Comprehensive Study Guide on Group Therapy updated 2026
2015 CFT Comprehensive Exam - Study Guide
Access Here
Must use Moodle and be enrolled in CFT Comp Exam Course
Must complete 2-item quiz to confirm your seat in the exam
[Key: Green: Title of Section Blue: Outline of Topic Red: Expanded Information]
6303 Group Therapy
Theoretical concepts of group therapy
• Therapy is emotional and a corrective experience
• Change does not occur through interpretation and insight, but through relational
experiences that contradicts the client’s pathogenic beliefs
• Gain greater sense of self through the group
• Experiencing of positive and negative affect and self-disclosure creates change
Principles of group dynamics (4)
▪ http://commons.wvc.edu/bwarman/cds204/
Handouts/ATTC%20Group%20Skills
%20Series_2.pdf (This article/newsletter is
awesome!)
1. Universality:
[Page numbers for reference from: Yalom, I.D. and Leszcz, M.
(2005) The Theory & Practice of Group Psychotherapy , 5th ed.
. N.Y.: Basic Books.]
• the 2 of the 11 therapeutic factors that change occurs
nd
through in a group.
• group members have sense of “extreme social isolation” and
a “heightened sense of uniqueness” and this creates
“interpersonal difficulties” with group members hindering the
“possibility of deep intimacy.” (p. 6)
• “Despite the complexity of human problems, certain common
denominators between individuals are clearly evident, and
the members of a therapy group soon perceive their
similarities to one another.” (p. 7)
• “With rare exceptions, patients express great relief at
discovering that they are not alone, that others share the
same dilemmas and life experiences.” (p. 7)
• Multicultural groups: “Cultural minorities in a predominantly
Caucasian group may feel excluded because of different
cultural attitudes towards disclosure, interaction, and
affective expression.” (p. 8) Should be helped to moved “…
pass a focus on concrete cultural differences to transcultural
(universal) responses to human situation and tragedies.” (p.
8) Therapist must be aware of cultural factors of group
members.
,Comprehensive Study Guide on Group Therapy updated 2026
• Through universality one experiences relief, they are not
alone in their experiences in life, catharsis, and acceptance
by others in group.
2. Didactic Instruction:
• Learning facts through group dialogue; Psychoeducation in
nature
• Group share experience of Individual’s own process
• Therapist Role: encourage group sharing; pull in field
experts; deciphering moments for learning
3. Direct Advice:
• Reflective of the group’s age; Benefit of giving advice
• Shows mutual interest and caring
• Most effective when a series of alternative suggestions are
made about how to achieve a desired goal
• Therapist Role: emphasize the personalization of advice
focusing more on personal matters
4. Corrective Emotional Experience:
• “the basic principle of treatment”
• To expose the client, under more favorable circumstances, to
emotional situations that he could not handle in the past suitable to
repair the traumatic influence of the past.
• Intellectual insight alone is inefficient, this requires emotional
component and systematic reality testing.
Stages of group formation (6) and treatment
• Yalom’s 3 Stage Model of Group Therapy:
o Initial Stage
▪ Orientation
▪ Hesitant participation
▪ Search for meaning
▪ Dependency
o Second Stage
▪ Conflict
▪ Dominance
▪ Rebellion
o Third Stage
▪ Development of cohesiveness
▪ Group intimacy
• McKenzie & Livesly’s (1983) 6 Group Stages:
Stage 1 - Engagement
• Fundamental task: Resolve the issue of engagement of members
o Social system
o Group identity
• Primary mechanism is universality
,Comprehensive Study Guide on Group Therapy updated 2026
• Superficial disclosure on a content level
• External boundaries are clearly defined, but internal boundaries are
blurred
• Accomplished when all members have participated in self-
disclosure to some extent
Stage 2 - Differentiation
• Fundamental task: Recognize that differences exist among
members
• Shift to individual members and differences
• Goal is to explore differences (not ventilate hostility)
• Conflict and confrontation
• Processing of individualization and appreciation of genuine
individual differences
• Management of hostility in self and others
• Acceptance and incorporation of social expectations
• Development of cohesiveness as a social entity (with differences)
Stage 3 - Individuation
• Fundamental task: Promote individuation, allowing a deeper
appreciation of the complexity of each member
o Active interpersonal challenge in a supportive atmosphere
o Focus shifts to boundaries within each member
• Increase openness to psychological exploration; introspective stage
