PHASES OF IPT-G

Each of the three IPT phases has specific strategies and tasks for therapists and patients (Weissman et al., 2000). These phases are defined to guide therapists in helping individuals to identify problem areas, work on their goals, and consolidate their work in treatment. Although these same phases reflect an individual’s progression in IPT-G, they do not reflect the stages of group development, nor do they necessarily provide intervention strategies for fostering healthy group development. As such, a stage-oriented group approach (MacKenzie, 1994) complements the structure of the therapeutic tasks and the three phases of IPT. This model of group development parallels the developmental sequence of the three IPT phases (Table 20.2).

Therapist Activity Level in IPT-G

How “active” a therapist is during group psychotherapy sessions can vary widely, ranging from using a detailed agenda to maintain control of process, to moderate control through group exercises and active focusing techniques, to relatively unstructured groups that have only a general common direction or thematic focus. Therapist activity level for IPT-G falls in the middle of this range, with the therapist maintaining an active stance to keep members focused and engaged regarding predetermined areas of clinical relevance, while allowing the group to pursue pertinent issues that arise, as well as noting interactions within the group. Maintaining this stance is crucial, as a constantly shifting structure will fragment the group and impede effective group development.

The IPT-G therapist’s role involves greater emphasis on maintaining constructive group properties and less on specific therapist interventions. Strategic group management establishes structure, with the expectation that much of the therapeutic potential will arise through the vehicle of group interaction rather than from the

Table 20.2. Linking the Phases of IPT to the Stages of Group Development

IPT Phases/ Tasks

Group Stages

Members’ Work

Therapist Interventions

Initial

Sessions 1-5: Identify problem areas

Engagement Session 1 & 2

Members seek structure as they grapple with the anxiety of being in a group and sharing their problems.

Therapist establishes a structure that encourages appropriate self-disclosure and facilitates norms for effective

communication.

Differentiation Sessions 3-5

Members work to manage negative feelings over interpersonal differences as these emerge in the group.

Therapist helps members understand their reactions in the context of interpersonal differences in their outside social lives.

Intermediate Sessions 6-15: Work on goals

Work

Sessions 6-15

Members work out differences and strive toward common goals.

Therapist facilitates connections among members as they share their work with each other and encourages practice of newly acquired social skills inside and outside the

Termination

Sessions

16-20:

Consolidate

treatment

Termination Sessions 16-20

Members struggle with how to manage the impending loss of connection with other group members.

group.

Therapist helps members to consolidate their work and to plan continued work and assists members in grieving over loss of the group.

Copyright © 2000 Denise E. Wilfley, K. Roy McKenzie, R. Robinson Welch, et al. Reprinted by permission of Basic Books, a member of the Perseus Books Group.

therapist directly. Particularly in the early phase of the group, the therapist must pay attention to developing a cohesive working group environment. Once positive group process norms are established, the specific issues of individual members can receive greater attention. The therapist encourages active application to outside relationships and encourages the group to review and discuss how they are implementing and experiencing these changes. The therapist does not emphasize specific intragroup interactions, managing rather than exploring these. Although active, the therapist’s role largely consists of promoting therapeutic group activity: hence members may experience the therapist as a facilitator who sits, to some extent, in the background.

 
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