Chapter 16

1. Chapter 16 Existential, Gestalt, Rational-Emotive Behavior Therapy, and Psychodrama Groups Prepared by: Nathaniel N. Ivers, Wake Forest University

2. Roadmap • Existentialism • Gestalt • Rational-Emotive Behavior Therapy (REBT) • Psychodrama

3. Existentialism • Addresses what it means to be human • Stresses the importance of beliefs, such as values, freedom, and responsibility • Emphasis placed on discovering meaning in the midst of everyday life as well as in absurd and tragic events • Highlights the paradox of living fully in life and increasing awareness of death

4. Premises of Existential Groups • People form their lives by their choices. • Human beings are aware of their existence and their own mortality • Human beings have freedom to make choices and the freedom of responsibility for what they do (Frankl, 1997) • People are the authors of their lives and make their own lives meaningful.

5. Premises of Existential Groups • People make meaning in their lives in three ways: • Doing a deed, or achieving or accomplishing something • Experiencing a value, such as the intrinsic worth of a work of nature, culture, or love • Suffering, by finding a proper attitude toward unalterable fate (Frankl, 2000)

6. Premises of Existential Groups • People who do not actively seek meaning in life choose despair or psychopathology • Existentialism is the process of evaluating and simultaneously releasing and incorporating objects and events in life’s quest for meaning

7. Practice of Existential Theory in Group • Usually conducted with an emphasis on psychotherapy, counseling, and psychoeducation • During the group process, it is crucial that group members come to realize their potential and their responsibilities for making healthy and self-directed choices (May, 1983).

8. Practice of Existential Theory in Group • Goals of Existential Theory in a Group • Increase self-awareness • Increase personal responsibility • Enhance ability to handle anxiety • Increase ability to search for meaning

9. Role of the Existential Group Leader • Develop close relationships with all group members • Point out discrepancies between what group members say they want and what they are doing • Use themselves in as a source of knowledge and a model in regard to human experience • Are calm in the presence of turmoil • Discuss the meaning they have experienced and how they have overcome obstacles

10. Desired Outcomes of Existential Groups • Members will • Become more aware of themselves and the choices they have • Realize that their feelings, even painful ones, can be motivational (Greenstein & Breitbart, 2000) • Find new meaning in all aspects of their lives • Become more authentic • Increase interpersonal responsibility (Yalom & Josselson, 2011)

11. Strengths of Existential Groups • Deal with ultimate issues in life and present their members with opportunities to explore values and lifestyles • Provide a framework for other forms of group work • Deal with group members holistically (Lowenstein, 1993) • Are versatile • Are applicable to individuals from a wide range of cultures

12. Limitations of Existential Groups • Limited to members who are verbal, communicative, and unafraid to confront painful issues (Lowenstein, 1993) • Theory supporting existential groups has limited applicability outside of counseling and psychotherapy settings • Broadly based and do not generally deal with specific behaviors or concerns

13. Gestalt Therapy • Experiential and humanistic approach to change founded by Fritz Perls, along with Laura Perls and Paul Goodman • Emphasis of theory placed on teaching awareness skills • Evolved into Gestalt group process

14. Premises of Gestalt Groups • Four basic assumptions of Gestalt groups: • Principle of holism (integration) • Principle of awareness • Principle of figure/ground • Principle of polarities • Process • Complex and based on the assumption that groups are multidimensional systems that operate on several levels at once

15. Premises of Gestalt Groups • Assumptions • Impossible to understand the person in the group outside of the context of the group • People are proactive, especially if they are self-aware and present-focused • Individuals will experience certain amount of elasticity • Awareness gives people self-cohesiveness and enables them (Hagedorn & Hirshhorn, 2009)

16. Practice of Gestalt Theory in a Group • Function in several ways: • Focus on one person in the presence of other members (West Coast practice) • Emphasis is more interactive, involving direct, here-and-now group member communities (East Coast style) (Early, 2000) • Balance between interaction and one-on-one focus • Dual-focused Gestalt Group Work (Harman, 1988) • Floating Hot Seat (Yontef & Jacobs, 2014)

17. Practice of Gestalt Theory in a Group • Gestalt group practitioners share many common beliefs and practices: • They stay centered on the here and now • They ask group members to work on a specific problem to help foster greater awareness • They emphasize behavioral processes • Experiments • Exercises

