The Theory and Practice of Group Psychotherapy

By Irvin D. Yalom | Go to book overview

CHAPTER 9
The Composition
of Therapy Groups

Imagine the following situation: a psychiatric outpatient clinic with ten group therapists ready to form groups and seventy patients who, on the basis of the selection criteria outlined thus far, are suitable group therapy candidates. Is there an ideal or superior way to compose those ten groups?

Or imagine this more common clinical situation: a triage specialist deems that a patient is a suitable candidate for dynamic group therapy, and there are several dynamic therapy groups operating in the clinic, each with one vacancy. Into which group should the patient go? Which group would offer the best fit for that particular patient? For both problems, we must answer the question, Is there a superior method of composing a group? If valid principles about the effective total composition of a group can be established, the corollaries of those principles might provide guidelines for replacing members who leave the group. We grope in the dark if we try to replace a missing unit without any knowledge of the organization of the total system.

In this chapter, I shall examine research evidence and clinical observations bearing on group composition. Is it possible that the proper blend of individuals will form an ideal group? That the wrong blend will remain an inharmonious aggregate, never coalescing into a working group? Again, as in preceding chapters, I focus on those type of groups whose therapeutic discourse relies heavily on member-to-member interaction. Group compositional issues have far less relevance for the homogeneous, problem-specific cognitive behavioral group.

First, we must be clear about what we mean when we speak about right and wrong "blends." Blends of what? What are the ingredients of our blend? Of the infinite number of human characteristics, which are germane to the task of

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