Exploring psychotherapy group cultures : essays on group theory and the development of matrix representation grid, a method for observing therapeutic group processes

Abstract: There is full agreement in the literature that group therapy groups are efficient but also may be occasionally damaging for participants due to vicissitudes in group dynamics and group process. Better understanding of the nature of therapeutic group processes presupposes advancements in group theory and in group process research. This thesis approaches both aspects from a group analytic perspective (a.m. S.H. Foulkes). One result is a theory about individual development of relating capacities to dyads, subgroups, small and large groups as effects inside self-development as described in the recent theory developed by Daniel Stern. Studies of these proposed relating capacities and the concepts network and group membership in relation to the group analytic definitions of the concepts group and group matrix have created a basis for the formulation of a more comprehensive Matrix Theory of Processes in Therapeutic Groups, potentially helpful in clarifying why therapy groups may turn either therapeutic or damaging in various sequences. It is argued in the thesis that group process research foremost should concern the group-as-a-whole using observation methods. For outcome research a considerable number of reliable research methods studying individual patients are available. For observing the group-as-a-whole only Whitaker and Liebermann's "Group Focal Conflict theory" and Agazarian and Simon's "Structural Analysis of Verbal Interaction in Groups" have been developed. In order to strengthen that research approach this project has developed a therapy group observation method based on group analytic theory, especially the concept of group matrix, and on the previous research on group specific therapeutic factors (e.g. by Yalom; Bloch & Crouch and Bednar & Kaul). The instrument, called Matrix Representation Grid, (MRG), can help an observer in assessing group themes related to group climate, offering opportunities for graphic illustration of the ongoing group process and for micro-outcome evaluation (Orlinsky, Grawe and Parks) of group process maturity and therapeutic climate. Group climate is according to the theory of the MRG a manifestation of the group matrix in operation via eight group determinants, i.e., elaborations of the therapeutic factors of previous research. The MRG has been conceptually and empirically validated in the project, using three independent observers Its validity has been demonstrated and its interjudge agreement coefficient between three observers was found to be 0.69 and its kappa value 0.56. The MRG is now considered ready for further clinical use.