Exploring psychotherapy group cultures : Essays on group theory and the development of MATRIX REPRESENTATION GRID, a method for observing therapeutic group processes

EXPLORING PSYCHOTHERAPY GROUP CULTURES. Essays on grouptheory and the development of MATRIX REPRESENTATION GRID, a methodfor observing therapeutic grup processes. G ran Ahlin, Department of ClinicalNeuroscience, Section for Clinical Alcohol and Drug Addiction Research,Karolinska Institutet, Stockholm, Sweden. There is full agreement in the literature that group therapy groupsare efficient but also may be occasionally damaging for participants due tovicissitudes in group dynamics and group process. Better understanding of thenature of therapeutic group processes presupposes advancements in grouptheory and in group process research. This thesis approaches both aspectsfrom a group analytic perspective (a.m. S.H.Foulkes). One result is a theoryabout individual development of relating capacities to dyads, subgroups, smalland large groups as effects inside self-development as described in the recenttheory developed by Daniel Stern. Studies of these proposed relating capacitiesand the concepts network and group membership in relation to the groupanalytic definitions of the concepts group and group matrix have created a basisfor the formulation of a more comprehensive Matrix Theory of Processes inTherapeutic Groups, potentially helpful in clarifying why therapy groups mayturn either therapeutic or damaging in various sequences.It is argued in the thesis that group process research foremost should concernthe group-as-a-whole using observation methods. For outcome research aconsiderable number of reliable research methods studying individual patientsare available. For observing the group-as-a-whole only Whitaker and Lieber-mannls "Group Focal Conflict theory" and Agazarian and Simon's "StructuralAnalysis of Verbal Interaction in Groups" have been developed. In order tostrengthen that research approach this project has developed a therapy groupobservation method based on group analytic theory, especially the concept ofgroup matrix, and on the previous research on group specific therapeutic factors(e.g., by Yalom; Bloch & Crouch and Bednar & Kaul). The instrument, calledMatrix Representation Grid, (MRG), can help an observer in assessing groupthemes related to group climate, offering opportunities for graphic illustration otthe ongoing group process and for micro-outcome evaluation (Orlinsky, Graweand Parks) of group process maturity and therapeutic climate. Group climate isaccording to the theory of the MRG a manifestation of the group matrix inoperation via eight group determinants, i.e., elaborations of the therapeuticfactors of previous research. The MRG has been conceptually and empiricallyvalidated in the project, using three independent observers Its validity has beendemonstrated and its interjudge agreement coefficient between three observerswas found to be 0.69 and its kappa value 0.56.The MRG is now considered ready for further clinical use.Key-words: group analytic psychotherapy, group matrix, group process theory,group therapy research, group observation studies, group determinants, MatrixRepresentation Grid method.ISBN 91-628-1887-