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44-532: It has been noted that the term confrontation has "a negative image, largely because people tend to confront others not about pleasant things but about painful, unpleasant things" and that it also "suffers from the stigma of being overly aggressive in both nature and intent". An examination of a hypothetical confrontation is the basis of confrontation analysis (also known as dilemma analysis), an operational analysis technique used to structure, understand and think through multi-party interactions such as negotiations. It

88-630: A group's ability to maintain a safe yet challenging 'formative space'. Academics at the University of Oxford studied the inter-organizational dynamics of a national democratic therapeutic community over a period of four years; they found external steering by authorities eroded the community's therapeutic model, produced a crisis, and led to an intractable conflict which resulted in the community's closure. A form of group therapy has been reported to be effective in psychotic adolescents and recovering addicts. Projective psychotherapy uses an outside text such as

132-467: A means of addressing a dispute, is the opposite of conflict avoidance . It has also been noted that " conflict and confrontation often occur together", and conflict resolution methods may dissipate the cause behind the confrontation. Where a person or entity initiating a confrontation is belligerent or overly emotional, the confronted person or entity may seek to withdraw from the situation by asserting that they will be unable to communicate rationally with

176-430: A novel or motion picture to provide a "stable delusion " for the former cohort and a safe focus for repressed and suppressed emotions or thoughts in the latter. Patient groups read a novel or collectively view a film. They then participate collectively in the discussion of plot, character motivation and author motivation. In the case of films, sound track, cinematography and background are also discussed and processed. Under

220-469: A single member of one group by a single member of the other group can lead to a confrontation between the groups as a whole. A person who is confronted may respond in a number of ways, including accepting or denying points with which they have been confronted, becoming belligerent, or seeking to avoid the confrontation altogether. It has been observed that "[m]any people seem to dislike confrontations while an equal number seem to relish them". Confrontation, as

264-428: A therapeutic application of "calling a spade a spade" by restating information already provided. As Jurgen Ruesch wrote, this incorporates an "element of aggression" in order to demonstrate "discrepancies between intent and effect, between word and action". This may be especially useful in cases when the patient is being deceptive, pretend to be ignorant, or is oblivious to their own inconsistencies. In psychotherapy ,

308-492: A therapist may deliberately engage in a confrontation with the patient to assist the patient in dealing with an issue that the patient has avoided discussing. Such a confrontation is not necessarily loud, abrasive, or argumentative, nor does it necessarily require antipathy between the parties. A person can confront another quietly, and as an act of friendship. At the extreme, attack therapy (sometimes known as confrontation therapy) involves highly confrontational interaction between

352-516: Is a key component of milieu therapy in a therapeutic community . The total environment or milieu is regarded as the medium of therapy, all interactions and activities regarded as potentially therapeutic and are subject to exploration and interpretation, and are explored in daily or weekly community meetings. However, interactions between the culture of group psychotherapeutic settings and the more managerial norms of external authorities may create 'organizational turbulence' which can critically undermine

396-428: Is carried out using time-limited therapy with diagnostically homogenous groups. However, long-term intensive interactional group psychotherapy assumes diverse and diagnostically heterogeneous group membership, and an open-ended time scale for therapy. Good outcomes have also been demonstrated for this form of group therapy. Research on computer-supported and computer-based interventions has increased significantly since

440-444: Is clear evidence for the effectiveness of group psychotherapy for depression : a meta-analysis of 48 studies showed an overall effect size of 1.03, which is clinically highly significant. Similarly, a meta-analysis of five studies of group psychotherapy for adult sexual abuse survivors showed moderate to strong effect sizes, and there is also good evidence for effectiveness with chronic traumatic stress in war veterans. There

484-480: Is less likely to react counterproductively to differences. SCT also emphasizes the need to recognize the phases of group development and the defenses related to each phase in order to best make sense and influence group dynamics. In the United Kingdom group psychotherapy initially developed independently, with pioneers S. H. Foulkes and Wilfred Bion using group therapy as an approach to treating combat fatigue in

