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57-666: The broader concept of group therapy can be taken to include any helping process that takes place in a group, including support groups , skills training groups (such as anger management , mindfulness , relaxation training or social skills training), and psychoeducation groups. The differences between psychodynamic groups, activity groups, support groups, problem-solving and psychoeducational groups have been discussed by psychiatrist Charles Montgomery. Other, more specialized forms of group therapy would include non-verbal expressive therapies such as art therapy , dance therapy , or music therapy . The founders of group psychotherapy in

114-536: A claim against the Trust for discrimination on the basis of race and religion was commenced. Over the years many hundreds of staff members, at all levels, have contributed to the work of this institution. This list is merely representative of some of the lasting contributors to the different fields encompassed by the Clinic. In line with Hugh Crichton-Miller's original vision for clinics to be set up in communities across

171-605: A flawed model of care lacking holistic circumspection —merely treating discrete problems (in billable increments) rather than maintaining health. Therapy and treatment , in the middle of the semantic field, can connote either the holism of care or the discreteness of intervention , with context conveying the intent in each use. Accordingly, they can be used in both noncount and count senses (for example, therapy for chronic kidney disease can involve several dialysis treatments per week ). The words aceology and iamatology are obscure and obsolete synonyms referring to

228-633: A group's ability to maintain a safe yet challenging 'formative space'. Academics at the University of Oxford studied the inter-organizational dynamics of a national democratic therapeutic community over a period of four years; they found external steering by authorities eroded the community's therapeutic model, produced a crisis, and led to an intractable conflict which resulted in the community's closure. A form of group therapy has been reported to be effective in psychotic adolescents and recovering addicts. Projective psychotherapy uses an outside text such as

285-469: A leading clinic within the newly created National Health Service . At this point its education and training services were managed separately by the Tavistock Institute for Medical Psychology , which was also the umbrella for the Tavistock Institute , involved in social action research and thinking about group relations and organisational dynamics, and for work with marital couples. The clinic

342-530: A more "holistic" approach. It was set to close at the end of March 2024. In February 2023, BBC journalist Hannah Barnes' book, Time to Think: The Inside Story of the Collapse of the Tavistock's Gender Service for Children was published. Barnes describes the premise of the book by saying, "I wanted to write a definitive record of what happened [at GIDS] because there needs to be one." The Tavistock

399-430: A novel or motion picture to provide a "stable delusion " for the former cohort and a safe focus for repressed and suppressed emotions or thoughts in the latter. Patient groups read a novel or collectively view a film. They then participate collectively in the discussion of plot, character motivation and author motivation. In the case of films, sound track, cinematography and background are also discussed and processed. Under

456-580: A similar model of participatory engagement around themes of diversity, racism, and sexual orientation. The Tavistock Institute , which had been part of the Tavistock family, moved to its own premises in 1994. The Tavistock Centre for Couples Relationships, TCCR, formerly the Tavistock Institute of Marital Studies, was always a separate, charitably-funded organisation which left the Tavistock Centre for new premises in 2009. In 1994,

513-708: A year from the United Kingdom and abroad. The Trust is based at the Tavistock Centre in Swiss Cottage . The founding organisation was the Tavistock Institute of Medical Psychology founded in 1920 by Hugh Crichton-Miller . The Tavistock and Portman NHS Trust was formed in 1994, when the Tavistock Clinic merged with the neighbouring Portman Clinic in Fitzjohns Avenue . The Portman specialises in areas of forensic psychiatry , including

570-515: Is a key component of milieu therapy in a therapeutic community . The total environment or milieu is regarded as the medium of therapy, all interactions and activities regarded as potentially therapeutic and are subject to exploration and interpretation, and are explored in daily or weekly community meetings. However, interactions between the culture of group psychotherapeutic settings and the more managerial norms of external authorities may create 'organizational turbulence' which can critically undermine

627-484: Is a specific type of prioritization by lines of therapy. It is controversial in American health care because unlike conventional decision-making about what constitutes first-line, second-line, and third-line therapy, which in the U.S. reflects safety and efficacy first and cost only according to the patient's wishes, step therapy attempts to mix cost containment by someone other than the patient (third-party payers) into