• More engagement and less conflict – focus on self
Stage 4 - Intimacy
• Fundamental task: Experience intimacy and to explore the
implications of close relationships
o Understanding of self and others in a more complex way
• Group members grow to have more influence on each other as
relationships within the system become deeper and more complex
• Danger of irresponsible closeness: overt sexual relationships are
usually catastrophic for the group
Stage 5 - Mutuality
• Fundamental task: Develop a sense of mutual responsibility among
members and to explore the meaning of closeness
o Responsibility of internal autonomy and interpersonal
responsibility to others
o Control through dominance or submission in relationships
must be resolved
• Development of trust is ongoing and continuous
• How the group handles responsibilities dictate group growth and
climate
Stage 6 - Termination
• Ending of this artificial social system
• May occur at any point
• At least until group progress to stage 3
, Comprehensive Study Guide on Group Therapy updated 2026
• Goal: to achieve disengagement with an incorporation of the group
as a positive and constructive experience
• Group members experience a sense of loss and separation
• Opportunity to deploy group coping skills
• Danger of regression and decompensation into demoralized,
nihilistic state
Creation and maintenance of the group
• Place:
o Privacy and freedom from distractions
o Therapeutic setup
o Open and closed groups
▪ Pros
▪ Cons
• Time:
o 60-120 minutes
o Diminishing returns
o Once to twice weekly
o Desired intensity
• Size
o Ideally 7 or 8 members
o “Critical mass”
• Preparation:
o Group misconceptions
o Common group problems
o Group process (systemic perspective)
• Secure an appropriate private meeting place free of
distraction
• establish a policy about the life span of the group, open vs
closed group
• admit new members
• set frequency of meetings; Yalom prefers twice weekly
meetings
• duration of sessions, at least 60 minutes to no more than 80-
90
• size of the group, ideal size approx 7-8 with a range of 5-10
• consider individual pre-group sessions until member starts in
group in order to build therapeutic alliance and prepare the
patient for the group therapy setting (address
misconceptions and expectations)
• Therapist attends to gatekeeping and prevention of member
attrition
• If drop outs occur (except for in the case of closed groups)
the therapist must add new members.
2015 CFT Comprehensive Exam - Study Guide
Access Here
Must use Moodle and be enrolled in CFT Comp Exam Course
Must complete 2-item quiz to confirm your seat in the exam
[Key: Green: Title of Section Blue: Outline of Topic Red: Expanded Information]
6303 Group Therapy
Theoretical concepts of group therapy
• Therapy is emotional and a corrective experience
• Change does not occur through interpretation and insight, but through relational
experiences that contradicts the client’s pathogenic beliefs
• Gain greater sense of self through the group
• Experiencing of positive and negative affect and self-disclosure creates change
Principles of group dynamics (4)
▪ http://commons.wvc.edu/bwarman/cds204/
Handouts/ATTC%20Group%20Skills
%20Series_2.pdf (This article/newsletter is
awesome!)
1. Universality:
[Page numbers for reference from: Yalom, I.D. and Leszcz, M.
(2005) The Theory & Practice of Group Psychotherapy , 5th ed.
. N.Y.: Basic Books.]
• the 2 of the 11 therapeutic factors that change occurs
nd
through in a group.
• group members have sense of “extreme social isolation” and
a “heightened sense of uniqueness” and this creates
“interpersonal difficulties” with group members hindering the
“possibility of deep intimacy.” (p. 6)
• “Despite the complexity of human problems, certain common
denominators between individuals are clearly evident, and
the members of a therapy group soon perceive their
similarities to one another.” (p. 7)
• “With rare exceptions, patients express great relief at
discovering that they are not alone, that others share the
same dilemmas and life experiences.” (p. 7)
• Multicultural groups: “Cultural minorities in a predominantly
Caucasian group may feel excluded because of different
cultural attitudes towards disclosure, interaction, and
affective expression.” (p. 8) Should be helped to moved “…
pass a focus on concrete cultural differences to transcultural
(universal) responses to human situation and tragedies.” (p.
8) Therapist must be aware of cultural factors of group
members.
,Comprehensive Study Guide on Group Therapy updated 2026
• Through universality one experiences relief, they are not
alone in their experiences in life, catharsis, and acceptance
by others in group.
