Cognitive Behavioral Group Therapy

Challenges and Opportunities

Ingrid Söchting





Dedication

For my group therapy colleagues

About the Author

Ingrid Söchting is chief clinical psychologist in an outpatient mental health program and clinical assistant professor in the Department of Psychiatry at the University of British Columbia. Over the past 20 years, she has been instrumental in developing cognitive behavioral group therapy (CBGT) programs for depression, obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and posttraumatic stress disorder, as well as interpersonal therapy (IPT) groups for later life depression. She supervises and teaches CBGT and IPT to psychology and psychiatry residents and is the codirector of the Richmond Psychotherapy Training Program. She has received several teaching excellence awards. She lectures and consults nationally and internationally. She is involved in group psychotherapy research and has published over 25 peer-reviewed journal articles and book chapters. She received her PhD in clinical psychology at Simon Fraser University, Vancouver, Canada, and trained at the University of British Columbia as an intern and postdoctoral fellow from 1994 to 1997 to become a CBT therapist. She is a Canadian certified CBT therapist and a Certified Group Therapist of the American Group Psychotherapy Association.

Acknowledgments

This book is the sum of many people’s work. I have benefited from their teaching, supervision, consultation, group cofacilitation, research collaboration, and collegial inspiration.

This book is also written in gratitude to the hundreds, if not thousands, of group members in our program who trusted their facilitators and were therefore able to engage in challenging exposures and revisions of their previously held self-denigrating beliefs.

First and foremost, thanks to my team of exceptionally skilled and supportive outpatient mental health group program colleagues. They are, in alphabetical order: Ellen Abrams, clinical counselor; psychiatrist Jaswant Bhopal; Veronica Clifton, social worker; Lorna Clutterham, psychiatric nurse; Denise Coles, clinical counselor; Abi Dahi, psychiatrist; Heather Donaldson, psychiatrist; Maureen Edgar, counseling psychologist; Rosemary Messmer, clinical counselor; Jamal Mirmiran, psychiatrist; Erica O’Neal, psychiatrist; Sue Paul, rehabilitation assistant; Nicola Piggott, nurse; Dan Ring, recreational therapist; Petra Rutten, recreational therapist; Shelagh Smith, occupational therapist; Betty Third, occupational therapist; Darren Thompson, psychiatrist; and Tova Wolinsky, social worker. I also extend my appreciation to psychiatrists Harry Karlinsky, Raj Katta, Carolyn Steinberg, David Cohen and psychologists Timothy Crowell, Ingrid Fedoroff, and Suja Srikameswaran for their collegiality and cheerful support for this book.

Going back to an earlier era, I offer thanks to my graduate school supervisors and mentors James Marcia and Robert Ley, who provided rich teachings in psychodynamic theory, Erik Erikson’s psychosocial developmental stages, and Carl Rogers’s psychotherapy principles. Thanks to my first cognitive behavioral therapy (CBT) practicum supervisor, Georgia Nemetz, who continues to be a role model, and to my internship and postdoctoral CBT supervisors for their commitment to excellent supervision, teaching, and thoughtful applications of CBT: William Koch, the late Peter McLean, Randy Paterson, Charles Brasfield, and Lynn Alden.

Several people have kindly donated their time and mental energy to read some or all chapters. I am deeply thankful to psychiatry residents Margaret Wong, John Tavares, and Alan Bates, who offered valuable feedback from their novice CBGT perspectives, as well as to experienced group therapists who read chapters related to their expertise. A profound thank you to psychologist Colleen Allison, who read the entire manuscript, for her keen attention to where the reader “stumbles,” for alerting me to new research findings, and for her insightful and sharp perspective; to psychiatrist George Hadjipavlou, who read several chapters and offered substantial comments on content and style; to psychologist Rosalind Catchpole for sharing in enthusiasm and research updates on groups for children; to doctoral students in clinical psychology Alison Welsted and Kirstie Kellman-McFarlane for their clinical and research experience with compulsive hoarding; to psychologist Heather Fulton for her ability to effectively teach and disseminate CBT for addictions; and to psychologist Mahesh Menon for his encouraging and helpful comments on the psychosis chapter.

A special thanks to Shannon Long, the librarian who for years has helped with literature searches and supplied articles for various group programming needs, to formatting wizard Suzanne Daigle for help with the appendices, and to Kjartan Jaccard for his careful attention and diligence in producing the author index.

A number of other colleagues—too many to name—have played a large role in supporting and influencing my CBT work over the years. Some have played a more direct role in this book. Thanks to psychologists Theo De Gagné and Christopher Wilson for our collaboration on a chapter in the Oxford Guide to Low Intensity CBT (2010), which provided some of the “bare bones” for this book; to psychologist Mark Lau for the Oxford Guide chapter opportunity and other collaborations as well as his detailed comments on the mindfulness section; and to professor John Ogrodniczuk for his mentoring in my development as a clinician-researcher.

Thanks to my manager Jo-Anne Kirk for granting me a leave of absence to complete this book.

A huge thank you to the Wiley Blackwell team: senior editors Darren Reed and Karen Shield, editorial assistants Olivia Wells and Amy Minshull, copyeditor Kumudhavalli Narasiman, account manager Revathy Kaliyamoorthy and production project manager Radjan Lourde Selvanadin. Your encouragement, reasonableness, and excellent communication have made this project more enjoyable. Also a heartfelt thank you to the four reviewers of the initial proposal for this book. They were not only enthusiastic about the need for it, but also offered constructive feedback and suggestions.

Thanks to my family without whom my stamina would quickly have been depleted. I am especially grateful to my patient partner, journalist Douglas Todd, who read the entire manuscript more than once and offered excellent suggestions for giving this book a livelier tone. I particularly value and learn from Douglas’s genuine interest in psychology and psychotherapy. A hearty thank you to my adult children—Ingram, Kjartan, Torsten, and Sigbrit—your expressions of support, each in your own way, make a big and meaningful difference. I treasure your sibling group cohesion.

“Tak” to my Danish family for their moral support from afar: my mother Karin Michelsen, her partner Martin Daugaard-Hansen, my sister, psychiatrist Astrid Söchting, and last, but not least, my loving and bookish late father, Robert Söchting.

Thank you to all who have directly or indirectly shaped this book. Any mistakes, unclear writing, misunderstandings, or misrepresentations are solely my responsibility.