Transcript Yalom’s Therapeutic Factors

Yalom’s Therapeutic Factors
By
Patti Higgins
Yalom’s Therapeutic Factors
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Yalom (1995) defined therapeutic factors as
"the actual mechanisms of effecting change
in the patient" (p. xi).
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Yalom identified 11 factors that influence
the processes of change and recovery
among group therapy clients.
11 Therapeutic Factors
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Universality - feeling of
having problems similar
to others, not alone
Altruism - helping and
supporting others
Instillation of hope encouragement that
recovery is possible
Guidance - nurturing
support & assistance
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Imparting information teaching about problem
and recovery
Developing social skills
- learning new ways to
talk about feelings,
observations and
concerns
Interpersonal learning finding out about
themselves & others
from the group
11 Therapeutic Factors
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Cohesion - feeling of
belonging to the group,
valuing the group
Catharsis – release of
emotional tension
Existential factors – life
& death are realities
Imitative behavior –
modeling another’s
manners & recovery
skills
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Corrective
recapitulation of family
of origin issues –
identifying & changing
the dysfunctional
patterns or roles one
played in primary
family
Assessment of factors
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Therapeutic Factors
Inventory (TFI) empirically derived
comprehensive
assessment of the
presence or absence of
the 11 therapeutic factors
in a group (Lese &
MacNair-Semands,
1997)
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Yalom Q-sort assesses
patients’ perceptions of
therapeutic factors and
consists of 60 statements
representing 12
categories of therapeutic
factors. A ranking of 1 to
60 is produced.
Bloch, Reibstein, Crouch,
Holroyd and Themen's
(1979) assessment uses
independent raters to
judge presence of
therapeutic factors.
Navajo sweat lodge study
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Colmant and Merta (1999)
explored the Navajo sweat lodge
ceremony as a culturally relevant
and therapeutic approach to group
therapy. They compared the sweat
lodge ceremony used at a
residential treatment center for
Navajo males aged 6-15 years old
with disruptive behavior disorders,
to modern group work with
Yalom’s therapeutic factors.
Differences among factors’ values
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Older women in an outpatient therapy group ranked existential awareness as the
most important therapeutic factor (McLeod & Ryan, 1993).
Morgan & Ferrell (1999) found therapists' perceived interpersonal learning,
universality, & imparting info highest for group of incarcerated males.
Schwartz and Waldo (1999) found imparting of information and development
of socializing techniques most valuable in educational groups for batterers.
Campbell & Page (1993) found recovering drug addicts ranked highest:
information dissemination, corrective recapitulation of the primary family,
development of socializing techniques, imitative behavior, interpersonal
learning, group cohesiveness, and catharsis.
Mawson & Kahn (1993) reported women in career counseling group rated
cognitive and affective components as most valuable.
Tomasulo, Keller & Pfadt (1991) found psycheducational groups therapeutic.
Kivlighan & Goldfine (1991) found guidance increased across the stages of
group, universality and hope decreased, and catharsis increased in beginning.
Yalom’s adages:
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Therapy group is a
social microcosm and
a reenactment of the
primary family.
Therapists should
listen to their patients.
Patients should listen
to and learn from one
another.