Postpartum group therapy with unwed mothers.
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This paper reports on the utilization of family system concepts in the understanding and treatment of trichotillomania. The paper discusses family interactional aspects of trichotillomania in four families as well as a description of assessment, intervention and follow-up procedures used with each family group.
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Group psychotherapy may often be the treatment of choice for patients whose somatic symptoms are a reflection of interpersonal difficulties which are not of sufficient magnitude to warrant referral to a mental health professional. This type of treatment can be offered in the context of family practice, with benefit to both patient and physician. The physician may function as co-therapist with a more experienced group leader; it is essential, also, that competent supervision be available. Such a group was established in a family practice center; it met for 20 weekly sessions. Patient improvement ranged from minimal to considerable; in addition, the frequency of visits to the Center for essentially non-medical reasons decreased considerably, with the greatest decrease in such visits occurring 6 to 15 months after termination of group treatment. This is the first part in a four-part series dealing with group therapy in family medicine.
To tailor a behavioral science curriculum to family practice needs, less importance should be given to inpatient psychiatry, and more emphasis to the common outpatient problems seen in the primary care setting. The experience of co-leading a short-term couples therapy group during residency training can assist the family physician in becoming more comfortable with marital counseling. Each couples group was co-led by a resident and a behavioral scientist, with couples who had requested marital treatment from the mental health service of a health maintenance organization. After couples were initially evaluated with a pregroup questionnaire, a number of group therapy sessions were co-led, using specific communications techniques and exercises. Benefits to the resident included development of skills in handling small groups, learning behavioral tools for assisting couples, and developing increased comfort in approaching psychosocial issues.