Group Works!
Evidence on the Effectiveness of Group Therapy
During the last 30
years, studies have shown the growing benefits of group
psychotherapy in a number of areas of life challenges. Through
groups, individuals find a forum of peer support, gaining strength
as they share their feelings and experiences with others who are
facing the same obstacles as themselves. Some gain strength in
seeing the resourcefulness of those in the same situation, while
others renew their feelings of self-worth through assisting others.
During the group
process, people develop a support network through each other -- no
longer feeling isolated by their condition and gaining a greater
sense of normalcy. With certain medical conditions, group
psychotherapy can contribute to general improvement in one’s
psychosocial functioning. Research also has shown that survival
rates have, in some cases, actually increased, with proper therapy.
Research has demonstrated that various forms of group psychotherapy
are equally beneficial with positive results found across the board
for a variety of disorders.
Group therapy is also cost-effective when compared to individual
treatment. When a therapist’s time is spent with an entire group
instead of one person, the expense for individuals is significantly
reduced while the benefits remain and, in some instances, prove to
be even greater.
References
Who Can Benefit from Groups
Addictions and
Substance Abuse
Cancer
Patients
HIV/AIDS Patients
Character Disorders
Depression &
Grief
Eating
Disorders
Youth Violence
Addictions and Substance Abuse
Support for group
therapy as an essential element of substance abuse and addiction
treatment is unequivocal and overwhelming. It is rare -- if not
impossible -- to find any treatment program in this country that
does not utilize group therapy as a crucial component of its
treatment regimen. Recommendations from expert clinical practice
guidelines and best research evidence all indicate that it is vital
that group therapy remain a staple of substance abuse and addiction
treatment. Enthusiastic collaboration from directors of training and
Federal guidelines from the National Institute of Drug Abuse (NIDA)
and the National Institute of Alcoholism and Alcohol Abuse (NIAAA)
have resulted in the mandate that group therapy be a part of every
substance abuser’s treatment. While therapeutic efficiency and
cost-effectiveness play an increasingly important role in the
utilization of group therapy as the treatment of choice for this
population, there are other distinctive features and advantages of
group treatment. Over the last twenty years, a general consensus has
emerged that group treatment provides a number of unique
opportunities for substance abusers to learn about themselves and
alter their abuse of substances.
Some of the
advantages of group therapy include:
1. mutual identification with and
acceptance from others going through similar problems as they learn
they are not alone or unique as they struggle with their compulsive
use of substances,
2. positive peer support with the
abstinence or reduction of substance use,
3. role modeling for abstinence or
reduction of substance use is enhanced because the substance abuser
has the opportunity to better understand their own attitudes about
substance use and their defenses against giving up or reducing
substance use by confronting similar attitudes and defenses in
others,
4. affiliation, cohesiveness, social
support while learning to identify and communicate feelings more
directly,
5. structures, discipline and limit
setting while permitting experiential learning and exchange of
factual information about recovery and drug use,
6. installation of hope, inspiration
for the future and the pursuit of shared goals and ideas.
References
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Cancer Patients
Many cancer
patients have witnessed positive results with group therapy. For
patients in the early stages, group therapy helps them deal with
their illness in a multitude of ways. For instance, as emotional
distress decreases, a person’s social activity, coping and
self-esteem has increased. For those in more advanced stages,
people have not only gained a greater sense of purpose in life but
have also found pain and fatigue to become less of a problem. When
those who are unaware or in denial take part in therapy, their
deterioration is often lessened, while improvements are enhanced for
those already aware of their condition. People who are limited in
social and personal resources find group psychotherapy can lead to
greater benefits. More compellingly, studies support the value of
long-term interactive groups for those with advanced cases of
widespread disease. In the case of breast cancer, for example,
patients in a group psychotherapy test survived significantly longer
than those in the control conditions. Additionally, members of
cancer support groups notice a reduction in their amount of pain and
stress-related physical problems.
