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Module 9: Learning Activity

University of Rochester School of Nursing

NUR454 Group and Family Psychotherapy

October 25, 2023

Study Questions
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1. Background and Underlying theory. Define and describe the following key concepts

in experiential family therapy and existential group therapy (Corey, Ch. 9 and Nichols

Ch. 7). Give applied examples.

A. Existential anxiety

Existential anxiety is a fundamental concept in existential therapy, which explores

individuals' struggles with the inherent anxieties and dilemmas of human existence. It arises

from the awareness of one's mortality, freedom, isolation, and the apparent lack of inherent

meaning in life. In family therapy, existential anxiety can affect not only individuals but the

entire family system. Families may experience existential anxiety when faced with significant

life changes, such as a terminal illness or the loss of a family member.

Example: Consider a family dealing with the terminal illness of a parent. The family members

may grapple with existential anxiety as they confront the reality of death, their own mortality,

and questions about the meaning of life. The therapist can help them explore these anxieties,

encouraging open conversations and supporting each family member's unique response to

existential questions.

B. Choice & personal responsibility in logotherapy

Logotherapy, developed by Viktor Frankl, emphasizes the importance of choice and

personal responsibility in finding meaning in one's life. It posits that individuals have the

freedom to choose their attitudes and responses to life's challenges. In family therapy, this

concept can be applied by helping family members recognize their role in creating and

maintaining their family dynamics.

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Example: A family is experiencing conflict due to a lack of communication. The therapist

encourages each family member to take responsibility for their communication patterns and

choices. By acknowledging that they can choose to improve their communication and that

they are responsible for their actions, the family members can work together to create more

constructive interactions.

C. Search for authenticity

Existential therapy often focuses on the search for authenticity, which means being true to

oneself and living in alignment with one's values and beliefs. In family therapy, this concept

involves helping family members express their true selves and foster genuine connections

within the family.

Example: In a family where a teenager feels pressured to conform to their parent's

expectations, the therapist can facilitate a conversation about authenticity. The teenager can

express their desire to pursue their interests and values, and the family can work on

understanding and supporting this pursuit while maintaining a healthy family connection.

D. Search for meaning

The search for meaning is a core existential concept that suggests individuals strive to find

purpose and significance in their lives. Helping families explore and create shared meanings

can enhance their cohesion and resilience in family therapy.

Example: A family may be struggling with a sense of emptiness or a lack of purpose. The

therapist can guide them in identifying and nurturing shared values and goals. Through this

process, the family can create a sense of meaning and direction that unites them.

E. Family Myths
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Family myths are narratives or stories within a family that define its identity and provide

explanations for various aspects of family life. These myths can be both positive and negative,

shaping family dynamics. In family therapy, examining these myths can help family members

gain insight into their beliefs and behaviors.

Example: A family might hold a myth that they must always appear perfect to the outside

world. This belief can lead to high levels of stress and inauthenticity. The therapist can work

with the family to challenge this myth, encouraging more open and genuine interactions.

F. Mystification

Mystification in family therapy refers to a lack of clarity and transparency in

communication, where family members may not fully understand each other's thoughts,

feelings, or actions. This can contribute to misunderstandings and conflicts within the family

system.

Example: A family member might frequently act out in anger, causing confusion and

frustration among other family members. The therapist can address this mystification by

facilitating open dialogue and helping the family member express their underlying emotions

and concerns, leading to better understanding and resolution.

2. Define the following terms in group and family psychotherapy of each (Nichols, Ch. 7 and

Corey Ch. 10).

A. Phenomenological stance

In both family and group psychotherapy, the phenomenological stance refers to the

therapist's approach to understanding the subjective experiences and perspectives of individuals

or family members. It involves suspending judgment, preconceptions, and interpretations in order

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to fully grasp the unique way each person perceives and experiences reality. Therapists adopting

this stance seek to empathize and explore the clients' inner world without imposing their own

assumptions or biases.

B. Existential encounter

In family and group psychotherapy, an existential encounter is a therapeutic moment when

clients confront their own existence, choices, and the ultimate questions of life. It involves

exploring the fundamental aspects of human existence, such as freedom, responsibility, and

meaning. Existential encounters encourage clients to grapple with their own life's purpose and

values within the therapeutic context.

C. Self-actualization

Self-actualization is a concept commonly associated with humanistic and person-centered

approaches. It refers to the process of realizing and fulfilling one's potential, striving for personal

growth, and becoming the best version of oneself. In family and group therapy, self-actualization

can involve helping clients or family members pursue their unique paths to self-realization while

being supported by the therapeutic process.

D. Congruent communication

Congruent communication is the act of expressing one's thoughts, feelings, and behaviors

in a way that is authentic, genuine, and in alignment with one's inner experiences. In both family

and group therapy, congruent communication is vital for building trust and promoting open and

honest interactions. Therapists encourage clients to express themselves transparently and

congruently, which can foster healthier relationships within families or groups.

E. Person centered communication

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Person-centered communication is closely associated with Carl Rogers' humanistic

approach. It involves active listening, empathy, and unconditional positive regard. In family and

group therapy, person-centered communication focuses on creating a safe and supportive

environment where clients can express their thoughts and emotions freely. Therapists aim to

reflect clients' feelings and experiences, fostering a nonjudgmental and empathetic atmosphere.

