Increasing Positive Patient Outcomes Part 4

Group Therapy Techniques to Address Honesty, Open Mindedness and Willingness

Last month I introduced the incomplete sentence group therapy technique. The sentences for this group exercise were clustered around three critical issues in recovery: honesty, open mindedness and willingness. Three key conditions for successful recovery. The goal of this intervention is to facilitate awareness, an awareness of how each group member interferes with their ability to be honest, open minded, or willing.

Awareness is in and of itself therapeutic. When a person becomes aware of how they are sabotaging their honesty, their open mindedness, or their willingness they spontaneously move in the direction of more honesty, open mindedness and willingness. So let’s take a look at how you can use the incomplete sentences to facilitate awareness.

Let’s imagine that I am facilitating a group session in a 30-day inpatient program. In yesterday’s session I sensed a reluctance among the group members to challenge each other. It’s almost as if the members of this group have made a pact with each other to avoid their pain. I let the group know that I had a hunch that they were enabling each other. They seemed dumbfounded and were not certain what I meant. I told them that I wanted to explore this issue in our next group meeting if they were open to my suggestion. They all agreed.

Instead the the typical “feeling round” I suggested that we start the meeting with an incomplete session exercise. I asked them to complete the following sentence with the first thought that came to their mind. “The hardest thing about confronting each other is ________.” Here are their responses:

John (New to the group): The hardest thing about confronting each other is that I don’t believe I have the training to tell someone that what they are doing is wrong.”

Bill (Been in group 3 weeks, doing well): The hardest thing about confronting each other is that I am afraid I won’t be liked.

Darryl (Been in group 2 weeks, high AMA risk): The hardest thing about confronting each other is that I believe what they are doing with their lives is none of my business.

Shaun (Been in group 1 week): The hardest thing about confronting each other is that I could say something that might offend someone. We do have to live with each other after the group.

Jorge (Been in group 2 weeks): The hardest thing about confronting each other is that I don’t believe I have the right to interfere with someone else’s life.

Two themes surfaced in the responses that the group members gave to the incomplete sentences: 1) anxiety about not being liked if something is said that upsets someone, and 2) the concern that one doesn’t have the right to say something to someone else about how they are behaving. These two types of concerns created a resistance that interfered with the therapeutic climate and functioning of the group, and therefore need to be addressed.

After each member of the group completed the sentence I asked them all to reflect on what they heard from each other. Typically this discussion with the group after an incomplete sentence exercise identifies the themes that surfaced during the exercise. If it doesn’t, then I help out. In this case let’s say they correctly identified the anxiety about being liked and the concern about meddling. I would then point out to the group that they were putting being liked ahead of being of real value to each other, that giving someone feedback about what they are doing or what they are avoiding might save their life.

The next thing I would address is the concern they had about crossing a boundary, they shouldn’t cross, if they gave each other feedback. I would tell them that this might be true, but it might not. They could however do something to find out if someone was open to hearing what they have to say: they could check it out with the person before offering them the feedback. I woud then ask them if they could see my point and let’s say they said they could.

After this discussion it would be important to actually have some of the group members try on this new behavior. Therefore I asked those individuals who brought this up as a concern to identify who they wanted to give feedback and to check it out with them if they were open to hearing what they had to say. Integrating this new understanding of how to function is an important step to insuring that the group will realize its therapeutic potential.

By Allen Berger, Ph.D.

References
Berger, A. (1990, 2007). How to get the most out of group therapy. Mn: Hazledon.
Luft, J. (1963,1970). Group Processes: An Introduction to Group Dynamics. Mayfield Publishing Co.: California.
Luft, J. (1969). Of Human Interaction. Mayfield Publishing Co.: California.