This article on 'group dynamics' is the last part following the 'history and prospect' and the 'theory and practice', series composed of three parts to understand the group psychotherapy. To explain the core theme concerning the group dynamics, we compared the therapeutic group in clinical scope with the work group in social scope for convenience. And this article principally was for the therapeutic group. We can discover many similarities between groups and organizations when we observe the details although they appear quite different with different goals. Therefore, if the leader of a group in the clinical and social setup has a full knowledge in group dynamics, he would be effective in functional roles with increased sensitivity and understanding of group process. This article was written in order of the history of group dynamics, the theory of group dynamics, group development, and leadership. The group psychotherapy derives from individual psychotherapy. To lead group psychotherapy successfully, Therapists have to be knowledgeable not only of the concept of psychotherapy but also the concept of group dynamics.
Group Processes ; Leadership ; Psychotherapy ; Psychotherapy, Group*

Recently, the Korean psychiatrists has faced to the difficult situation because of the separation of medical practice and pharmaceutical dispensing and the revision of mental health law. In this situation, this article was written for the desirable development and application of group psychotherapy in Korea in the basis of the history of foreign group psychotherapy. Introduction is composed of definition of group psychotherapy, reasons why the group psychotherapy is not applied so actively in psychiatric area, the present of group psychotherapy, therapeutic effect, and therapeutic outcome. Main subjects are the history of foreign group psychotherapy, the prospect of group psychotherapy, and Korean group psychotherapy. Group psychotherapy has been formally accepted as one of therapeutic modalities that must be as equally effective as individual psychotherapy even if group psychotherapy derives from individual psychotherapy. Those days, in psychiatric clinic in Korea psychophamacotherapy and brief symptom oriented therapy have been applied mainly due to the economic principle of medical environment and insurance policy. And psychiatrists apply psychotherapeutic modalities in there less and less. The importance of group psychotherapy should be emphasized one of holistic and humanistic therapy which provides the field of encounter for therapists and patients. As Community Mental Health Service in Korea are expanding and the separation of medical practice and pharmaceutical dispensing is being performed. The group psychotherapy and psychodrama should be perceived as a much more effective and efficient therapeutic modality in the settings of inpatient and outpatient clinics.
Ambulatory Care Facilities ; Humans ; Inpatients ; Insurance ; Jurisprudence ; Korea ; Mental Health ; Mental Health Services ; Psychiatry ; Psychodrama ; Psychotherapy ; Psychotherapy, Group*

The aim of this article is to understand group psychotherapy. In group psychotherapy, psychoanalytic theory and cognitive-behavioral theory have been accepted as perennial effective therapeutic modalities. But nowadays, all theories give the group psychotherapy vitality and liveness as a therapeutic modality in practical setting. The orders of the group psychotherapy that current therapists prefer according to their theoretical background are as follows: psychodynamic/psychoanalytic, group as a whole/systems, transactional analysis/gestalt/redecision, interpersonal/interactional, cognitive/behavioral, object relations, group analysis, psychodrama, existential/humanistic, and self psychology. The practice of group psychotherapy includes four therapy group, encounter group, training group, and education group or self-help group. Therapy group has the goal of symptom relief and personality reconstruction for patients. Encounter group has the goal of self growth and self realization for non-patients. Training group has the goal of training in human relationship and self maturation for mental health personnels. Self help group has the goal of education and support for patient families and patients. Group psychotherapy has been accepted as a therapeutic modality that are equally effective as individual psychotherapy although group psychotherapy has been derived from individual psychotherapy. Recently, individual psychotherapy has been less practiced yearly because of the pressure of economic difficulties of medical insurance in developed countries. Therefore, the importance of group psychotherapy with its therapeutic effectiveness and cost-efficiency is uprising.
Developed Countries ; Education ; Humans ; Insurance ; Mental Health ; Object Attachment ; Psychoanalytic Theory ; Psychodrama ; Psychotherapy ; Psychotherapy, Group* ; Self Psychology ; Self-Help Groups ; Sensitivity Training Groups