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684-401: Is also called polychemotherapy, whereas chemotherapy with one agent at a time is called single-agent therapy or monotherapy. Adjuvant therapy is therapy given in addition to the primary, main, or initial treatment, but simultaneously (as opposed to second-line therapy). Neoadjuvant therapy is therapy that is begun before the main therapy. Thus one can consider surgical excision of a tumor as

741-426: Is carried out using time-limited therapy with diagnostically homogenous groups. However, long-term intensive interactional group psychotherapy assumes diverse and diagnostically heterogeneous group membership, and an open-ended time scale for therapy. Good outcomes have also been demonstrated for this form of group therapy. Research on computer-supported and computer-based interventions has increased significantly since

798-441: Is clear evidence for the effectiveness of group psychotherapy for depression : a meta-analysis of 48 studies showed an overall effect size of 1.03, which is clinically highly significant. Similarly, a meta-analysis of five studies of group psychotherapy for adult sexual abuse survivors showed moderate to strong effect sizes, and there is also good evidence for effectiveness with chronic traumatic stress in war veterans. There

855-423: Is less likely to react counterproductively to differences. SCT also emphasizes the need to recognize the phases of group development and the defenses related to each phase in order to best make sense and influence group dynamics. In the United Kingdom group psychotherapy initially developed independently, with pioneers S. H. Foulkes and Wilfred Bion using group therapy as an approach to treating combat fatigue in

912-517: Is less robust evidence of good outcomes for patients with borderline personality disorder , with some studies showing only small to moderate effect sizes. The authors comment that these poor outcomes might reflect a need for additional support for some patients, in addition to the group therapy. This is borne out by the impressive results obtained using mentalization-based treatment , a model that combines dynamic group psychotherapy with individual psychotherapy and case management . Most outcome research

969-460: Is the first therapy that will be tried. Its priority over other options is usually either: (1) formally recommended on the basis of clinical trial evidence for its best-available combination of efficacy, safety, and tolerability or (2) chosen based on the clinical experience of the physician. If a first-line therapy either fails to resolve the issue or produces intolerable side effects , additional (second-line) therapies may be substituted or added to

1026-493: Is very limited, preliminary research in individual therapy suggests possible increases of treatment efficiency or effectiveness. Further, the use of app- or computer-based monitoring has been investigated several times. Reported advantages of the modern format include improved between-session transfer and patient-therapist-communication, as well as increased treatment transparency and intensity. Negative effects may occur in terms of dissonance due to non-compliance with online tasks, or

1083-567: The Human Services', remains one of the classic texts to emerge from the Tavistock Clinic. The Tavistock's tradition of social and political engagement has been renewed in recent years through its programme of Policy Seminars which model a dialogic, exploratory approach to policy analysis and debate with the social epidemiologist , Richard G. Wilkinson , the psychologist, Oliver James and the columnist, Polly Toynbee , among recent contributors. The series of Thinking Space events follows

1140-489: The Second World War. Foulkes and Bion were psychoanalysts and incorporated psychoanalysis into group therapy by recognising that transference can arise not only between group members and the therapist but also among group members. Furthermore, the psychoanalytic concept of the unconscious was extended with a recognition of a group unconscious, in which the unconscious processes of group members could be acted out in

1197-720: The Tavistock Clinic joined with the Portman Clinic to become the Tavistock and Portman NHS Trust. In 2006 the Trust acquired NHS Foundation Trust status and become the Tavistock and Portman NHS Foundation Trust. It is an active member of UCL Partners , the Academic Health Service Centre located in North London . Paul Burstow , a former Minister of State for Care and Support in the Cameron-Clegg coalition government, became Chair of

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1254-529: The Tavistock Clinic's newest professional training. Applications of the clinical ideas and skills of its multidisciplinary clinicians are at the heart of its education and training, with academically validated programmes developing from the early 1990s with the University of East London , and later with the University of Essex and Middlesex University . Work discussion, supervised clinical practice and experiential group relations work are central to many trainings all of which aim to equip mental health workers with

1311-510: The Tavistock established the Gender Identity Development Service (GIDS), a highly specialised clinic for young people presenting with difficulties with their gender identity. In July 2022, following a critical independent review from Hilary Cass , it was announced that this service would be discontinued and replaced with regional clinics providing a more "holistic" approach. By the 1960s The Tavistock Clinic

