Facilitating inpatient group therapy is difficult. Groups are often under-supported in modern inpatient units, training and guidance for therapists is minimal, and patient stays have gotten shorter, limiting rapport building and therapeutic opportunity. After reading this book, I have learned enormously helpful tips for making groups more meaningful, accessible, and enjoyable for myself and my patients.
I have become attached to the "here and now" methods discussed within Yalom's experiential therapy. Since reading this book, I have begun to incorporate the "here and now," eliciting emotions within the group and calling forth patient reflection instead of focusing on hypothetical post-discharge scenarios. Offering mildly emotional activities to allow for frustration, sadness, and joy to be felt, contained, and processed within a group session has increased meaning for my patients. My use of mirroring and healthy self disclosure opens people up to discussion. Encouraging peer interactions has become a major goal in my groups, not just repeated psychoeducation and worksheets completed solo.
Though this book has added a lot to my practice, Yalom's experiential therapy does not come without areas of concern, from my perspective. Many of the interventions he describes, such as his agenda setting group facilitation, requires that the patients be of a higher cognitive functioning, as he states, but also possess a notable amount of insight. From my experience, many of my patients do not demonstrate this insight in their three to five day stays in my unit. As many are in crisis, dissociated, or have not built rapport with me nor the other patients, asking them to set agendas or seek "here and now" goals is a rather tall order. Similarly, diving into this kind of psychodynamic work could be invasive and unsettling to many, and is not necessarily the most trauma-informed modality. As he stated in the beginning of the book, a unit and its culture must be built around supporting the group programs, and without this support, groups will not be as successful as they could be.
Limitations aside, I have incorporated Yalom's techniques in my groups and found increased fulfillment in myself and increased engagement in my patients. Really interesting work.