Stages of a Group and Yalom’s Therapeutic Forces
This is a continuation of discussing group therapy (starting from the introduction).
Dr. Irvin D. Yalom is the guru of group therapy, specifically interpersonal, and is mentioned in many research books and articles. Although Dr. Yalom’s textbooks read more like a novel, he makes group therapy and its purpose more relatable and fun in clinical practice than most resources. He was the first person to put a theoretical perspective on group work and believed that all groups had to go through specific phases.
Dr. Yalom is most known for his 11 therapeutic/curative factors that are mechanisms of effecting change in a person with group therapy. It’s also important to know the stages of groups were created by psychologist Dr. Bruce Tuckman (1965):
5 Stages or Phases of the Group
In the pregroup phase, the leader will consider the direction and framework of the group:
- Stage 1. Forming; the orientation phase. The leader is most active in this stage. Universal norms are discussed such as confidentiality, attendance, and rules of communication and participation are addressed. This is the stage that discusses the time frame/termination of the group.
- Stage 2. Storming; the transition phase. Anxiety, ambiguity, and conflict become prevalent as group members test and act-out behaviors to define themselves and the group norms. This stage creates an interpersonal climate where members should feel free to disagree with each other.
- Stage 3. Norming; the cohesiveness phase. Members develop group-specific standards (cohesiveness) and therapeutic alliance forms such as disapproving late-arriving members, or the level of anger/conflict that will be tolerated.
- Stage 4. Working; the performing phase. During this stage, individual growth and team productivity, and effectiveness occur. Members experiment with new ideas or behaviors and egalitarianism develops.
- Stage 5. Adjourning; the termination phase. The closure for the group as a whole or the individual that left. The primary task is to discuss and review actual outcomes and achievements, explore feelings of what worked (and what didn’t), and any feelings of loss. Introducing new concerns or initiatives is not appropriate.
To remember the stages of groups, the best mnemonic I could think of was; I had to form a storm in the north (norm) and then work or adjourn. Another reason for knowing the group stages is for documentation and understanding how to gauge the group productivity plus strengths and weaknesses.
Relating these processes/terms were overall very useful for remembering key points and measuring the group dynamics.
Dr. Yalom’s Therapeutic Forces in Groups
- Instillation of Hope: encouragement that recovery is possible by sharing stories and information.
- Universality: recognition of a shared experience and knowing a person’s problems are not unique.
- Imparting of Information: teaching about problems and learning factual information about treatment options.
- Altruism: helping and supporting others by experiencing the ability to help another person can build self-esteem. It helps to develop adaptive coping mechanisms.
- Simulation of the primary family: identifying & changing the dysfunctional patterns or roles one played in the primary family.
- Development of social skills: learning new ways to talk about feelings, observations, and concerns.
- Imitative Behavior: modeling another’s manners & recovery skills.
- Interpersonal Learning (modeling, vicarious learning): finding out about themselves & others from the group. Yalom also describes 3 important concepts with interpersonal learning; 1. The importance of interpersonal relationships, 2. The corrective emotional experience, and 3. The group is a social microcosm.
- Group Cohesiveness (belonging): the feeling of belonging to the group, and valuing the group.
- Catharsis: the release of emotional tension i.e. a burst of crying. Express emotions in a safe environment.
- Existential Factors (risk, responsibility): Learning to take responsibility for one’s own actions.
