The research evidence for distributed leadership in therapy groups

Idealization and Omnipotence within the Group Matrix

This paper describes a group where development is limited through idealization of the group conductor. The splitting which results from the group members' determination to meet informally (the pavement group) leads to `cure' only being obtainable through development of an idealized relationship with the conductor.

Warm, emotionally involved, non-rivalrous relationships occur on the pavement, as do normal disappointing relationships. Within the group the conductor is often attacked and criticized, but the hidden idealization persists, together with the hopelessness of ever attaining the desired relationship.

The personal networks of group members form a group matrix in which a persecutory authority permanently resides which will block the individual's maturation. At a certain point members must leave the group if they are to develop and mature. There is no potential for rapprochement with the omnipotent authority within the matrix. This authority is typically located within the conductor, but any member who attempts to establish the idealized relationship becomes the location for this authority, and the object of envious attack.

The concepts of self-psychology (Heinz Kohut) are applied to the group and the matrix.

Psicoterapia de grupo e considerações sobre o paciente como agente da própria mudança

Nas últimas décadas a psicoterapia de grupo tem merecido considerável atenção por parte dos pesquisadores. Tendo por base publicações recentes, os autores tecem considerações sobre a indicação, a necessidade de se adotar critérios de seleção, os resultados esperados e o prognóstico, bem como o processo de mudança. A revisão da literatura evidencia tendência de se reconhecer o cliente como agente de sua própria mudança, e é colocada em relevo a forma particular que este processo assume na psicoterapia de grupo.

The nequipos' collusion with the patient's family of origin in analytic group psychotherapy

When the analytic group is led by individuals paired for educational reasons, that is, by a supervisor and his or her student, the difficulty in conducting the group becomes magnified. Such teams are called nequipos and it is hypothesized that they will not function optimally until the latter phases of their development. The authors describe the mistakes they made as early phase nequipos in their treatment of one patient in group psychotherapy.

A sociometric test to identify emergent leader and member roles: phase I

This is the first phase in the design of a sociometric test for the empirical identification of four leadership roles: Task, Emotional, Scapegoat, and Defiant Leaders and one Nonleader member role. Eighteen different questions have been used in studying 273 cases in 31 closed psychotherapy groups. (1) A factor analysis identified two factors that describe an involvement/commitment dimension (Factor 1) and a positive/negative change dimension (Factor 2). (2) A discriminant function analysis showed that the five roles were differentiated at a statistically significant level. (3) Role assignments, based on weights, produced by this test were compared to clinically identified leaders with an overall hit rate of 97%, indicating a low error factor when the formulas were applied to this data base. Steps for the next phases in the construction of this test are outlined.

Job stress, satisfaction, and mental health among general practitioners before and after introduction of new contract

OBJECTIVE

To compare measures of job stress, job satisfaction, and mental health among general practitioners before and after the introduction of the new contract in April 1990.

DESIGN

Cross sectional postal questionnaire survey in July 1990. Comparison of results with those obtained in previous survey in November 1987.

SETTING

General practice in United Kingdom.

SUBJECTS

1500 general practitioners randomly selected from general medical services lists, 917 of whom (61%) returned questionnaires usable for statistical analysis.

MAIN OUTCOME MEASURES

Aspects of job causing stress, job satisfaction (Warr, Cook, and Wall scale), and mental health (Crown-Crisp experiential index).

RESULTS

Compared with 1987, in 1990 doctors experienced more stress from night calls (mean score 3.83 in 1990 v 3.45 in 1987), emergencies during surgery hours (3.72 v 3.48), and interruption of family life by telephone (3.58 v 2.73; p less than 0.001 for all three variables). Scores for somatic anxiety and depression were higher in both men and women in 1990 (men: somatic anxiety 3.12 v 2.36; depression 3.80 v 2.94; women: somatic anxiety 3.56 v 2.65; depression 4.02 v 3.37; p less than 0.001). Job satisfaction had also decreased in 1990 (5.23 v 4.26; p less than 0.001).

CONCLUSIONS

Doctors experienced more stress, less job satisfaction, and poorer mental health in 1990 than in 1987. These changes may have resulted from the introduction of the new contract.