Fundamental Clinical Dilemmas in Contemporary Group Psychotherapy

Abstract

Time-limited and problem-focused trends in mental health services from contemporary economic forces in both managed care and institutional settings have had a direct effect on the clinical decision-making of group psychotherapists. This article outlines five dilemmas that are examined in the light of the current milieu. These include the varying degrees of homogeneity versus heterogeneity in patient selection, the integration of psychoeducational methods with interpersonal processes in group therapy, the effects of time limitations on the collective therapeutic focus of the group, the balance between support and confrontation in time-limited group treatment and the dilemmas surrounding the therapist’s relative degree of transparency versus opaqueness in the group.