2. Didactic Instruction:
• Learning facts through group dialogue; Psychoeducation in
nature
• Group share experience of Individual’s own process
• Therapist Role: encourage group sharing; pull in field
experts; deciphering moments for learning
3. Direct Advice:
• Reflective of the group’s age; Benefit of giving advice
• Shows mutual interest and caring
• Most effective when a series of alternative suggestions are
made about how to achieve a desired goal
• Therapist Role: emphasize the personalization of advice
focusing more on personal matters
4. Corrective Emotional Experience:
• “the basic principle of treatment”
• To expose the client, under more favorable circumstances, to
emotional situations that he could not handle in the past suitable to
repair the traumatic influence of the past.
• Intellectual insight alone is inefficient, this requires emotional
component and systematic reality testing.
Stages of group formation (6) and treatment
• Yalom’s 3 Stage Model of Group Therapy:
o Initial Stage
▪ Orientation
▪ Hesitant participation
▪ Search for meaning
▪ Dependency
o Second Stage
▪ Conflict
▪ Dominance
▪ Rebellion
o Third Stage
▪ Development of cohesiveness
▪ Group intimacy
• McKenzie & Livesly’s (1983) 6 Group Stages:
Stage 1 - Engagement
• Fundamental task: Resolve the issue of engagement of members
o Social system
o Group identity
• Primary mechanism is universality
,Comprehensive Study Guide on Group Therapy updated 2026
• Superficial disclosure on a content level
• External boundaries are clearly defined, but internal boundaries are
blurred
• Accomplished when all members have participated in self-
disclosure to some extent
Stage 2 - Differentiation
• Fundamental task: Recognize that differences exist among
members
• Shift to individual members and differences
• Goal is to explore differences (not ventilate hostility)
• Conflict and confrontation
• Processing of individualization and appreciation of genuine
individual differences
• Management of hostility in self and others
• Acceptance and incorporation of social expectations
• Development of cohesiveness as a social entity (with differences)
Stage 3 - Individuation
• Fundamental task: Promote individuation, allowing a deeper
appreciation of the complexity of each member
o Active interpersonal challenge in a supportive atmosphere
o Focus shifts to boundaries within each member
• Increase openness to psychological exploration; introspective stage
• More engagement and less conflict – focus on self
Stage 4 - Intimacy
• Fundamental task: Experience intimacy and to explore the
implications of close relationships
o Understanding of self and others in a more complex way
• Group members grow to have more influence on each other as
relationships within the system become deeper and more complex
• Danger of irresponsible closeness: overt sexual relationships are
usually catastrophic for the group
Stage 5 - Mutuality
• Fundamental task: Develop a sense of mutual responsibility among
members and to explore the meaning of closeness
o Responsibility of internal autonomy and interpersonal
responsibility to others
o Control through dominance or submission in relationships
must be resolved
• Development of trust is ongoing and continuous
• How the group handles responsibilities dictate group growth and
climate
Stage 6 - Termination
• Ending of this artificial social system
• May occur at any point
• At least until group progress to stage 3
, Comprehensive Study Guide on Group Therapy updated 2026
• Goal: to achieve disengagement with an incorporation of the group
as a positive and constructive experience
• Group members experience a sense of loss and separation
• Opportunity to deploy group coping skills
• Danger of regression and decompensation into demoralized,
nihilistic state
Creation and maintenance of the group
• Place:
o Privacy and freedom from distractions
o Therapeutic setup
o Open and closed groups
▪ Pros
▪ Cons
• Time:
o 60-120 minutes
o Diminishing returns
o Once to twice weekly
o Desired intensity
• Size
o Ideally 7 or 8 members
o “Critical mass”
• Preparation:
o Group misconceptions
o Common group problems
o Group process (systemic perspective)
• Secure an appropriate private meeting place free of
distraction
• establish a policy about the life span of the group, open vs
closed group
• admit new members
• set frequency of meetings; Yalom prefers twice weekly
meetings
• duration of sessions, at least 60 minutes to no more than 80-
90
• size of the group, ideal size approx 7-8 with a range of 5-10
• consider individual pre-group sessions until member starts in
group in order to build therapeutic alliance and prepare the
patient for the group therapy setting (address
misconceptions and expectations)
• Therapist attends to gatekeeping and prevention of member
attrition
• If drop outs occur (except for in the case of closed groups)
the therapist must add new members.
