Structured Techniques for Handling Loss and Addition of Members in Adolescent Psychotherapy Groups

Abstract

Loss and addition of a member in young adolescent psychotherapy groups often creates critical, disruptive increases in anxiety levels, intense, nonproductive recapitulation of individual members' previous experiences with loss, and some scapegoating of the new member. This article describes structured techniques for facilitating these changes which have been effective with in-patient groups and have generalized successfully to a number of other treatment settings with similar patient groups. The techniques include: (1) guidelines for structured group discussion sessions aimed at developing specific coping skills, which review "successful and unsuccessful ways of handling loss;" (2) a "Legacy Tape" and "Remembrance Book" concept for departing members which creates a formal ritual effective in moderating group anxiety levels and grief reactions to loss and change; and (3) Pre-therapy training programs for new members which include therapy contracts, guidelines for group participation and expectations for behavior, and video-tape introduction to the group psychotherapy process.