OBJECTIVES: Training group with mental health professionals includes didactic process, experience as a member(patient) and a leader(therapist). It is divided into four parts as like 1) lecture, case conference, book reading and seminar about theory and practice, 2) observation, 3) training group(including workshop), and 4) supervision. Among them, the training group and the supervision have been accepted as the most effective methods. Authors have developed and practiced the training group model for mental health professionals including psychiatric residents which aim for the activation of group psychotherapy in mental health area, psychiatrists' initiative in group psychotherapy area, and the training and nurturing of qualified mental health professionals. The objectives of this study are as follows;firstly, we examine the change of defense mechanism and ego function after performing group psychotherapy for mental health professionals;secondly, we analyze the therapeutic factors reported that participants were helped;thirdly, we analyze main features which include group content and process manifested in training group:lastly, we have objectives that the training group is settled down as an effective educational method to foster the personal growth and qualification as a specialist, and also that this study provides a basic research data to set up the training program and the requirements for group psychotherapy. METHODS: This study was performed 5 times from 1997 to 2000. The participants were composed of 37 mental health professionals including psychiatric residents. Among them, 29 participants(male 2, female 27) were chosen as the final subjects except 9 participants dropped out in the process of this study. At first, we take an application of pre-treatment/post-treatment experimental design to evaluate the personality change after performing the training group. EDMT(Ewha Defence Mechanism Test) and EC(Egogram Checklist), the objective questionnaires, were used as the evaluation scale. And 13-therapeutic factor scale and simple subjective questionnaires were performed just after each session and the self-report total assessment questionnaires were performed at the end of this study. RESULTS: To compare mean scores between pre-treatment and post-treatment in EDMT, the mature defense was increased significantly, the immature defense was decreased significantly, and the narcissistic defense and neurotic defense were not changed significantly. To compare mean scores between pre-treatment and post-treatment in EC, Nurturing Parent(NP), Adult(A) and Free Child(FC) were increased significantly. Therapeutic factors ranked highly were interpersonal learning, existential factor, Identification with therapist, catharsis, and socializing technique in order. The total assessment questionnaires reported that the 100% of participants were helped, the 48.3% of participants were changed in their lives, the 89.7% of participants would propose training group to others positively, and the 58.6% of participants had minds to join this kind of program if given again for them. CONCLUSIONS: This result showed that the defense mechanism and ego function of participants were changed. The training group experience makes participants reflect themselves, examine their conflicts and understand others. That also gives them chances of improving insight about group phenomena and understanding about therapeutic factors essential to the mental health professionals, having confidence on the group therapy by learning leadership and techniques, and improving understanding about the psychotherapy on the whole. Therefore, it is needed in the future that the training group would be widely adapted as an educational tool of psychotherapy and group psychotherapy for the mental health professionals as well as psychiatric residents in mental health area.
Catharsis ; Education ; Ego ; Female ; Humans ; Leadership ; Learning ; Mental Health* ; Organization and Administration ; Psychotherapy ; Psychotherapy, Group ; Surveys and Questionnaires ; Research Design ; Specialization

OBJECTIVES: Group psychotherapy is more economic than individual psychotherapy and effective to adolescents especially. Group psychotherapy with adolescents will be used widely when adolescents problems are becoming more important so that government focuses on them. This article aims for the readers to understand group psychotherapy easily. METHODS: This article is based on reviewing lots of articles related to adolescent group psychotherapy published at home and abroad and our researches and practical experiences in regard with inpatient and outpatient group with adolescents for a long time. This article is described in order of history, theory, model, development stage, and therapeutic factor. RESULTS: Theories of group psychotherapy have been affected by about 200 psychotherapy theories. Among a lot of theories, psychoanalytic theory and cognitive-behavioral theory have been accepted as a perennial effective therapeutic modality. In Korea, structuralized cognitive-behavioral group therapy is currently pervaded in Youth Counselling Center or General Social Welfare Center. But because that is generally consist of skill training and problem solving centered approach, it is difficult to achieve therapeutic goal of ultimate behavioral change in basis of genetic insight. On the contrary, it is known that psychoanalytic group therapy has more benefit to raise adolescent universal value, group norms, group rules, confidentiality, and community consciousness for adolescents. and that group therapy provides adolescents with more secure and caring conditions. Here and now, adolescent group therapists apply wide theories and various techniques with flexible attitudes to go together with unapproachable adolescents. Models of group psychotherapy have various mode related to age, disorders, functional level, developmental level, clinical environment, structural modalities, and intervention goal. Developmental stages of the group psychotherapy consist of formal stage, conflictual stage, normal stage, and performing stage. And then those are divided with the first stage, middle stage, and the last stage in an adolescent group. Therapeutic factors of an adolescent group are as follows. Interpersonal learning, catharsis, existential factor, and group cohesiveness are highly evaluated in an encounter group and a long-term group for personality change. And catharsis, universality, identification, and group cohesiveness are highly evaluated in a short-term group. To handle the adolescent group, therapist capability is very critical. Special knowledge, technique, and endurance are needed for the group therapist to lead an adolescent group. Even though some therapist lead the adult group for a long time, they have to get special training and supervision to lead the adolescent group. CONCLUSIONS: Group psychotherapy has been formally accepted as one of therapeutic modalities that must be as equally effective as individual psychotherapy even if it derives from individual psychotherapy. Adolescent group psychotherapy is currently accepted as one of the most important therapeutic modalities although it is not highlighted as same as adult group psychotherapy. Group therapy is the most desirable therapeutic method for adolescents because they go through a transitional critical time for change and they are especially affected by peer group.
Adolescent* ; Adult ; Catharsis ; Confidentiality ; Consciousness ; Humans ; Inpatients ; Korea ; Learning ; Organization and Administration ; Outpatients ; Peer Group ; Problem Solving ; Psychoanalytic Theory ; Psychotherapy ; Psychotherapy, Group* ; Sensitivity Training Groups ; Social Welfare

