ABSTRACT
The ‘negotiations’ around a treatment contract will include different aspects of group participation. Patients are informed about group size and composition, time, location, duration, price, rules, etc. It may be important to help patients understand that the group is a place especially suited for working on interpersonal problems. If the patient is unaware of these aspects of his or her problems, it can be important to try to reformulate the problems in an interpersonal language. It is also important to discuss their goal(s) for the therapy. The therapist also has a responsibility of informing patients about the purpose of the group, what is expected of them and something of how they have to behave in the group. Rules about openness, activity, duty of not revealing things outside the group, etc., should not be presented in an authoritarian way, since the therapist aims from the start to build an accepting and caring group culture, based on equality. It may also be important to say something about previous positive experiences with group therapy, what group research results show, and so forth, in order to create positive expectations for the therapy. This motivational work may be especially important because patients are often less motivated for group therapy than individual therapy. A primary reason for this might be that just the thought of having to relate to several persons at the same time mobilizes anxiety and resistance. This is easy to understand since interpersonal problems are often central elements in the cluster of problems patients face. This affords us the opportunity to demonstrate and explore with the patient what their anxiety and scepticism is about. As a consequence of this it may be possible, even in the preparatory sessions, to formulate central issues that need to be dealt with and worked through, for example the wish to be ‘the only one’, fear of being dominated or of dominating others, fear of becoming everyone’s helper, fear of hurting others, etc. It is especially important to explore all negative ideas and expectations, which, if not addressed, may easily lead to destructive acting out.
