Postwar period

Group psychotherapy moved from inspirational and didactic models to psychodynamic and analytic models in the postwar period.

United Kingdom

The group-analytic tradition

Based at the Maudsley Hospital after the Second World War, Foulkes gathered about him a small group of clinicians and others who developed his ideas and practices. Drawing on the ideas of Trigant Burrows, they called it group analysis and later established the Group-Analytic Society. Generations of clinicians went on to work or train with him at the Maudsley and elsewhere. His first book written in the heat of the Northfield experience, outlined the basics of his approach. A later text, written with James Anthony, has been in continuous publication ever since and remains one of the most widely read in the field. (33) Other publications followed and, with one of this paper's authors (MP) and other colleagues, training courses were established which lead to the founding of the Institutes of Group Analysis and Family Therapy, the Association of Family Therapists, and the Association of Therapeutic Communities. (34) There are now training courses in group analysis in many centres in the United Kingdom and continental Europe. The journal Foulkes established, Group Analysis, continues as the major publication in European group psychotherapy, there are regular European symposia, and increasing representation of and respect for group analysis at international conferences. Group-analytic psychotherapy has undergone clinical evaluation by a number of clinicians. (3 3 3Z) The 'Tavistock' approach

This approach originates in the work of Bion, Ezriel, Sutherland, and their colleagues. It shares with group analysis an interest in the underlying pattern of object relations in groups but, under the influence of Bion—its major exponent—his basic assumption theory is applied to the exclusion of almost everything else. Bion's monograph(38) was his only publication on groups and marked the end of his interest in the subject. The approach has been especially influential in staff training and consultancy which, given the slender theoretical foundations on which it rests, suggests a wide responsiveness in the field to basic assumption theory. The approach has undergone further development in the United States, where it is often referred to as group-as-a-whole. When employed as a therapy it can overlook the individuality of a group's members, disturbing some patients whose experience of the group situation can repeat early developmental traumas of neglect and misunderstanding by caretakers. Malan's study of effectiveness(39> raised serious questions about the model's efficacy in its clinical applications, but its training applications continue to influence the field.

United States

Early pioneers

Jacob Moreno was the innovator of group psychodrama, a pioneer form of group psychotherapy. (4.9 He also introduced sociometry, a scientific method for the study of group affiliations and conflicts, which is widely accepted and used by social psychologists. Slavson was an educationalist of psychoanalytic persuasion who became the central figure in the early development of group psychotherapy. His clinical influence, particularly with groups for the parents of children in difficulty, and his focus on the dynamics of projection in groups has been of lasting importance.(4,42> His organizational efforts led to the formation of the American Group Psychotherapy Association. Alexander Wolf and Emanuel Schwartz began to apply psychoanalytic ideas to group psychotherapy in the late 1930s. (4 44) In their approach, people underwent individual psychotherapy in the setting of a group, a kind of parallel process alongside their fellow patients, with attention focused on the transferential relationship between each individual and their therapist. The approach has been of lasting importance in creating a clinical framework for combining individual and group therapy. Foulkes' criticism at the time was that the approach overlooked any systematic use of group-specific process. In contrast with their 'psychotherapy in the group' he offered group analysis as a clinical alternative, describing it as 'psychotherapy by the group'.

Irving Yalom

Yalom's interpersonal approach was influenced by the interpersonal psychotherapy of Sullivan and Frank. His Theory and Practice of Group Psychotherapy was the first systematic account of groups informed by research and remains one of the most influential books in the field. (45,46) Bloch and Crouch^D have extended this work. Yalom's later text on inpatient group psychotherapy(48) systematized group work in that setting.

The contemporary field

There are many centres of excellence, a wide range of methods and models, and an empirical base grounded in research. (!,49,5,0) The most useful single text is that by Rutan and Stone/51 Collections by Kaplan and Sadock(52> and by Alonso and Swiller(53,» cover the field. Psychoanalytic models have a rich diversity of theory with contributions from object relations, self-psychology, and social systems theory.(5,5.9 The Modern Group movement is among the most innovative, beginning with a classic text by Spotnitz(56) and developing through an active training programme, a journal ( The Modern Group), and publications by Ormont(57) and others.

Continental Europe

Group methods have played an active part in the reconstruction of mental health services throughout Europe in the postwar period. Distinctive approaches are emerging. Those in Germany include psychosomatic practice^8 and the Gottingen model/59 The journal of the Heidelberg Institute of Group Analysis gives access to a vigorous field. A major research study, based in Germany, is in progress in which therapists throughout Europe are taking part and which aims to provide a detailed evaluation of group therapy, its patients, and its therapists. (69 Other distinctive developments include those in Italy (61) and original training models such as those in Greece'62) and Norway.(63)

Funny Wiring Autism

Funny Wiring Autism

Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.

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