As an alternative to group psychotherapy, worked out by Dr. Moreno, the psychodrama is being carried on mainly for a large group of inpatients at 40-50% of the country's psychiatric and training hospitals. The authors have developed a Korean psychodrama model for a group mental health having following characteristics:(1) a one-time treatment, (2) open-group therapy, and (3) structured, large group approach. Korean psychodrama model was proved to be a low cost, highly effective approach in that patients could be dealt with en masse to quite a satisfactory degree: at the same time Korean psychodrama model is easily accessible for any psychiatric doctor or trainee in dealing with a patient. In addition, Korean psychodrama model is highly conducive to experiencing and training related people in psychotherapeutic practice as this model has shown up 79.4% approval rate among patients after treatment. Due to the recent crunch in medical insurance financing, psychotherapy is changing from individual long-term type to a more time-limited type. Despite the mental health law passed in 1995, from the human psychotherapy standpoint, the worsening economic situation has made it difficult for a psychiatrist to deal with patient on a one-to-one basis. As a result, the burden of most psychiatrists, is snowballing day by day. In this context psychodrama seems to be a promising, reliable alternative to group psychotherapy, both medically and economically. It will be a treatment modality for years to come.
Humans ; Inpatients* ; Insurance ; Jurisprudence ; Mental Health ; Psychiatry ; Psychodrama* ; Psychotherapy ; Psychotherapy, Group

OBJECTIVES: The long-term outpatient group psychotherapy with the chronically ill is an effective, expedient therapeutic modality that makes patients maintain medication and improve their symptoms, helps patients resolve emotional conflict, and corrects their maladaptive interpersonal relationship. Therefore, we performed weekly the semi-opened, heterogeneous, long-term(open-ended), outpatient group psychotherapy to be applicable effectively for the chronically ill. The objectives of this study are as follows; first, we introduce therapeutic principles and management methods of the group psychotherapy to be applicable in the clinical environment with the chronically ill; second, we examine the therapeutic factors in each group development stage which are helped by participants, and analyze the characteristics showed in the process of study; third, we verify the appropriateness and the validity of this group psychotherapy and then establish the base of the effective long-term outpatient therapy for the chronically ill that will be settled down as a applicable treatment modality economically and efficiently in the present medical environment of Korea. METHODS: This study was performed in the subject of the chronically ill who attended at the day care program of Community Mental Health Center in Hanam city from January 1998 to June 1999. The participants were 27 patients, but we dropped 7 patients who attended under 6 months because of long-term group. So the last subjects were 20 patients (12 males and 8 females) who attended for 18 months. The 13 therapeutic factors scale was filled out by participants just after each session and the self-report total assessment questionnaire was performed at the time of study-termination and patient-termiation. RESULTS: The ranks of 13 therapeutic factors scale are as follows: in the forming stage, the upper ranks of therapeutic factors were existential factor, guidance of therapists, instillation of hope, altruism, and catharsis in order. And in the storming stage, the upper ranks of therapeutic factors were existential factor, instillation of hope, guidance of therapists, catharsis, and group cohesiveness in order. Lastly in the norming stage, the upper ranks of therapeutic factors were existential factor, altruism, corrective recapitulation, interpersonal learning, and catharsis in order. According to the total assessment questionnaire about group psychotherapy reported by the participants 90% of them were helped, 80% of them had an idea to recommend this program to other patients actively, and 75% of them had an opinion to attend again this program if given for them. And they evaluated positively about the structure of this program and the therapist. CONCLUSIONS: The long-term outpatient group psychotherapy would be applicable effectively to the chronically ill as a economic, efficient therapeutic modality for rehabilitation. It is much more effective for therapist to perceive in detail the therapeutic factors in each group develop-ment stage when he perfoms the group psychotherapy.
Altruism ; Catharsis ; Chronic Disease ; Day Care, Medical ; Gyeonggi-do ; Hope ; Humans ; Korea ; Learning ; Male ; Mental Health ; Mentally Ill Persons* ; Outpatients* ; Psychotherapy, Group* ; Surveys and Questionnaires ; Rehabilitation

