ABSTRACT
Not everyone who becomes a member of a therapeutic group gains in personal ways. Some people gain very little from their experience in a group, some seem hardly to gain at all, and some experience actual harm. This chapter considers influences on little or no gain and on harm, and discusses what a therapist can do in the face of them. The chapter is organised into the following sections:
• Definitions of little or no gain and of harm. • The influence of a group’s composition on little or no gain or harm. • The influence of a group’s size: groups which are or become too small. • The influence of interactions and dynamics within the group. • The influence of therapist actions or failure to act. • The influence of the stance and behaviour of individual members, which can
either support or limit the gains which they achieve. • Are individuals in groups neglected or deprived because of the presence of other
patients? • Dynamics associated with little or no gain compared with dynamics associated
with harm. • References in the literature to no-gain or to harm-generating features of groups. • Can a therapist avoid the occurrence of no-gain and/or of harm?
