Yalom’s Therapeutic Factors
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Transcript Yalom’s Therapeutic Factors
Yalom’s Therapeutic Factors
By
Patti Higgins
Yalom’s Therapeutic Factors
Yalom (1995) defined therapeutic factors as
"the actual mechanisms of effecting change
in the patient" (p. xi).
Yalom identified 11 factors that influence
the processes of change and recovery
among group therapy clients.
11 Therapeutic Factors
Universality - feeling of
having problems similar
to others, not alone
Altruism - helping and
supporting others
Instillation of hope encouragement that
recovery is possible
Guidance - nurturing
support & assistance
Imparting information teaching about problem
and recovery
Developing social skills
- learning new ways to
talk about feelings,
observations and
concerns
Interpersonal learning finding out about
themselves & others
from the group
11 Therapeutic Factors
Cohesion - feeling of
belonging to the group,
valuing the group
Catharsis – release of
emotional tension
Existential factors – life
& death are realities
Imitative behavior –
modeling another’s
manners & recovery
skills
Corrective
recapitulation of family
of origin issues –
identifying & changing
the dysfunctional
patterns or roles one
played in primary
family
Assessment of factors
Therapeutic Factors
Inventory (TFI) empirically derived
comprehensive
assessment of the
presence or absence of
the 11 therapeutic factors
in a group (Lese &
MacNair-Semands,
1997)
Yalom Q-sort assesses
patients’ perceptions of
therapeutic factors and
consists of 60 statements
representing 12
categories of therapeutic
factors. A ranking of 1 to
60 is produced.
Bloch, Reibstein, Crouch,
Holroyd and Themen's
(1979) assessment uses
independent raters to
judge presence of
therapeutic factors.
Navajo sweat lodge study
Colmant and Merta (1999)
explored the Navajo sweat lodge
ceremony as a culturally relevant
and therapeutic approach to group
therapy. They compared the sweat
lodge ceremony used at a
residential treatment center for
Navajo males aged 6-15 years old
with disruptive behavior disorders,
to modern group work with
Yalom’s therapeutic factors.
Differences among factors’ values
Older women in an outpatient therapy group ranked existential awareness as the
most important therapeutic factor (McLeod & Ryan, 1993).
Morgan & Ferrell (1999) found therapists' perceived interpersonal learning,
universality, & imparting info highest for group of incarcerated males.
Schwartz and Waldo (1999) found imparting of information and development
of socializing techniques most valuable in educational groups for batterers.
Campbell & Page (1993) found recovering drug addicts ranked highest:
information dissemination, corrective recapitulation of the primary family,
development of socializing techniques, imitative behavior, interpersonal
learning, group cohesiveness, and catharsis.
Mawson & Kahn (1993) reported women in career counseling group rated
cognitive and affective components as most valuable.
Tomasulo, Keller & Pfadt (1991) found psycheducational groups therapeutic.
Kivlighan & Goldfine (1991) found guidance increased across the stages of
group, universality and hope decreased, and catharsis increased in beginning.
Yalom’s adages:
Therapy group is a
social microcosm and
a reenactment of the
primary family.
Therapists should
listen to their patients.
Patients should listen
to and learn from one
another.