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528-519: Is less robust evidence of good outcomes for patients with borderline personality disorder , with some studies showing only small to moderate effect sizes. The authors comment that these poor outcomes might reflect a need for additional support for some patients, in addition to the group therapy. This is borne out by the impressive results obtained using mentalization-based treatment , a model that combines dynamic group psychotherapy with individual psychotherapy and case management . Most outcome research

572-413: Is the underpinning mathematical basis of drama theory . It is derived from game theory but considers that instead of resolving the game, the players often redefine the game when interacting. Emotions triggered from the potential interaction play a large part in this redefinition. So whereas game theory looks on an interaction as a single decision matrix and resolves that, confrontation analysis looks on

616-558: Is the underpinning mathematical basis of drama theory . The word confrontation from its root to confront , comes from the Middle French confronter and Medieval Latin confrontare , meaning to border or to bound . These in turn are formed from a combination of con , meaning with or together , and frons or front , meaning face or forehead . Together, they carry a contemporary usage meaning to set against each other or to bring face-to-face and are similar in meaning to

660-898: Is usually applied to psychodynamic group therapy where the group context and group process is explicitly utilized as a mechanism of change by developing, exploring and examining interpersonal relationships within the group. The broader concept of group therapy can be taken to include any helping process that takes place in a group, including support groups , skills training groups (such as anger management , mindfulness , relaxation training or social skills training), and psychoeducation groups. The differences between psychodynamic groups, activity groups, support groups, problem-solving and psychoeducational groups have been discussed by psychiatrist Charles Montgomery. Other, more specialized forms of group therapy would include non-verbal expressive therapies such as art therapy , dance therapy , or music therapy . The founders of group psychotherapy in

704-500: Is very limited, preliminary research in individual therapy suggests possible increases of treatment efficiency or effectiveness. Further, the use of app- or computer-based monitoring has been investigated several times. Reported advantages of the modern format include improved between-session transfer and patient-therapist-communication, as well as increased treatment transparency and intensity. Negative effects may occur in terms of dissonance due to non-compliance with online tasks, or

748-481: The Second World War. Foulkes and Bion were psychoanalysts and incorporated psychoanalysis into group therapy by recognising that transference can arise not only between group members and the therapist but also among group members. Furthermore, the psychoanalytic concept of the unconscious was extended with a recognition of a group unconscious, in which the unconscious processes of group members could be acted out in

792-543: The UN has four. It has three persuasion dilemmas in that the Bosnian Serbs are not going to do the three things they want them to (not attack the enclaves, withdraw the heavy weapons and not take hostages). It also has a rejection dilemma in that the Bosnian Serbs do not believe they will actually use the air strikes, as they think the UN will submit to their position, for fear of having hostages taken. Faced with these dilemmas,

836-494: The UN modified the card table to eliminate its dilemmas. It took two actions: Firstly, it withdrew its forces from the positions where they were vulnerable to being taken hostage. This action eliminated the Bosnian Serbs' option (card) of taking hostages. Secondly, with the addition of the Rapid Reaction Force , and in particular its artillery the UN had an additional capability to engage Bosnian Serb weapons; they added

880-517: The UN proposal. The final table was an agreement as shown in the Final Card table (see thumbnail and picture). Confrontation analysis does not necessarily produce a win-win solution (although end states are more likely to remain stable if they do); however, the word confrontation should not necessarily imply that any negotiations should be carried out in an aggressive way. The card tables are isomorphic to game theory models, but are not built with

924-621: The USA but across the world. An early development in group therapy was the T-group or training group (sometimes also referred to as sensitivity-training group, human relations training group or encounter group), a form of group psychotherapy where participants (typically, between eight and 15 people) learn about themselves (and about small group processes in general) through their interaction with each other. They use feedback, problem solving, and role play to gain insights into themselves, others, and groups. It

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968-779: The United States were Joseph H. Pratt, Trigant Burrow and Paul Schilder . All three of them were active and working at the East Coast in the first half of the 20th century. In 1932 Jacob L. Moreno presented his work on group psychotherapy to the American Psychiatric Association , and co-authored a monograph on the subject. After World War II , group psychotherapy was further developed by Moreno, Samuel Slavson , Hyman Spotnitz , Irvin Yalom , and Lou Ormont . Yalom's approach to group therapy has been very influential not only in