1368-492: The Trust in November 2015. The Trust provides clinical services for children and families, young people and adults. It also provides multi-disciplinary training and education. These programmes include core professional training, for example in psychiatry , psychology , social work and advanced psychotherapy training, as well as applied programmes for anyone working in the mental health or social care workforce. Since 2010,

1425-629: The USA but across the world. An early development in group therapy was the T-group or training group (sometimes also referred to as sensitivity-training group, human relations training group or encounter group), a form of group psychotherapy where participants (typically, between eight and 15 people) learn about themselves (and about small group processes in general) through their interaction with each other. They use feedback, problem solving, and role play to gain insights into themselves, others, and groups. It

1482-808: The United States were Joseph H. Pratt, Trigant Burrow and Paul Schilder . All three of them were active and working at the East Coast in the first half of the 20th century. In 1932 Jacob L. Moreno presented his work on group psychotherapy to the American Psychiatric Association , and co-authored a monograph on the subject. After World War II , group psychotherapy was further developed by Moreno, Samuel Slavson , Hyman Spotnitz , Irvin Yalom , and Lou Ormont . Yalom's approach to group therapy has been very influential not only in

1539-426: The algorithm. Therapy freedom and the negotiation between individual and group rights are involved. Treatments can be classified according to the method of treatment: Tavistock Clinic The Tavistock and Portman NHS Foundation Trust is a specialist mental health trust based in north London. The Trust specialises in talking therapies . The education and training department caters for 2,000 students

1596-538: The armed forces. The staff also offered treatment to members of the civilian population who might be traumatised by the prospect of a further world war, which could bring bombing of cities, evacuation of children and the shocks of loss and bereavement. After the Second World War, the Tavistock Clinic benefited from the Northfield Hospital experience and from the arrival of talented professionals from Europe, many fleeing Nazi persecution . In 1948 it became

1653-645: The clinical work of the Trust has diversified, with new services, such as the Family Drug and Alcohol Court in Milton Keynes , and the City and Hackney community psychotherapy service. It is the largest provider of transgender services in England, but funding for the service has not kept pace with demand. In August 2019, 5,717 people were on the waiting list for a first appointment, and average waiting time

1710-648: The constriction of in-session group interaction. Last but not least, group phenomena might influence the motivation to engage with online tasks. Therapy A therapy or medical treatment is the attempted remediation of a health problem, usually following a medical diagnosis . Both words, treatment and therapy , are often abbreviated tx , Tx , or T x . As a rule, each therapy has indications and contraindications . There are many different types of therapy. Not all therapies are effective . Many therapies can produce unwanted adverse effects . Treatment and therapy are often synonymous, especially in

1767-517: The country, his dream was not realised in his 'native' Scotland for another 50 years. However, with Jock Sutherland's return to Edinburgh in 1968, he became the catalyst for the formation of an organisation modelled on the London centre, albeit on a smaller scale. The Scottish Institute of Human Relations (SIHR), now defunct, was constituted as a charitable educational institution in Edinburgh in

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1824-670: The early 1970s. Eventually a branch was opened in Glasgow . The 'MacTavi', as it was sometimes fondly called, worked closely with the National Health Service in Scotland and provided psychoanalytic training and courses for professionals in the health and educational systems and beyond. It also guided adults and children into treatment for the forty years of its operation. SIHR was finally dissolved in 2013 and its centres closed down. Some of its functions were taken over by

1881-477: The emotional, organisational, and relational capacities to operate confidently in front line settings. A BBC TV series 'Talking Cure: Jan' brought the work of the Clinic to a wider audience in 1999 and remains relevant today. Organisational consultancy by former CEO Anton Obholzer, featured in the TV series, and their edited collection, with Vega Roberts, 'The Unconscious at Work: Individual and Organizational Stress in

1938-415: The entry on psychodrama claims it is not a form of group therapy). Another recent development in the theory and method of group psychotherapy based on an integration of systems thinking is Yvonne Agazarian 's systems-centered therapy (SCT), which sees groups functioning within the principles of system dynamics. Her method of "functional subgrouping" introduces a method of organizing group communication so it

1995-594: The first-line therapy for a certain type and stage of cancer even though radiotherapy is used before it; the radiotherapy is neoadjuvant (chronologically first but not primary in the sense of the main event). Premedication is conceptually not far from this, but the words are not interchangeable; cytotoxic drugs to put a tumor "on the ropes" before surgery delivers the "knockout punch" are called neoadjuvant chemotherapy, not premedication, whereas things like anesthetics or prophylactic antibiotics before dental surgery are called premedication. Step therapy or stepladder therapy