References
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HIV/AIDS Patients
HIV/AIDS patients
undergoing group psychotherapy have reported lower levels of stress
and burnout as well as improvements in their physical condition as
well as greater self-efficiency and hardiness. For homosexual men
suffering from depression, group therapy often provides improvements
in psychiatric symptoms. With adolescents, self-esteem has
increased while behavioral problems, distress and family stressors
have often decreased. Patients who participated in Cognitive
Behavioral Stress Management groups noticed reductions in
depression, anxiety and self-reported healthcare visits.
References
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Character Disorders
Intense group
psychotherapy sessions have yielded significant results for people
with character disorders. As patients improve interpersonal skills,
mood control and self-esteem, dysfunction levels in social and
family situations, along with the severity of their disturbance can
diminish, leading to an overall improvement in life satisfaction.
Group psychotherapy also has helped reduce depression and suicidal
tendencies in some instances of personality disorders. Improvement
has been shown through working in a variety of different groups and
situations, giving patients the opportunity to work with a large
number of peers and staff. In such circumstances, patients show
improvement solely from group therapy, without having individual
treatment. Further, once patients are involved in therapy they may
be more apt to experience a reduction in symptoms particular to
their specific disorder.
References
Top of Page
Depression & Grief
Group psychotherapy is also used to
help treat people with depression. For example, women who have
suffered the loss of a child have reduced their amount of grief and
post-traumatic stress syndrome through group. Surrounding
themselves with a peer group helps women heal and regain a sense of
hope. Likewise for single depressed mothers, participants can
increase their self-esteem and function better within their families
with the right support.
References
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Eating Disorders
Eating disorders
are also treated by group. In the case of bulimia nervosa some
group participants have been able to reduce the amount of bingeing
and purging with even greater benefits resulting from earlier
interventions and more intensive therapy. Overall, eating behavior
has been shown to improve while simultaneously reducing anxiety and
depression.
References
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Youth Violence
Youth violence is
a disturbing trend. As violence has risen in our schools,
prevention methods are being sought to prevent young people from
such detrimental behavior. By bringing versions of group therapy
into the classroom, students are shown how to avoid aggressive
behavior and its consequences. In studies where youths previously
involved in violence took part in group therapy, a significant
reduction was seen in aggressiveness and in subsequent arrests;
academic performance also was shown to improve. With early
intervention and active discussion about violence, many students can
learn how to curb violent tendencies and interact more normally with
others.
References
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About the American
Group Psychotherapy Association
The American Group Psychotherapy Association is the
foremost professional association dedicated to the field of group
psychotherapy, operating through a tri-partite structure: AGPA, a
professional and educational organization; the Group
Foundation for Advancing Mental Health, its philanthropic arm; and the
International Board for Certification of Group Psychotherapists, a standard setting and certifying
body. This multidisciplinary association has 3,000 members,
including psychiatrists, psychologists, social workers, nurses,
clinical mental health counselors, marriage and family therapists,
pastoral counselors and creative arts therapists, many of whom have
been recognized as specialists through the Certified Group
Psychotherapist credential. The association has 31 local and
regional societies located across the country. Its members are
experienced mental health
professionals who
lead psychotherapy groups and various non-clinical groups. Many are
organizational specialists who work with businesses, not-for-profit
organizations, communities and other "natural" groups to help them
improve their functioning.
For information on
group therapy and AGPA call 212-477-2677, toll free at 877-668-AGPA
(2472), or visit our website at
www.agpa.org.
Information About Group Psychotherapy
Search for
a Psychotherapist Near You
Top of Page
References:
GROUP WORKS
1.
Leszcz. M. & Goodwin,
P.J. (1998) The Rationale and Foundations of Group Psychotherapy for
Women with Metastatic Breast Cancer. In Sherman, Mosier, Burlingame
et. al. Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. New
York: American Group Psychotherapy Association, p. 3.
2.
Simonton, S. & Sherman,
A. (2000) An Integrated Model of Group Treatment for Cancer
Patients. In Piper, E. & Ogrodiczuk, J.S. Brief Group Therapy,
p. 10.
3.
Spiegal, D. et. al.
(1989) Effect of Psychosocial Treatment on Survival of Patients with
Metastatic Breast Cancer. In Sherman, Mosier, Burlingame et. al.
Group Interventions for Patients with Cancer and HIV Disease: Part
I. Efficacy at Different Phases of Illness. New York: American
Group Psychotherapy Association, p. 70.
