Session 2: The Role of Members

The group climate intensifies in Session 2 as members reveal more about themselves, their relationships, and their emotional reactions. The group is on track if members can discuss key people in their lives, begin to show signs of connection to each other, and demonstrate some understanding of the association between symptoms and interpersonal functioning. The therapist focuses in this session on members learning to identify and manage the emotions they experience in the group. Some members might hint at feeling overwhelmed by emotions. Members may also worry about “fitting in” with the group or whether the group will be help them. It is useful, therefore, to urge members to stick with the process, and let them know they will likely feel more comfortable as they come to trust each other more. (See Table 20.5 for a summary checklist covering Session 2.)

By the second session, the initial review of target goals in Session 1 will likely lead members to discuss ways in which they have begun to apply new approaches to their problem areas. In this excerpt from an IPT-G binge eating group, notice how the

Table 20.5. Summary Checklist for Session 2

Therapist Tasks

1. Start and end group on time.

2. Review introductions and important structural aspects of IPT, as needed.

3. Teach members their role in IPT treatment.

4. Cultivate positive group norms:

  • • Encourage all members to join discussion of interpersonal relationships related to target goals.
  • • Continue to assist members in making connections among target goals, difficulties managing relationships, and associated symptoms.
  • • Facilitate member self-disclosure and awareness of feelings.
  • • Help members begin to modify goals and to understand how to apply them.

Individual Patient Tasks

1. Deepen feelings of connection to other members.

2. Continue to learn how to use group structure and process to work on target goals.

3. Review significant interpersonal relationships.

4. Continue to make connections among target goals, difficulties managing relationships, and associated symptoms.

5. Begin to share more about self and feelings.

6. Begin to modify target goals, and understand how to apply them in daily life.

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 redirects Robert’s focus on his symptoms to an awareness of his struggles in his current relationships with his wife and father:

therapist: Many of the goals you have created center on the important people in your lives. Much of the binge eating centers on either difficulties in relationships or lack of relationships. As you share more about how your goals are fitting, also talk more about these important people. Not only does it give us more information, so we understand you more fully, but it also gives us the opportunity to help you achieve some of these relationship goals. robert: Well, for me, last week was a pretty mellow week as far as my eating. I spent a lot of hours at work, so I didn’t have a whole lot of hours to eat, which was good. I had an episode Sunday, though. When I finished my work, I went in and started cooking, and I didn’t stop until I got a phone call. Thank goodness he called me last night because I would’ve eaten all the way through till this morning. co-therapist: One of the things you shared with me, and I think a lot of you have talked about this, is that eating is a way to unwind, you know, and to kind of destress. Instead of talking to or doing something with someone, a friend or spouse, you turn to food.

robert: Boy, did I unwind, right on the refrigerator . . .

Co-therapist: How are some of the other things going with working on your goals, with your relationship with your wife?

Robert: Good. My wife and I are actually talking quite a bit more. She’s not used to that, so she’s kind of wondering. But then she knows why I’m asking her questions and then talking to her more, because of the group and my goals. She’s pretty private herself and doesn’t talk a lot either. So it’s weird for us to do that. You know, it’s like I try to sneak the information out of her.

Co-therapist: So, that was one of the things you’re working on, to share more? It’s great that you’re already trying to do that. I think a few others have that as a goal also.

Robert: Yeah, sharing with her more in general and also about how I feel about my father. He’s out of the hospital. I haven’t known him for very long, since we were only recently reunited, so I want to keep him around as much as I can.

Nancy: It’s good to hear that he’s doing better.

Jeanne: I think I told you that my daughter found me after many years—she was adopted out. . .

In this example, the therapist was able to keep the group discussion focused on relevant tasks, while encouraging Robert for beginning to work towards his goals.

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