2052-559: The form of irrational processes in group sessions. Foulkes developed the model known as group analysis and the Institute of Group Analysis , while Bion was influential in the development of group therapy at the Tavistock Clinic . Bion's approach is comparable to social therapy , first developed in the United States in the late 1970s by Lois Holzman and Fred Newman , which is a group therapy in which practitioners relate to

2109-444: The group, not its individuals, as the fundamental unit of development. The task of the group is to "build the group" rather than focus on problem solving or "fixing" individuals. In Argentina an independent school of group analysis stemmed from the work and teachings of Swiss-born Argentine psychoanalyst Enrique Pichon-Rivière . This thinker conceived of a group-centered approach which, although not directly influenced by Foulkes' work,

2166-468: The guidance of the therapist, defense mechanisms are bypassed by the use of signifiers and semiotic processes. The focus remains on the text rather than on personal issues. It was popularized in the science fiction novel, Red Orc's Rage . Group therapy is now often utilized in private practice settings. Group analysis has become widespread in Europe, and especially the United Kingdom, where it has become

2223-477: The immediate post-war period. In 1948 the creation of the children's department supported the development of training in child and adolescent psychotherapy. Dr John Bowlby supported this new training and naturalistic infant observation . He also developed Attachment Theory. Husband and wife clinicians James Robertson and Joyce Robertson showed in their film work the impact of separation in temporary substitute care on young children for example, when their parent

2280-426: The mid-1990s. For a comprehensive overview of current practices see: Computer-supported psychotherapy . Several feasibility studies examined the impact of computer-, app- and media-support on group interventions. Most investigated interventions implemented short rationales, which usually were based on principles of cognitive behaviour therapy (CBT). Most research focussed on: While the evidence base for group therapy

2337-585: The most common form of group psychotherapy. Interest from Australia, the former Soviet Union and the African continent is also growing. Psychedelic-assisted group psychotherapy can be more cost-efficient in comparison to individual psychedelic-assisted psychotherapy models, because therapists can split the costs among all participants of the group. A 2008 meta-analysis found that individual therapy may be slightly more effective than group therapy initially, but this difference seems to disappear after 6 months. There

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2394-418: The provider of such care is soon finished). In contrast, the word intervention tends to be specific and concrete, and thus the word is often countable ; for example, one instance of cardiac catheterization is one intervention performed, and coronary care (noncount) can require a series of interventions (count). At the extreme, the piling on of such countable interventions amounts to interventionism ,

2451-696: The study of therapies. The English word therapy comes via Latin therapīa from ‹See Tfd› Greek : θεραπεία and literally means "curing" or "healing". The term therapeusis is a somewhat archaic doublet of the word therapy . Levels of care classify health care into categories of chronology, priority, or intensity, as follows: Treatment decisions often follow formal or informal algorithmic guidelines. Treatment options can often be ranked or prioritized into lines of therapy : first-line therapy , second-line therapy , third-line therapy , and so on. First-line therapy (sometimes referred to as induction therapy , primary therapy , or front-line therapy )

2508-539: The treatment of addictive, sociopathic and criminal behaviours and tendencies. It has developed as a centre for psychoanalysis within the NHS since being included at its founding in 1948. The Trust and predecessor organisations have been influential beyond medicine, including in the British Army , management consultancy , prison and probation services. It owes its name to the fact that its original location

2565-534: The treatment regimen, followed by third-line therapies, and so on. An example of a context in which the formalization of treatment algorithms and the ranking of lines of therapy is very extensive is chemotherapy regimens . Because of the great difficulty in successfully treating some forms of cancer, one line after another may be tried. In oncology the count of therapy lines may reach 10 or even 20. Often multiple therapies may be tried simultaneously ( combination therapy or polytherapy). Thus combination chemotherapy

2622-530: The usage of health professionals . However, in the context of mental health , the term therapy may refer specifically to psychotherapy . The words care , therapy , treatment , and intervention overlap in a semantic field , and thus they can be synonymous depending on context . Moving rightward through that order, the connotative level of holism decreases and the level of specificity (to concrete instances) increases. Thus, in health-care contexts (where its senses are always noncount ),