18. Practice of Gestalt Theory in a Group • Experiments and exercises revolve around five main themes: • Enactment • Directed behavior • Fantasy • Dreams • Homework (Polster & Polster, 1973)

19. Practice of Gestalt Theory in a Group • Some of the better known exercises: • Making the rounds • Rehearsal • Role reversal • Body language • Changing question to statements

20. Practice of Gestalt Theory in Groups • Some of the better known exercises: • Empty chair technique • Top dog/underdog dialogue • Fantasy exercises • Dream work • Energy field • Homework

21. Role of the Gestalt Group Leader • Help group members locate their impasses and work through tem to awareness and growth • Create an atmosphere that promotes growth within the group

22. Role of the Gestalt Group Leader • Play several roles during the group’s life span: • Expert-helper • Seer • Communications expert • Frustrator • Creator • Teacher (Levin & Shepherd, 1974)

23. Desired Outcome of Gestalt Groups • As a result of Gestalt group, members should • Be more aware of themselves in the here and now and change (Flores, 1988) • Will shed layers of neurosis • Come to realize self-growth through implosiveness and explosiveness (Perls, 1970) • Be more congruent on personal and interpersonal levels and are less likely to mired down in the past

24. Strengths of Gestalt Groups • Suitable to group leaders with a humanistic-existential philosophy of helping (Vander Kolk, 1985) • Focus on working through impasses and becoming integrated • Foster a variety of exercises and experiences • Work with a variety of difficulties, from addiction to couple communication (Browne-Miller, 1993; Curman & Curman, 1994)

25. Limitations of Gestalt Groups • Gestalt approach may eschew the cognitive side of human nature • Gestalt groups may not be able to help the group work through impasses • Gestalt approach may create potential danger of abusing techniques and people • Gestalt groups are difficult to research

26. Rational-Emotive Behavior Therapy • Founded by Albert Ellis • Focuses on behaviors as well as cognitions • REBT groups have varied in size openness, and type. • Usually the groups are limited to 12.

27. Premises of REBT Groups • Underlying premises are stoic and humanistic • Based on the idea that thinking about events, not external circumstances, produces feelings and behaviors (Fehr, 2013) • Process of change is built on an A-B-C model of human interaction

28. Premises of REBT Groups • A-B-C Model of Human Interaction • A – Activating event (Event) • B – Belief (Thought process) • C – Consequences (Feeling state resulting from thoughts) • Four types of thoughts • Negative • Positive • Neutral • Mixed

29. Premises of REBT Groups • REBT stresses the dual nature of human beings • Individuals have rational and irrational beliefs that can be modified through disputation (Ellis, 1976) • REBT is a philosophy of life as well as a treatment for changing behaviors (Weinrach, 1996)

30. Practice of REBT in a Group • Three types of REBT groups: • Open-ended problem-solving group • Topic-specific group • Preventative • REBT groups tend to be didactic, philosophical, and skills-oriented • Group member situations are analyzed using the A-B-C approach • Little attention is given to past events in REBT groups. The focus in on the here and now.

31. Practice of REBT in a Group • Group members and leaders provide feedback and suggestions. • Disputations “D” take three forms • Cognitive disputation • Imaginal disputation • Behavioral disputation

32. Role of REBT Group Leader • Group leader • Ensures that the group is “philosophically and cognitively based” (Hansen et al., 1980, p. 246) • In counseling and psychotherapy groups, encourages members to work as auxiliary counselors

33. Role of REBT Group Leader • Encourages rational thinking in a number of ways • Teaching group members about the origins of emotions • Being active in the group process by challenging and probing • Encouraging group members to help one another to think rationally • Using activity-oriented experiences in the group and homework assignments outside the group • Allowing the expression of feelings previously hidden by group members that are dealt with in a practical, rational way (Ellis, 1974)

34. Desired Outcome of REBT Groups • To learn how to think rationally • To achieve particular goals in their own lives connected with using REBT to overcome an irrational belief such as anxiety (Cowan & Brunero, 1997) • To have a better knowledge of how REBT can be employed in situations in which they have no firsthand experience • To gain the experience of personally understanding the process of change

35. Strengths of REBT Groups • REBT groups focus on the importance of cognition in influencing people’s emotions and actions (Weinrach, 1996) • REBT essentials can be taught quickly • REBT groups are excellent environments for clients who are phasing out of individual therapeutic counseling (Wessler & Hankin, 1988) • REBT groups are versatile; the theory is geared to working with large segments of the population • REBT groups provide opportunities for members to do homework, take verbal and nonverbal risks, and learn from the experiences of others

36. Limitations of REBT Groups • Its traditional focus on the individual, not the group • Its confrontive and directive stance • It may not be appropriate with individuals who are borderline-disturbed • Its lack of rigorous research specifically focused on REBT.

