Description Of Treatment

Behavioral group therapy (BGT) is an effective, efficient psychotherapy that has been successfully adapted to treat a wide variety of psychological disorders, and occasionally to address psychosocial aspects of physical ailments (e.g., irritable bowel syndrome). BGT shares some characteristics with other forms of group psychotherapy and is not simply a didactic, classroom-style approach to skills acquisition. At the same time, it is also a unique group therapy in several respects. The content is structured, both within and across sessions. Compared to group therapy in general, the design of BGT is specific toward the target problem, even in some of the more "generic" forms of BGT that tackle groups of problems. BGT is multimodal in nature whereby a package of treatment components is assembled to address the multidimensional nature of most forms of psychopathology. Finally, the number of sessions is generally fixed and the duration of treatment is measured in weeks rather than months. BGT uses closed groups of medium size (e.g., 6 to 8 individuals), and is often preceded by one-on-one interviews with prospective group members and one of the therapists in order to establish diagnoses and assess suitability for group therapy Following formal treatment, a more informal group open to "graduates" of the BGT program is often useful to provide booster sessions for those who require it.

There are important advantages to offering behavior therapy in a group setting. The first reason is efficiency More people can be helped with less therapist time, although it can require more administrative coordination and scheduling. In the case of relatively homogeneous groups that are organized around the primary disorder, there comes the reassuring sense of common, shared experience for many individuals. Perhaps the most important advantage of the group format is that the role of the therapist can be systematically decentralized and instead a self-help approach is encouraged. Group members can act as supportive coaches in reviewing and engaging in exposure exercises, and can work together in cognitive restructuring. Group cohesion and a self-help orientation can promote self-reliance and ultimately self-efficacy and mastery. Accordingly, terms like "program" may be preferable to "therapy," and "group member" may be preferable to "patient."

The next section provides a theoretical overview of BGT. Immediately following this overview we present two case illustrations of BGT. The first involves a protocol for panic disorder with agoraphobia, and serves to highlight different types of exposure techniques in BGT. The second BGT protocol has more cognitive components and is designed to treat generalized social phobia. The chapter concludes with a brief discussion of applications and exclusions for BGT, along with a summary of the current empirical knowledge base.

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