2679-404: The word care tends to imply a broad idea of everything done to protect or improve someone's health (for example, as in the terms preventive care and primary care , which connote ongoing action), although it sometimes implies a narrower idea (for example, in the simplest cases of wound care or postanesthesia care , a few particular steps are sufficient, and the patient's interaction with

2736-437: Was about two years. The Gender Identity Development Service (GIDS) at the Tavistock Centre has come under scrutiny due to reports that concerns over children's welfare were "shut down". The Tavistock and Portman NHS Trust have defended their practices. In July 2022, following criticism in the interim report by Hilary Cass , it was announced that this service would be discontinued, and replaced with regional clinics providing

2793-515: Was admitted to hospital. The Australian Hazel Harrison was teacher-in-charge from 1954 to 1956 where she worked with Bowlby. They looked in detail at English pre-school education. The Tavistock Clinic opened its Adolescent Department in 1959, recognising the distinctive developmental needs and difficulties of younger and older adolescents. In 1967 it absorbed the London Child Guidance Clinic , founded in 1929. In 1989

2850-573: Was also clear that to offer free treatment to all who need it meant that the Tavistock Clinic needed to generate income by providing training to clinical professionals who could eventually help people across the UK and beyond. The clinical staff were also researchers. These principles remain influential to this day. Following its foundation the Tavistock Clinic developed a focus on preventive psychiatry, expertise in group relations – including army officer selection – social psychiatry, and action research . There

2907-422: Was also providing both 1-year and 4-year professional training courses in educational psychology , the latter embracing a teacher training element through Leicester University School of Education. For a number of years the senior tutor and principal psychologist for these courses was Irene Caspari who did much to promote the concept and practice of Educational therapy . In the 1970s systemic psychotherapy became

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2964-534: Was an openness to different streams of research and thought as, for instance, the famous series of lectures given by the Swiss psychiatrist and one time collaborator of Sigmund Freud , Carl Jung , which were attended by doctors, churchmen and members of the public, including H. G. Wells and Samuel Beckett . Its staff, who were still mainly unpaid honorary psychiatrists, psychologists and social workers, were interested in researching and consulting to leadership within

3021-751: Was fully compatible with it. Irvin Yalom proposed a number of therapeutic factors (originally termed curative factors but renamed therapeutic factors in the 5th edition of The Theory and Practice of Group Psychotherapy (1st edition 1970, 5th edition 2005). Group therapy can form part of the therapeutic milieu of a psychiatric in-patient unit or ambulatory psychiatric partial hospitalization (also known as day hospital treatment). In addition to classical "talking" therapy, group therapy in an institutional setting can also include group-based expressive therapies such as drama therapy , psychodrama , art therapy , and non-verbal types of therapy such as music therapy and dance/movement therapy. Group psychotherapy

3078-531: Was in Tavistock Square in central London. When it moved later to larger premises, it took its name with it. Although Hugh Crichton-Miller was a psychiatrist who developed psychological treatments for shell-shocked soldiers during and after the First World War , clinical services were always destined for both children and adults. The clinic's first patient was a child. From its foundation it

3135-488: Was managed on a democratic model by a professional committee and developed further its distinct focus on multi-disciplinary and community-centred work. At the Clinic's centenary in 2020 many post-war Tavistock staff contributed personal chapters in "The Tavistock Century" (edited by Margot Waddell and Sebastian Kraemer, Phoenix Publishing House https://firingthemind.com/product/9781912691715/ ) New developments in child and adolescent mental health were particularly fruitful in

3192-608: Was named by the Health Service Journal as one of the top hundred NHS trusts to work for in 2015. At that time, it had 449 full-time equivalent staff, and a sickness absence rate of 0.92%. 84% of staff recommend it as a place for treatment and 73% recommended it as a place to work. The Trust borrowed £58 million in 2016, which it intends to repay by selling its current sites. The Tavistock has been accused of forcing racist ideology on students, with lectures such as "Whiteness - A Problem of Our Time", and in 2022

3249-777: Was pioneered in the mid-1940s by Kurt Lewin and Carl Rogers and his colleagues as a method of learning about human behavior in what became the National Training Laboratories (also known as the NTL Institute ) that was created by the Office of Naval Research and the National Education Association in Bethel, Maine, in 1947. Moreno developed a specific and highly structured form of group therapy known as psychodrama (although

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