Child Abuse

INDIVIDUAL OR GROUP THERAPY? ON TREATMENT FOR SURVIVORS

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In essence, individual therapy occurs when one therapist works with a single individual in a session, whereas group therapy is defined by treatment delivered by one or more therapists to one or more individuals in the same session.

In individual therapy the issues are brought forth with one therapist listening and responding to the concerns. The type of feedback that is given, or if feedback is given, is dependent on the therapist’s training. The highly personal nature of the exchange between the therapist and the client allows for specific focus on the issues presented. While the dynamics of the relationship between the therapist and client are typically considered important, they can often take a while to emerge before they can have a therapeutic effect. Read more on individual therapy here (link).

Group therapy, on the other hand, involves simultaneous interaction with people typically outside the client’s social and familial network: relative strangers. Sometimes the groups are homogeneous, with people in the group having similar issues, and other times they are heterogeneous, with the members having diverse background and concerns. Working with victimized people requires a committed moral stance. The therapist is called upon to bear witness to a crime. S/he must affirm a position of solidarity with the victim(s). This does not mean a simplistic notion that the victim can do no wrong; rather, it involves an understanding of the fundamental injustice of the traumatic experience and the need for a resolution that restores some sense of justice.

Traumatic events destroy the sustaining bonds between individual and community. Those who have survived learn that their sense of self, of worth, of humanity, depends upon a feeling of connection with others. The solidarity of a group provides the strongest protection against terror and despair, and the strongest antidote to traumatic experience. Trauma isolates; the group re-creates a sense of belonging. Trauma shames and stigmatizes; the group bears witness and affirms. Trauma degrades the victim; the group exalts her/him. Trauma dehumanizes the victim; the group restores their humanity.

Repeatedly in the testimony of survivors there comes a moment when a sense of connection is restored by another person’s unaffected display of generosity. Something in themselves that the victims believes to be irretrievably destroyed—faith, decency, courage—is reawakened by an example of common altruism. Mirrored in the actions of others, the survivor recognizes and reclaims a lost part of herself or himself. At that moment, the survivor begins to rejoin the human commonality.

Commonality with other people carries with it all the meanings of the word common. It means belonging to a society, having a public role, being part of that which is universal. It means having a feeling of familiarity, of being known, of communion. It means taking part in the customary, the commonplace, the ordinary, and the everyday. It also carries with it a feeling of smallness, or insignificance, a sense that one’s own troubles are ‘as a drop of rain in the sea.’ The survivors who have achieved commonality with others can rest from their troubles. Their recovery is accomplished; all that remains before them is their life.

While in principle groups for survivors are a good idea, in practice it soon becomes apparent that to organize a successful group is no simple matter. Groups that start out with hope and promise can dissolve acrimoniously, causing pain and disappointment to all involved. The destructive potential of groups is equal to their therapeutic promise. The role of the group leader carries with it a risk of the irresponsible exercise of authority. Conflicts that erupt among group members can all too easily re-create the dynamics of the traumatic event, with group members assuming the roles of perpetrator, accomplice, bystander, victim, and rescuer. Such conflicts can be hurtful to individual participants and can lead to the group’s demise.

Therefore, In order to be successful, a group must have a clear and focused understanding of its therapeutic task and a structure that protects all participants adequately against the dangers of traumatic re-enactment. Though groups may vary widely in composition and structure, these basic conditions must be fulfilled without exception. The choice to become involved in group or individual therapy will depend on a number of different factors, including affordability, one’s comfort level with discussing problems in front of other individuals, and the type of intervention being used. Neither form of therapy is “better” than the other, but both represent different approaches to reaching the same goal.

 

  1. Psychology Today: The Healing Crowd; Dan J. Tomasulo PhD., MFA, MAPP
  2. Oxford Treatment Center: http://www.oxfordtreatment.com/drug-therapy/group-and-individual/
  3. Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror by Judith Lewis Herman

 

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