4.
Fuhriman, A. &
Burlingame, G.M. (1994). Group Psychotherapy: Research and
Practice. Piper, E. & Ogrodiczuk, J.S., Brief Group Therapy, p.
2.
5.
McRoberts, C. et. al.
(1998) Comparative Efficacy of Individual and Group Psychotherapy.
In Piper, E. & Ogrodiczuk, J.S., Brief Group Therapy, p. 3.
6.
Tschuschke, V., et. al.
(1999) Gruppentherapie Versus Einzeltherapie [Group Versus
Individual Psychotherapy – Equally Effective?] in Burlingame, G.M.,
MacKenzie, K.R. and Strauss, B. Small Group Treatment: Evidence
for Effectiveness and Mechanisms of Change, p. 38.
Top of Page
ADDICTIONS AND SUBSTANCE ABUSE
1.
Brook, D. W. (2008). Group therapy. In M. Galanter & H.D. Kleber
(Eds.), The American Psychiatric Publishing textbook of
substance abuse treatment. (4th ed.; pp.1413-1427).
Arlington, VA: American Psychiatric Publishing, Inc.
2.
Brook, D. W., &
Spitz, H. I. (Eds.).
(2002). The
Group Therapy of Substance Abuse. New York: Haworth Medical
Press.
3.
Center for Substance Abuse Treatment. (2005). Substance Abuse
Treatment: Group Therapy. Treatment Improvement Protocol (TIP)
41. DHHS Publication No SMA (05-3991). Rockville, MD:
Substance Abuse and Mental Health Services Administration.
4.
Flores, P. J. (2004). Addiction as an attachment disorder.
Lanham, MD: Jason Aronson.
5.
Flores, P. J. (2007).Group psychotherapy with
group populations: An integration of 12 Step and psychodynamic
theory (3rd ed.). Binghamton, NY: Haworth
Medical Press.
6.
Khantzian, E. J., Halliday, K. S., & McAuliffe, W. E.
(1990). Addiction and the vulnerable self. New York: Guilford
Press.
7.
Project MATCH Research Group. (1997). Matching alcoholism treatments
to client heterogeneity: Project MATCH post-treatment drinking
outcomes. Journal of Studies on Alcohol, 58, 7-29.
8.
Roth, J. (2004). Group psychotherapy and recovery from addiction:
Carrying the message. New York: Haworth Press.
9.
Vannicelli, M. (1992) Removing the Roadblocks:
Group Psychotherapy with Substance Abusers and Family Members.
New York: Guilford Press
10.
Vannicelli, M. (1989) Group Psychotherapy with Adult Children of
Alcoholics: Treatment Techniques and Counter transference
Considerations. New York: Guilford Press
11.
White, W. L. (2008). Recovery Management and Recovery-Oriented
Systems of Care: Scientific Rationale and Promising
Practices. Produced under grants and contracts funded by the
Center for Substance Abuse Treatment, Substance Abuse and Mental
Health Services Administration, U.S. Department of Health and Human
Services, Center for Substance Abuse Treatment, 5600 Fishers Lane,
Rockwall II, Suite 618, Rockville, MD 20857, 301-443-5053 and the
Philadelphia Department of Behavioral Health/Mental Retardation
Services.
12.
Washton, A. M. (2004). Group therapy with
outpatients. In J. H. Lowinson, P. Ruiz, R. B. Millman, & J. G.
Langrod (Eds.), Substance abuse: A comprehensive textbook(4th
ed).; (pp. 671-680). Philadelphia: Lippincott Williams & Wilkens.
13.
Weiss, R. D.,
Jaffee, W. B., de Minil, V. P., et al.
(2004). Group
therapy for substance use disorders: What do we know? Harvard
Review of Psychiatry; 12, 339-350.
Top of Page
CANCER
1.
Sherman, A. C.,
Burlingame, G.M., Cleary, T. et. al. Group Interventions for
Patients with Cancer and HIV Disease: Part I. Efficacy at Different
Phases of Illness. New York: American Group Psychotherapy
Association, p. 10.
2.