1012-411: The aim of finding a solution . Instead, the aim is to find the dilemmas facing characters and so help to predict how they will change the table itself. Such prediction requires not only analysis of the model and its dilemmas, but also exploration of the reality outside the model; without this it is impossible to decide which ways of changing the model in order to eliminate dilemmas might be rationalized by

1056-518: The card "Use artillery against Bosnian Serbs". Because of this, the UN's threat of air strikes became more credible. The situation changed to that of the Second Card Table: The Bosnian Serbs wanted (see 4th column): The UN wanted (See 5th column): If no further changes were made then what the sides were saying would happen was (see 1st column): Faced with this new situation, the Bosnian Serbs modified their position to accept

1100-505: The case in "confronting the evidence" or "confronting the truth". Confrontation may occur between individuals, or between larger groups. Because groups are composed of multiple individuals, with each member having their own specific triggers for a violent response to a perceived provocation, risk factors which "may not be sufficient individually to explain collective violence, in combination [can] create conditions that may precipitate aggressive confrontations between groups". Thus provocation of

1144-503: The characters. Sometimes analysis of the ticks and crosses can be supported by values showing the payoff to each of the parties. Group therapy Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group. The term can legitimately refer to any form of psychotherapy when delivered in a group format, including art therapy , cognitive behavioral therapy or interpersonal therapy , but it

1188-456: The contemporary usage of the word conflict . It can be employed, in the most literal sense, to indicate adjacency, such as one parcel of land to another. In a more figurative sense, it may be more commonly used to indicate opposition, similar to some usages of the word face , such as "to confront/face the military might of France". This may be used to indicated both physical opposition, as well as opposition to objects or ideas, such as would be

1232-415: The entry on psychodrama claims it is not a form of group therapy). Another recent development in the theory and method of group psychotherapy based on an integration of systems thinking is Yvonne Agazarian 's systems-centered therapy (SCT), which sees groups functioning within the principles of system dynamics. Her method of "functional subgrouping" introduces a method of organizing group communication so it

1276-524: The example on the right (Initial Card Table), taken from the 1995 Bosnian Conflict . This represents an interaction between the Bosnian Serbs and the United Nations forces over the safe areas. The Bosnian Serbs had Bosniak enclaves surrounded and were threatening to attack. Each side had a position as to what they wanted to happen: The Bosnian Serbs wanted (see 4th column): The UN wanted (See 5th column): If no further changes were made then what

1320-546: The form of irrational processes in group sessions. Foulkes developed the model known as group analysis and the Institute of Group Analysis , while Bion was influential in the development of group therapy at the Tavistock Clinic . Bion's approach is comparable to social therapy , first developed in the United States in the late 1970s by Lois Holzman and Fred Newman , which is a group therapy in which practitioners relate to

1364-444: The group, not its individuals, as the fundamental unit of development. The task of the group is to "build the group" rather than focus on problem solving or "fixing" individuals. In Argentina an independent school of group analysis stemmed from the work and teachings of Swiss-born Argentine psychoanalyst Enrique Pichon-Rivière . This thinker conceived of a group-centered approach which, although not directly influenced by Foulkes' work,

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1408-466: The guidance of the therapist, defense mechanisms are bypassed by the use of signifiers and semiotic processes. The focus remains on the text rather than on personal issues. It was popularized in the science fiction novel, Red Orc's Rage . Group therapy is now often utilized in private practice settings. Group analysis has become widespread in Europe, and especially the United Kingdom, where it has become

1452-466: The initiator until the initiator changes their approach. George Devereux was among the first to explore the therapeutic function of confrontation as it relates to psychoanalysis . He described it as a form of "induc[ing] or forc[ing] the patient to pay attention to something he has just said or done." As Carlson and Slavik continue, this is for the purpose of revealing "new avenues for examination" and to "increase awareness". Devereux saw confrontation as