OBJECTIVES: The purpose of this study was to investigate important therapeutic factors in encounter group and compare these therapeutic factors with those in long-term outpatient group psychotherapy, to understand the content and process in real cases for facilitation of interpersonal learning which is important for long-term outpatient group psychotherapy, and to acquire basic data of long-term outpatient group psychotherapy on the basis of this understanding. METHODS: The subject was 7 encounter groups, composed of 41 persons. We used short form of Yalom's Q-sort to find important therapeutic factors in encounter group. We selected 2 cases for analyzing the process and content in these cases. RESULTS: Three of the most important therapeutic factors were existential factors','self understanding', and 'interpersonal teaming(input)'. CONCLUSION: We suggest that interpersonal learning is the most important therapeutic factor in encounter group.
Humans ; Learning ; Outpatients ; Psychotherapy, Group* ; Q-Sort ; Sensitivity Training Groups

Group psychotherapy is an important therapy far inpatient treatment. A lot of studies proved the effect of inpatient group psychotherapy. Therefore it is necessary to use group psychotherapy actively for inpatient treatment. There are many models of inpatient group psychotherapy made in foreign counties. But It is difficult to apply those models themselves directly in Korean inpatient unit, and so it is an urgent issue to make an inpatient group psychotherapy model that fits Korean inpatient unit setting. According to this need we made our paper in order to introduce an effective model of group psychotherapy for Korean inpatients in detail, and then to provide opportunity for effective inpatient treatment. The characteristics of this inpatient group psychotherapy model are as follows. 1) This model of group psychotherapy give a field in which a therapist encounter inpatients as a human being. 2) This model is easy to perform generally, and helpful to a comprehensive therapeutic approach for inpatients. 3) In this model heterogeneous inpatients participate in a same one group, therefore this model is able to apply various inpatients. 4) This model makes the basis of continuous outpatient treatment or day hospital treatment, and the basis of outpatient group psychotherapy or individual psychotherapy. 5) Group functions as a social microcosm, and so reveals patient's interpersonal relationship and gives the opportunity to treat it. Therefore group helps patients to be adapted well to inpatient unit and society. 6) In this model, social workers, nurses, or students in practice play a role of healthy egos or observers, and so they can activate group psychotherapy. And this model co be used as a practical and useful tool of the education for psychiatric residents, medical students, social workers, and other students. Psychiatrists seem to be less interested in group psychotherapy than other mental heath practitioners. But it may be appropriate for well trained psychiatrists to use group psychotherapy with individual psychotherapy.
Education ; Ego ; Humans ; Inpatients* ; Outpatients ; Psychiatry* ; Psychotherapy ; Psychotherapy, Group* ; Social Workers ; Students, Medical

In this paper, first of all we compared psychoanalysis with psychodrama by a historical point of view. Next, we reviewed group Psychotherapy generally and considered the position of psychodrama through the comparison with various types of soup psychotherapy On the basis of this consideration, we compared Yalom's group psychotherapy as a typical type of group psychotherapy with psychodrama. Lastly, we discussed the application of group psychotherapy and psychodrama to each other. Psychoanalysis, psychodrama, and group psychotherapy developed separately at similar times in different fields. finally, these three fields met with one another in the field of psychiatry. Each of these three fields changed itself as a result of absorbing various things from one another. Therefore, nowadays these fields became to have a close relation with one another. Psychodrama is in a position as a type of group psychotherapies, so it is important to understand group Psychotherapy generally for understanding Psychodrama. Psychodrama has similar aspects to other group psychotherapies, but also has different aspects from other group psychotherapies. When we understand these aspects, we can conduct therapeutic works effectively in practice. Psychodrama's methods can be applied to group psychotherapy and group psychotherapy's theories can applied to psychodrama. When psychodrama and group psychotherapy takes good points from the other side they can make progress.
Psychoanalysis ; Psychodrama* ; Psychotherapy ; Psychotherapy, Group*