Evans, R.L. & Connis,
R.T. (1995) Comparison of Brief Group Therapies for Depressed Cancer
Patients Receiving Radiation Treatment. and Fawzy et. al (1990a) A
Structured psychiatric intervention for cancer patients. I. Changes
Over Time In Methods Of Coping and Affective Disturbance. In
Group Interventions for Patients with Cancer and HIV Disease: Part
I. Efficacy at Different Phases of Illness. by Sherman, A. C.,
Burlingame, G.M., Cleary, T. et. al. New York: American Group
Psychotherapy Association, p. 8.
3.
Helgeson, V.S. et. al
(1999) Education and Peer Discussion Group Interventions and
Adjustment to Breast Cancer and Samerel, N. et. al. (1997) Effect
of Support Groups with Coaching on Adaptation to Early Stage Breast
Cancer in Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. by
Sherman, A. C., Burlingame, G.M., Cleary, T. et. al. New York:
American Group Psychotherapy Association, p. 8.
4.
Fawzy et. al., 8.
5.
Edelman, S. et. al.
(1999a) Group CBT Versus Supportive Therapy with Patients with Have
Primary Breast Cancer. In Sherman, A. C., Burlingame, G.M., Cleary,
T. et. al. Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. New
York: American Group Psychotherapy Association, p. 8.
6.
De Vries, M. J. et. al.
(1997) Phase II Study of Psychotherapeutic Intervention in Advanced
Cancer. In Sherman, A. C., Burlingame, G.M., Cleary, T. et. al.
Group Interventions for Patients with Cancer and HIV Disease: Part
I. Efficacy at Different Phases of Illness. New York:
American Group Psychotherapy Association, p. 9.
7.
Goodwin, P.J. et. al.
(2001) The Effect of Group Psychosocial Support On Survival in
Metastatic Breast Cancer., Spiegal, D. & Bloom, J.R. (1993)
Group Therapy and Hypnosis Reduce Metastatic Breast Carcinoma Pain.,
and Spiegal, D. et. al. (1981) Group Support for Patients with
Metastatic Cancer. In Sherman, A. C., Burlingame, G.M., Cleary, T.
et. al. Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. New
York: American Group Psychotherapy Association, p. 9.
8.
Forester, B. et. al.
(1993) Group Psychotherapy During Radiotherapy: Effects on
Emotional and Physical Distress. In Sherman, A. C., Burlingame, G.M.,
Cleary, T. et. al. Group Interventions for Patients with Cancer
and HIV Disease: Part I. Efficacy at Different Phases of Illness.
New York: American Group Psychotherapy Association, p. 29.
9.
Antoni, M.H. et. al.
(2001) Cognitive-Behavioral Stress Management Intervention Decreases
the Prevalence of Depression and Enhances Benefit-Finding Among
Women Under Treatment for Early-Stage Breast Cancer, Helgeson, V.S.
et. al. (2000) Group Support Interventions for Women with Breast
Cancer: Who Benefits From What?. In Sherman, A. C., Burlingame, G.M.,
Cleary, T. et. al. Group Interventions for Patients with Cancer
and HIV Disease: Part I. Efficacy at Different Phases of Illness.
New York: American Group Psychotherapy Association, p. 35.
10.
Spiegal, D. et. al.,
(1981) Group Support for Patients with Metastatic Cancer. In
Sherman, A. C., Burlingame, G.M., Cleary, T. et. al. Group
Interventions for Patients with Cancer and HIV Disease: Part I.
Efficacy at Different Phases of Illness. New York: American
Group Psychotherapy Association, p. 9.
11.
Spiegal, D. et. al.
(1989) Effect of Psychosocial Treatment on Survival of Patients with
Metastatic Breast Cancer. In Sherman, A. C., Burlingame, G.M.,
Cleary, T. et. al. Group Interventions for Patients with Cancer
and HIV Disease: Part I. Efficacy at Different Phases of Illness.
New York: American Group Psychotherapy Association, p. 70.
12.
Goodwin, et. al. , 10.
Top of Page
1.
Chesney, M. et. al.
(1996) Coping Effectiveness Training for Men Living with HIV. In
Sherman, A. C., Burlingame, G.M., Cleary, T. et. al. Group
Interventions for Patients with Cancer and HIV Disease: Part I.