37. Psychodrama • One of the oldest and most dynamic theories devised for working with groups (Fox, 2008) • Founded by Jacob L. Moreno • Applicable in a number of settings and practiced worldwide • Explores the human psyche through dramatic action (D’Amato & Dean, 1988; Goldman & Morrison, 1984)

38. Premises of Psychodrama Groups • Encounter • Existential concept that involves total physical and psychological contact among persons on an intense, concrete, and complete basis in the here and now • Can relate to past events, anticipated ones, and present circumstances • Always involves taking a moment or a particular situation in one’s life and expanding it in various dimensions (Leveton, 2001)

39. Premises of Psychodrama Groups • Surplus reality • One particular dimension that the encounter deals with • “Psychological experience that transcends the boundaries of physical reality” (Blatner, 2005, p. 429) • These experiences may include relationships with those who have died or were never born, or with God

40. Premises of Psychodrama Groups • Spontaneity • Response people make that contains “some degree of adequacy to a new situation or a degree of novelty to an old situation” (Moreno, 1945, p. xii) • The purpose is to liberate oneself from scripts and stereotypes and gain new perspectives on life. • Responding in new creative ways is part of this process

41. Premises of Psychodrama Groups • Situation • Emphasis on the present, where “natural barriers of time, space, and states of existence are obliterated” (Greenberg, 1974, pp. 16-17). • Under these circumstances, clients are able to work on past problems, future fears, and current difficulties in the here-and-now atmosphere.

42. Premises of Psychodrama Groups • Tele • Total communication f feelings between people • Occurs most often when it is between two people • Can involve complete interpersonal and reciprocal empathy • Catharsis and insight • End products of spontaneity and tele (Greenberg, 1974) • Catharsis is an emotional purging • Insight is immediate new perception and understanding about one’s problem

43. Practice of Psychodrama in a Group • Physical and personal factors must be considered (e.g., stage, actors, protagonist) • Techniques must be employed in a methodical manner (Holmes & Karp, 1991; Moreno & Moreno, 1959)

44. Practice of Psychodrama in a Group • Stage • Area where the action takes place • May be a platform or simply part of a room • Protagonist • Person who is the subject of the psychodrama enactment (Blatner, 2005) • Actors • those who play the parts of other important people or objects in the play

45. Practice of Psychodrama in a Group • Director – person who guides the protagonist in the use of psychodramatic methods to help that person explore his or her problem (Blatner, 1996) • Audience • Others who may be present during the psychodrama

46. Practice of Psychodrama in a Group • The psychodrama process generally goes through three phases: • Warm up • Action • Integration

47. Practice of Psychodrama in a Group • Warm up phase • Characterized by the director making sure he or she is ready to lead the group and that members are ready to be led • May involve both verbal and nonverbal activities designed to put everyone in the right frame of mind to conduct the psychodrama and to establish trust and an atmosphere of spontaneity (Blatner, 2005; Moreno, 1940) • Include the engagement of action exercises • Allows members to process some of the technical procedures of the psychodrama (Leveton, 2001)

48. Practice of Psychodrama in a Group • Action phase • Involves the enactment of protagonists’ concerns • The director helps each protagonist “set the stage” for a specific scene in the here and now • Group participants are assigned auxiliary ego roles of significant others or things in the protagonist’s life. • After the opening scene is portrayed, the protagonist and auxiliary egos are given an opportunity to refine their roles and gear their interaction from the surface to significant events • The protagonist is helped to work through the situation

49. Practice of Psychodrama in Groups • Integration phase • Director encourages the group to give the protagonist as much personal, supportive, and constructive feedback as possible during this time • Feedback focuses initially on the affective, rather than the intellectual aspects of the enactment • At the completion of this phase, emphasis is placed on understanding and integration

50. Practice of Psychodrama in a Group • A few of the many psychodrama techniques • Creative imagery • The magic shop • Sculpting • Soliloquy • Monodrama or autodrama • Double and multiple double • Role reversal • Mirror