The use and effect of training groups as pretherapy
This investigation was undertaken to evaluate the effectivenss of a 3-day Patient Skill Training Laboratory(PSTL) designed to increase the facilitative behaviors (constructive behaviors enhancing group goals) of psychiatric outpatients during subsequent group psychotherapy. In addition the effect of the PSTL program on the following variables was also investigated: (1) level and distribution of patient participation, (2) group atmosphere, (3) leveling, (^) here-and-now orientation, (5) overall benefit received from the day hospital program, (6) psychological symptoms, (?) depression, and (8) anxiety. The subjects were psychiatric outpatients participating in a day hospital treatment program. These patients made up a total of 8 separate groups of subjects. The methodology required that 4 groups (experimental condition) receive the PSTL training with 2 of these groups assigned to one therapist (Therapist A) and the other 2 groups assigned to a second therapist (Therapist B). The other 4 groups were assigned to the control condition with 2 of these groups assigned to Therapist A and the other 2 groups assigned to Therapist B. Besides participation in PSTL, the experimental and control groups received identical treatment. It was hypothesized that groups receiving PSTL training would: (1) exhibit more facilitative behaviors, (2) participate verbally at a higher level, (3) have less variance between individual levels of participation, (4) reflect a group atmosphere more oriented towards work and cooperation, (5) demonstrate a higher degree of leveling in group, (6) apply a here-and-now orientation in group discussions more often, (7) obtain more benefit from the day hospital program, (8) manifest less psychological symptoms, (9) reveal less depression, and (10) display less anxiety. The first 6 hypotheses were confirmed. These hypotheses pertained to the more direct and immediate effects of the PSTL program. Experimental groups improved their level of facilitative behaviors significantly as a result of the PSTL training. On the other hand, control groups maintained a high level of facilitative behaviors across pre and post measures. There was a significant improvement on level of verbal participation demonstrated by experimental groups while control groups exhibited a general decline. The experimental groups showed an overall significant reduction in participation variance after receiving the PSTL training.This reduction in variance was not observed in the control groups. The lessening of participation variance was mostpronounced in the experimental groups conducted by Therapist B. The group atmosphere of the experimental groups improved significantly after the PSTL training while that of the control groups declined. The extent of leveling demonstrated by the experimental groups improved significantly after the PSTL training while control groups showed no improvement. The experimental groups demonstrated significant improvement from pre to post measures in their use of a here-andnow orientation while control groups remained unimproved. None of the remaining hypotheses were supported. There were no differences between experimental and control groupon benefit received from the day hospital program, psychological symptoms, depression, or anxiety. This lack of differences was explained as being due to the high level of stated benefit received from the day hospital program by all groups, the. initial low levels of psychological symptoms and low levels of depression exhibited by all groups, and the chronic and long-standing nature of anxiety levels demonstrated by all groups. Another explanation given for the lack of significant improvement by the groups that received the PSTL training on benefit received from the day hospital, psychological symptoms, depression, and anxiety was that these were all variables not directly focused on by the PSTL program. Additional findings indicated that although there were no measured differences between the 2 group therapists, both therapists were rated by their respective groups as showing significantly less facilitative behaviors and less verbal participation when working with the experimental groups. This difference was seen as partially accounting for (a) higher levels of facilitative behaviors shown by control groups throughout the study, (b) initial lower levels of facilitative "behaviors shown by the experimental groups, and (c) the initial higher levels of participation demonstrated by the control groups over the experimental groups. While these therapist effects were not anticipated, they show the influence that therapists' level of facilitative behaviors and verbal participation can have on groups. However, and perhaps more important, these results demonstrate the overriding effects of a brief 3-day training on group processes (PSTL). Groups receiving the PSTL training improved their performance on group behaviors whole the therapists' level of facilitative behaviors and verbal participation were lower than those shown with the control groups.