horney(22) the "here-and-now" has been vigorously implemented in the T-group. T-group trainers have been remarkably inventive in developing techniques which both plunge the group into the here-and-now as well as elucidate the here-and-now interpersonal and group processes; many group therapists have effectively applied these techniques to the therapeutic group process. Several accounts of encounter techniques applied to group therapy are described in a recent text.(4)

T-groups, springing from the field of social psychology, have behind them a long tradition of research in group dynamics. No comparable body of knowledge has been generated by group therapy, a field notoriously deficient in any systematic research. Thus, what is presently known of the basic science of group psychotherapy stems almost entirely from social-psychological research with task groups and T-groups; psychotherapy owes to the T-group much of its systematic understanding of such factors as group development, group pressure, group cohesiveness, leadership, and group norms and values. Furthermore, T-group research has elaborated a wealth of sophisticated research techniques and tools of which the group therapy field is now slowly availing itself. Thus far we have referred primarily to the traditional, responsibly led T-group. The current spinoffs of the T-group, the variegated new forms of the encounter group are, of course, even less research-oriented than the group psychotherapy field. They reflect in general the anti-rationalism of the present youth counter-culture and emphasize, particularly, emotional experience and expression. The groups generally place little emphasis on the cognitive working through of the experience; furthermore, the participants often do not espouse an ethos of change; they often come to the group not for the deliberate purpose of changing but to "turn on", to have an experience, to tune into their feelings. Within this framework, these groups have developed effective methods of evoking strong emotions in relatively brief periods of time. What relation does this have to psychotherapy? Generally, since 1943 when Franz Alexander(1) first formulated the concept of the "corrective emotional experience" psychotherapists have understood that an emotional experience is a necessary but not sufficient condition for change. Catharsis, though important, is in itself not, corrective; many individuals have powerful emotional experiences throughout their lives without learning from them or developing a sense of mastery. In dynamic psychotherapy, emotional experience and expression facilitate the therapeutic process in at least two major ways: first, the sharing and ventilation of strong affect deepens the therapist-patient or patient-other group members relationship; secondly, once the emotions are expressed and visible, the patient may be helped to recognize and to understand the irrational aspects and sources of some of his emotional reactions.

Some encounter group techniques to facilitate emotional expression  have proven useful for certain extremely schizoid, constricted individuals who have split off their affective life and who frustrate traditional therapeutic approaches by endlessly obsessing and intellectualizing. A powerful confrontive approach sometimes unfreezes these individuals and permits them to make rapid strides in therapy; indeed many therapists in California have referred such patients to encounter groups for this purpose. We note (and this is a point not often appreciated by clinically untrained encounter group leaders) that unfreezing is not equivalent to therapeutic change; it is a part process. But there is no reason to reject the possibility of therapy being conducted in stages, perhaps first an unfreezing, confrontive, affect-eliciting stage which results in rapid behavioral shifts and a second stage of working through the data generated by the first in an endeavor to make the behavioral changes more enduring. (The usefulness of encounter techniques as a stage in therapy is testable by research. Patients in ongoing individual therapy could be studied, with baseline date, before and after referral to an intensive short encounter group experience.) We must note, too, that many therapists have reported patients who have had an intense peak experience which, without subsequent working through, has resulted in marked and enduring improvement. Apparently in ways which we do not fully comprehend, a peak experience can serve as an internal reference point and counteract subsequent periods of despair or hopelessness.

For many years the length of the group therapy meeting was fixed; the ninety-minute meeting was part of the entrenched folk wisdom of the field. The encounter group field has, however, experimented with a large number of variations on the duration of the meeting: group meetings may last from several minutes, in some micro-lab techniques, to a marathon of forty-eight hours. Recently there has been a carryover into group therapy and many clinicians report experimentation with the time variable. Groups are described which meet regularly for four-, six- or eight-hour sessions; some therapists choose to meet less frequently but for longer sessions, for example, a six-hour meeting every other week; some psychiatric wards have instituted an intensive group therapy week where the patients meet in small groups for eight hours a day for five consecutive days; two clinicians(20) report favorable results with a "saturation group therapy" approach in which their patients meet for 16 weekends in each of which they spend approximately fifteen hours in group therapy.

Another influence on the practice of psychotherapy stemming from encounter groups is an increased emphasis on non-verbal behavior. Although traditional psychotherapeutic practice has for decades recognized the importance of non-verbal communication, it has failed to make maximal use of this knowledge. Non-verbal behavior may be important in at least two ways: 1) sometimes patients may communicate an affect non-verbally when they are unconscious or only dimly aware of the affect. Recognition and interpretation of the non-verbal act, gesture or posture by the therapist may assist the patient in his self-understanding. 2) At times the therapist may prescribe some non-verbal act which may help to explicate some important inter- or intrapersonal theme. (The prescribed behavior generates data by making explicit what had previously been implicit.) For example, if the group members are bitterly, but unknowingly, engaged in a status struggle, the group leader may ask the group to arrange themselves physically in a line according to their perceived hierarchy of influence. Such structural interventions are commonly used in encounter groups and some, if well selected and well timed, have been used effectively by group therapists.

Another important area of impact of encounter groups on the field of  psychiatry has occurred in the training of clinicians. The sensitivity training group was originally conceived as a technique of education; soon after its inception, group dynamicists recognized that personal involvement in a human relations group could be an extremely effective means of learning about both group dynamics and one's interpersonal behavior. For the last several years, a large number of psychiatric residencies have offered an experiential group as part of the training program in group therapy. Occasionally these groups develop (fortuitously or by design) into therapy groups, but generally they are led in a here-and-now based sensitivity group design. Most educators hold that it is as important for group therapists to have had some personal group experience as for individual therapists to have had some personal individual therapy. The American Group Psychotherapy Association which has formulated training requirements for accreditation as a group therapist, suggests a minimum of sixty hours as a participant in an experiential group. Such a group allows the trainee to experience personally the role of a member, the process of group development, the coercive power of group pressures, the threat of self-disclosure and the unrealistic expectations that members have of the group leader. Trainees profit most from their group experience if the leader helps them maintain a participant-observer role in which they involve themselves in the affective life of the group but yet retain the capacity to step back at appropriate times to appreciate the process of the group.


Encounter Groups and Psychiatry
© American Psychiatric Association

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