Efficacy at Different Phases of Illness. New York: American
Group Psychotherapy Association, p. 17.
2.
Auerbach, J.E. et. al.
(1992) A Behavioral Medicine Intervention as an Adjunctive Treatment
for HIV-related illness, and Gifford et. al. (1998).
In Sherman, A. C., Burlingame, G.M., Cleary, T. et. al. Group
Interventions for Patients with Cancer and HIV Disease: Part I.
Efficacy at Different Phases of Illness. New York: American
Group Psychotherapy Association, p. 17.
3.
Gifford, et. al., 17.
4.
Auerbach, J.E. et. al.,
17.
5.
Kelly, J.A., (1993)
Outcome of Cognitive-Behavioral and Support Group Brief Therapies
for Depressed, HIV-Infected Persons. In Sherman, A. C., Burlingame,
G.M., Cleary, T. et. al. Group Interventions for Patients with
Cancer and HIV Disease: Part I. Efficacy at Different Phases of
Illness. New York: American Group Psychotherapy Association,
p. 12.
6.
Rotheram-Borus, M. J.
et. al. (2001) An Intervention for Parents with AIDS and Their
Adolescent Children. In Sherman, A. C., Burlingame, G.M., Cleary,
T. et. al. Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. New
York: American Group Psychotherapy Association, p. 18.
7.
Antoni, M.H. et. al.
(1991) Cognitive-Behavioral Stress Management Buffers Distress
Responses and Immunologic Changes Following Notification of HIV-1
Seropositivity. In Sherman, A. C., Burlingame, G.M., Cleary, T. et.
al. Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. New
York: American Group Psychotherapy Association: 72, and Lutgendork,
S.K, (1997) Cognitive-Behavioral Stress Management Decreases
Dysphoric Mood and Herpes Simplex Virus-Type 2 Antibody Titers in
Symptomatic HIV-Seropositive Gay Men. In Sherman, A. C.,
Burlingame, G.M., Cleary, T. et. al. Group Interventions for
Patients with Cancer and HIV Disease: Part I. Efficacy at Different
Phases of Illness. New York: American Group Psychotherapy
Association, p. 75.
8.
Antoni, M.H. et. al.,
72.
9.
Goodkin, K. et. al.
(1998) A Bereavement Support Group Intervention Is Longitudinally
Associated with Slutary Effects on the CD4 Cell Count and Number of
Physician Visits. In Sherman, A. C., Burlingame, G.M., Cleary, T.
et. al. Group Interventions for Patients with Cancer and HIV
Disease: Part I. Efficacy at Different Phases of Illness. New
York: American Group Psychotherapy Association, p. 75.
Top of Page
1.
Piper, W.E., Rozie, J.S.,
Azim, H. F. A. & Joyce A.S., (1993) A Randomized Trial of
Psychiatric Day Treatment for Patients with Affective and
Personality Disorders. In Piper, E. & Ogrodiczuk, J.S. Brief
Group Therapy, p. 17.
2.
Linehan, M.M. et. al.
(1991) Cognitive-Behavioral Treatment of Chronically Parasuicidal
Borderline Patients., Linehan, M. M. et. al. (1993) Naturalistic
Follow-Up of a Behavioral Treatment of Chronically Parasuicidal
Borderline Patients., Linehan, M. M. et. al. (1999) Dialectical
Behavior Therapy for Patients with Borderline Personality Disorder
and Drug Dependence., and Munroe-Blum, H. & Marziali, E. (1995) A
Controlled Trial of Short-Term Group Treatment for Borderline
Personality Disorder. In Burlingame, G.M., MacKenzie, K.R. and
Strauss, B. Small Group Treatment: Evidence for Effectiveness and
Mechanisms of Change, p. 38.
3.
Piper, W.E. & Rosie, J.S.
(1998) Group Treatment of Personality Disorders: The Power of the
Group in the Intensive Treatment of Personality Disorders. In
Piper, E. & Ogrodiczuk, J.S. Brief Group Therapy, p. 15.
4.
