Psychometric assessments were carried out before the treatment and at scheduled discharge follow up. Attrition would not only affect the departing participant, Yalom [ 11 ] and Yalom and Leszcz [ 12 ] warned, but also harm those remaining in the group, to whom the group is less complete after someone has dropped out. The diagnosis can only be made if symptoms of re-experiencing, arousal and avoidance are present and a traumatic event is being reported, even though there are clinically relevant posttraumatic syndromes of sub threshold severity. Although GT should be based on a particularly careful indication, it is wide-spread, esp. We used the dissociative experiences scale DES; [ 38 ] to assess dissociative symptoms. High scorers tend not to participate in the group, are passive, private, reserved, not open and unlikely to share feelings with others or to participate in a constructive way. In addition to its genuine symptoms, PTSD is often linked to anxiety disorders, depression and somatoform disorders [ 21 ]. It measures the presence of the following criteria: As for making the indication for group therapy, further domains of interest pertain to the specific setting of a group which will typically offer a multitude of transferences to each client, and to certain symptoms considered inappropriate for GT, such as psychotic or somatoform.
Such intrusive memories can be either physical or emotional and are embedded in a physical state of alertness and fidgetiness causing the individual to avoid any stimuli related to the traumatic event. However, the GSI at follow-up was correlated to dissociation with the subscale amnesia recording the highest significance. Interestingly, these characteristics correspond to the exclusion criteria for GT defined by Strauss et al. Interestingly, the inspection of the exclusion criteria reveals a striking similarity to the features of post-traumatic conditions such as complex posttraumatic stress disorder cPTSD and borderline personality disorder BPD , as will be detailed below. The cut-off was set at 20, as is recommended by the author of the scale. Complex PTSD cPTSD and borderline personality disorder BPD After the concept of PTSD had been introduced, researchers and clinicians learned that it was not capable of capturing all the psychological and psychosomatic changes seen in the aftermath of trauma and therefore defined a form of posttraumatic distress with associated features they called cPTSD [ 26 ]. Kernberg [ 31 ] coined the term borderline personality organisation BPO that refers to a lack of integrated concepts of self and others identity diffusion in combination with the predominant use of immature defence mechanisms, such as splitting and projective identification. Cross tabulation linked the continuation of therapy to higher educational levels university vs. We selected variables as predictors for the following regression analyses according to their significance in previous tests. Instead, it is based on the assumption that complex and prolonged traumatic experience especially during childhood would result in alterations in self-perception, self-regulation and relationships to others, as well as dissociation and somatisation. All participants gave their written informed consent to participate in the study. Research does underscore this disadvantage with regards to small group processes [ 12 , 15 ] and suggests several predictors of low attendance: We used the dissociative experiences scale DES; [ 38 ] to assess dissociative symptoms. The GRQ has good construct [ 44 ] and convergent validity [ 16 ] and several studies have confirmed its factor structure [ 42 , 44 ]. In this respect, the participants of the present study were selected for their appropriateness for the setting. The concept of cPTSD, however, has been criticized for several reasons. T-tests are displayed in Table 2, which shows the associations between correlates of trauma and SCL subscales. In their article on assessment methodologies regarding small group processes, Strauss et al. The GSI at scheduled discharge was used as the follow-up measure. February 09, ; Accepted date: Given the extension of institutionalized GT, many of the clients referred to a hospital because of one of these disorders will be finding themselves in a psychotherapeutic group. Furthermore, interpersonal characteristics of the participant such as interpersonal sensitivity, social competence, likeability and friendliness contribute to therapeutic effectiveness, whereas competitive, domineering and aggressive behaviour may increase group attrition rates [ 2 ]. For each item, the participants were asked to indicate their individual degree and frequency of symptom experience on a scale ranging from Essentially, both, affective dysregulation in cPTSD and attachment issues in BPD, likely signify a troublesome indication for GT according to the above mentioned in- and exclusion criteria [ 18 ]. Psychometric assessments were carried out before the treatment and at scheduled discharge follow up. J Psychol Psychother 7: It is subdivided into subscales assessing identity diffusion, primitive defense mechanisms, reality testing and fear of closeness.
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