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Yalom’s Therapeutic Factors. By Patti Higgins. Yalom’s Therapeutic Factors. Yalom (1995) defined therapeutic factors as "the actual mechanisms of effecting change in the patient" (p. xi).

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Yalom’s Therapeutic Factors

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Yalom s therapeutic factors

Yalom’s Therapeutic Factors


Patti Higgins

Yalom s therapeutic factors1

Yalom’s Therapeutic Factors

  • Yalom (1995) defined therapeutic factors as "the actual mechanisms of effecting change in the patient" (p. xi).

  • Yalom identified 11 factors that influence the processes of change and recovery among group therapy clients.

11 therapeutic factors

Universality - feeling of having problems similar to others, not alone

Altruism - helping and supporting others

Instillation of hope - encouragement that recovery is possible

Guidance - nurturing support & assistance

Imparting information - teaching about problem and recovery

Developing social skills - learning new ways to talk about feelings, observations and concerns

Interpersonal learning - finding out about themselves & others from the group

11 Therapeutic Factors

11 therapeutic factors1

Cohesion - feeling of belonging to the group, valuing the group

Catharsis – release of emotional tension

Existential factors – life & death are realities

Imitative behavior – modeling another’s manners & recovery skills

Corrective recapitulation of family of origin issues – identifying & changing the dysfunctional patterns or roles one played in primary family

11 Therapeutic Factors

Assessment of factors

Therapeutic Factors Inventory (TFI) - empirically derived comprehensive assessment of the presence or absence of the 11 therapeutic factors in a group (Lese & MacNair-Semands, 1997)

Yalom Q-sort assesses patients’ perceptions of therapeutic factors and consists of 60 statements representing 12 categories of therapeutic factors. A ranking of 1 to 60 is produced.

Bloch, Reibstein, Crouch, Holroyd and Themen's (1979) assessment uses independent raters to judge presence of therapeutic factors.

Assessment of factors

Navajo sweat lodge study

Navajo sweat lodge study

  • Colmant and Merta (1999) explored the Navajo sweat lodge ceremony as a culturally relevant and therapeutic approach to group therapy. They compared the sweat lodge ceremony used at a residential treatment center for Navajo males aged 6-15 years old with disruptive behavior disorders, to modern group work with Yalom’s therapeutic factors.

Differences among factors values

Differences among factors’ values

  • Older women in an outpatient therapy group ranked existential awareness as the most important therapeutic factor (McLeod & Ryan, 1993).

  • Morgan & Ferrell (1999) found therapists' perceived interpersonal learning, universality, & imparting info highest for group of incarcerated males.

  • Schwartz and Waldo (1999) found imparting of information and development of socializing techniques most valuable in educational groups for batterers.

  • Campbell & Page (1993) found recovering drug addicts ranked highest: information dissemination, corrective recapitulation of the primary family, development of socializing techniques, imitative behavior, interpersonal learning, group cohesiveness, and catharsis.

  • Mawson & Kahn (1993) reported women in career counseling group rated cognitive and affective components as most valuable.

  • Tomasulo, Keller & Pfadt (1991) found psycheducational groups therapeutic.

  • Kivlighan & Goldfine (1991) found guidance increased across the stages of group, universality and hope decreased, and catharsis increased in beginning.

Yalom s adages

Yalom’s adages:

  • Therapy group is a social microcosm and a reenactment of the primary family.

  • Therapists should listen to their patients.

  • Patients should listen to and learn from one another.

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