Psychodynamic Group Psychotherapy, Fifth Edition by J. Scott Rutan & Walter N. Stone & Joseph J. Shay

Author:J. Scott Rutan & Walter N. Stone & Joseph J. Shay [Rutan, J. Scott]
Language: eng
Format: epub
ISBN: 9781462516643
Publisher: Guilford Publications
Published: 2014-06-23T00:00:00+00:00

Clinical Example 11.2

Jane and John were psychology interns. As part of their training, they needed to find partners to colead a therapy group. Jane and John had enjoyed a warm friendship during their first months of training and quickly selected one another as cotherapists. Each was married, and John was a new father. As their group proceeded, their supervisor noted a sudden increase in acting out among group members, including two “couples” meeting outside the group boundaries. As the supervisor struggled to understand the meaning of this new group behavior, Jane and John “confessed” that they had begun an affair.

Predictably, the group had sensed the special relationship that had developed between their new leaders. (We have written of “emotional knowing” in Chapter 9.) Although the relationship was too dangerous to speak of (or perhaps even to “know”), it could be enacted in group behavior. This rather dramatic example is a reminder of how we may communicate our emotions outside our awareness.

Coleadership, like any relationship, requires time and effort. It evolves, and with development of trust the experience can be gratifying and growth promoting for the clinicians, who in turn experience their work as more effective and gratifying. On the other hand, this effort can, at times, distort the purpose of the treatment to a solipsistic exploration of the clinicians’ relationship at the expense of the patients.

Overall, we feel that the definite disadvantages of cotherapy must be considered very actively before clinicians engage in it, then must be kept in mind as the group progresses. In training situations, there may be little alternative if trainees are to gain experience as group leaders, but supervisors of these groups should be attentive to the increased problems cotherapy imposes on trainees. With this said, for certain patient populations, particularly the chronically mentally ill and children’s groups, the disadvantages of cotherapy are outweighed by the value of having two therapists in the room.

Rutan and Alonso (1980) suggested an intriguing training alternative to the traditional model of cotherapy, an approach that incorporates the notion of a substitute. In this approach, two leaders are employed, but each leads the group separately for a prescribed number of weeks while the nonleading cotherapist becomes a silent observer. This model offers some advantages suggested for cotherapy (such as binocular vision, peer consultation, sharing of responsibility, and covering at times of illness or vacation) while neutralizing some competitive features of traditional cotherapy. This model has particular advantages as a teaching tool, because the observer therapist can more easily lead a didactic session with trainees who have observed the group session.

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