Piper, W.E., Rosie, J.S.,
Joyce, A.S., & Azim, H.F.A. (1996) Time-Limited Day Treatment for
Personality Disorders. In Piper, E. & Ogrodiczuk, J.S. Brief
Group Therapy, p. 16.
5.
Eckert, J. & Wuchner, M.
(1996) Long-Term Development of Borderline Personality Disorder.,
McCallum, M., Piper, W.E.., & O’Kelly, J.G. (1997) Predicting
Patient Benefit From a Group Oriented Evening Treatment Program.,
and Wilberg, T. et. al. (1998) Outpatient Group Psychotherapy: A
Valuable Continuation Treatment for Patients with Borderline
Personality Disorder Treated in a Day Hospital. In Burlingame, G.M.,
MacKenzie, K.R. and Strauss, B. Small Group Treatment: Evidence
for Effectiveness and Mechanisms of Change, p. 38.
Top of Page
DEPRESSION & GRIEF
1.
Murphy, S.A., (1997) A
Bereavement Intervention for Parents Following Sudden, Violent Death
of their 12-28 Year-Old Children: Description and Applications to
Clinical Practice. In Burlingame, G.M., MacKenzie, K.R. and
Strauss, B. Small Group Treatment: Evidence for Effectiveness and
Mechanisms of Change, p. 14.
2.
Yalom, I.D., (1995) The
Theory and Practice of Group Psychotherapy. In Burlingame, G.M.,
MacKenzie, K.R. and Strauss, B. Small Group Treatment: Evidence
for Effectiveness and Mechanisms of Change, p. 14.
Top of Page
EATING DISORDERS
1.
Burlingame, G.M.,
Fuhriman, A., & Mosier, J. The Differential Effectiveness of
Group Psychotherapy: A Meta-Analytic Perspective. Salt Lake
City, Utah: Brigham Young University, p. 13.
2.
Davis, R., Olmsted, M.P.,
& Rockert, W. (1990) Brief Group Psychoeducation for Bulimia
Nervosa: Assessing the Clinical Significance of Change., Peterson,
C. et. al. (1998) Group Cognitive-Behavioral Treatment of Binge
Eating Disorder: A Comparison of Therapist-Led Versus Self-Help
Formats., and Wilfley, D.E. et. al. (1993) Group
Cognitive-Behavioral Therapy and Group Interpersonal Psychotherapy
for the Nonpurging Bulimic Individual: A Controlled Comparison. In
Burlingame, G.M., MacKenzie, K.R. and Strauss, B. Small Group
Treatment: Evidence for Effectiveness and Mechanisms of Change,
p. 22.
3.
Mitchell, J.E., et. al.
(1993) Cognitive-Behavioral Group Psychotherapy of Bulimia Nervosa:
Importance of Logistical Variables. In Burlingame, G.M., MacKenzie,
K.R. and Strauss, B. Small Group Treatment: Evidence for
Effectiveness and Mechanisms of Change, p. 23.
4.
Mitchell, J.E. et. al.
(1990) A Comparison Study of Antidepressants and Structured
Intensive Group Psychotherapy in the Treatment of Bulimia Nervosa.
In Burlingame, G.M., MacKenzie, K.R. and Strauss, B. Small Group
Treatment: Evidence for Effectiveness and Mechanisms of Change,
p. 23.
Top of Page
YOUTH VIOLENCE
1.
Goldstein, A.P. et. al.
(1989) Reducing Delinquency: Intervention in the Community. In
Aronson, S. and Schamess, G. The Role of Group Psychotherapeutic
Interventions in Youth Violence Reduction and Primary Prevention – A
White Paper. New York: The American Group Psychotherapy
Association, p. 31.
2.
Aronson, S. and Schamess,
G. The Role of Group Psychotherapeutic Interventions in Youth
Violence Reduction and Primary Prevention – A White Paper. New
York: The American Group Psychotherapy Association, p. 33.
3.
Twemlow, Fonagy, et. al.
(1999). In Aronson, S. and Schamess, G. The Role of Group
Psychotherapeutic Interventions in Youth Violence Reduction and
Primary Prevention – A White Paper. New York: The American
Group Psychotherapy Association, p. 31.
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