1496-399: The interaction as a sequence of linked interactions, where the decision matrix changes under the influence of precisely defined emotional dilemmas . Confrontation analysis was devised by Professor Nigel Howard in the early 1990s drawing from his work on game theory and metagame analysis . It has been turned to defence, political, legal, financial and commercial applications. Much of

1540-428: The mid-1990s. For a comprehensive overview of current practices see: Computer-supported psychotherapy . Several feasibility studies examined the impact of computer-, app- and media-support on group interventions. Most investigated interventions implemented short rationales, which usually were based on principles of cognitive behaviour therapy (CBT). Most research focussed on: While the evidence base for group therapy

1584-584: The most common form of group psychotherapy. Interest from Australia, the former Soviet Union and the African continent is also growing. Psychedelic-assisted group psychotherapy can be more cost-efficient in comparison to individual psychedelic-assisted psychotherapy models, because therapists can split the costs among all participants of the group. A 2008 meta-analysis found that individual therapy may be slightly more effective than group therapy initially, but this difference seems to disappear after 6 months. There

1628-472: The parties communicate until they have made their positions clear to one another. These positions can be expressed as a card table (also known as an options board ) of yes/no decisions. For each decision each party communicates what they would like to happen (their position ) and what will happen if they cannot agree (the threatened future ). These interactions produce dilemmas and the card table changes as players attempt to eliminate these. Consider

1672-424: The patient and a therapist, or between the patient and fellow patients during group therapy , in which the patient may be verbally abused, denounced, or humiliated by the therapist or other members of the group. A 1990 report by the Institute of Medicine on methods for treating alcohol problems suggested that the self-image of individuals should be assessed before they were assigned to undergo attack therapy; there

1716-399: The result that, for the first time, I was able to understand my experiences within a theoretical model which allowed me to use them further Confrontation analysis can also be used in a decision workshop as structure to support role-playing for training, analysis and decision rehearsal. Confrontation analysis looks on an interaction as a sequence of confrontations. During each confrontation

1760-431: The sides were saying would happen was (see 1st column): Confrontation analysis then specifies a number of precisely defined dilemmas that occur to the parties following from the structure of the card tables. It states that motivated by the desire to eliminate these dilemmas, the parties involved will CHANGE THE CARD TABLE, to eliminate their problem. In the situation at the start the Bosnian Serbs have no dilemmas, but

1804-411: The theoretical background to General Rupert Smith 's book The Utility of Force drew its inspiration from the theory of confrontation analysis. I am in debt to Professor Nigel Howard, whose explanation of Confrontation Analysis and Game Theory at a seminar in 1998 excited my interest. Our subsequent discussions helped me to order my thoughts and the lessons I had learned into a coherent structure with

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1848-401: Was evidence that persons with a positive self-image may profit from the therapy, while people with a negative self-image would not profit, or might indeed be harmed. Confrontation analysis Confrontation analysis (also known as dilemma analysis ) is an operational analysis technique used to structure, understand and think through multi-party interactions such as negotiations. It

1892-754: Was fully compatible with it. Irvin Yalom proposed a number of therapeutic factors (originally termed curative factors but renamed therapeutic factors in the 5th edition of The Theory and Practice of Group Psychotherapy (1st edition 1970, 5th edition 2005). Group therapy can form part of the therapeutic milieu of a psychiatric in-patient unit or ambulatory psychiatric partial hospitalization (also known as day hospital treatment). In addition to classical "talking" therapy, group therapy in an institutional setting can also include group-based expressive therapies such as drama therapy , psychodrama , art therapy , and non-verbal types of therapy such as music therapy and dance/movement therapy. Group psychotherapy

1936-738: Was pioneered in the mid-1940s by Kurt Lewin and Carl Rogers and his colleagues as a method of learning about human behavior in what became the National Training Laboratories (also known as the NTL Institute ) that was created by the Office of Naval Research and the National Education Association in Bethel, Maine, in 1947. Moreno developed a specific and highly structured form of group therapy known as psychodrama (although

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