F. Unconditional positive regard

Unconditional positive regard is a core concept in person-centered therapy, emphasizing

the therapist's nonjudgmental acceptance and support for clients. In family and group therapy,

unconditional positive regard involves the therapist showing respect, care, and empathy toward

each member, regardless of their behavior or challenges. This acceptance helps clients feel valued

and encourages their personal growth.

G. Accurate empathy

Accurate empathy involves the therapist's ability to understand and convey the client's

inner experiences and emotions accurately. In family and group therapy, therapists strive to

put themselves in the clients' shoes, comprehending their feelings, perspectives, and struggles.

Accurate empathy enhances the therapeutic relationship and enables clients to feel understood

and heard, leading to more meaningful and effective therapy outcomes.

3. What are the goals of existential group psychotherapy? Yalom’s principles are useful

(Corey, Ch. 9)

Existential group psychotherapy, as outlined by Irvin D. Yalom and other existential

therapists, encompasses several key goals that aim to help individuals in a group context explore
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and address existential concerns. The following are the goals of existential group psychotherapy,

as influenced by Yalom's principles and concepts, as described by Corey (2023):

 Confronting Existential Issues: One of the primary goals of existential group therapy is

to create a safe space for members to confront existential concerns. This includes

addressing issues such as the meaning of life, freedom, isolation, and death. Group

members are encouraged to explore and discuss these universal human dilemmas openly.

 Enhancing Self-Awareness: Existential group therapy focuses on increasing self-

awareness among participants. Members are encouraged to reflect on their own values,

beliefs, and the choices they make. Through self-reflection and group interaction, they can

gain a deeper understanding of themselves and their life experiences.

 Fostering Authenticity: Authenticity is a central concept in existential therapy. Group

therapy encourages individuals to be true to themselves, express their genuine feelings,

and live in alignment with their values. The group setting provides opportunities for

members to practice being more authentic and transparent in their interactions.

 Promoting Responsibility: Existential therapy emphasizes the idea that individuals have

the freedom to make choices and are responsible for those choices. In a group context, this

means encouraging members to take responsibility for their actions, decisions, and the

impact they have on others. Through this, group members can develop a greater sense of

agency and self-empowerment.

 Exploring Meaning and Values: Group therapy provides a platform for members to

explore their personal values, beliefs, and what gives meaning to their lives. Group
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discussions and interactions can help individuals clarify their values and work toward a

more meaningful existence.

 Developing Interpersonal Skills: Existential group therapy allows members to practice

and refine their interpersonal skills within a supportive environment. It provides

opportunities for members to connect with others, share their experiences, and learn from

different perspectives, which can enhance their ability to form meaningful relationships

outside of the group.

 Creating a Supportive Community: Yalom's principles highlight the therapeutic

benefits of group cohesion and interpersonal relationships. Existential group therapy seeks

to foster a sense of community among group members, offering support, empathy, and

understanding in the face of existential challenges.

 Facing Death and Mortality: Existential therapy encourages individuals to confront their

mortality and the finite nature of human existence. In group therapy, members can share

their fears, anxieties, and insights related to death, ultimately helping them come to terms

with this existential reality.

 Promoting Personal Growth: Ultimately, the goal of existential group therapy is to

facilitate personal growth and self-actualization. Through the exploration of existential

concerns, increased self-awareness, and more authentic living, individuals can work

toward becoming the best version of themselves and living a more meaningful and

fulfilling life.

In summary, existential group psychotherapy, based on Yalom's principles, aims to help

individuals in a group setting address existential issues, enhance self-awareness, foster

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authenticity, and promote personal growth, all within the context of a supportive and empathetic

community.

4. What are the goals of experiential family therapy (Nichols Ch. 7).

Experiential family therapy, as described by Nichols (2017), has several key goals focused on

helping families improve their relationships, communication, and emotional well-being. The

primary goals of experiential family therapy are as follows:

1. Enhancing Emotional Expression: Experiential family therapy aims to create a safe and

supportive environment where family members can freely express their emotions. The

goal is to help family members identify and communicate their feelings, whether they are

positive or negative, without fear of judgment or criticism.

2. Promoting Authentic Communication: Authentic communication involves open and

honest interaction among family members. The therapy seeks to encourage family

members to communicate their true thoughts, needs, and desires without pretense or

defensiveness. This authenticity helps in addressing underlying issues and improving

understanding within the family.

3. Resolving Unfinished Business: Experiential family therapy often focuses on addressing

unresolved conflicts, past traumas, and unfinished emotional business within the family

system. The goal is to help family members confront and work through these issues to

create a healthier and more harmonious family dynamic.

4. Rebuilding Trust: In cases where trust has been eroded within the family, the therapy

aims to rebuild trust through improved communication and empathy. This involves
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helping family members understand one another's perspectives and validating their

experiences, ultimately fostering a more trusting and secure family environment.

5. Enhancing Family Bond and Cohesion: Experiential family therapy seeks to strengthen

the emotional bonds and cohesion within the family unit. The goal is to create a sense of

togetherness, mutual support, and belonging among family members, promoting a positive

family identity.

6. Promoting Empathy: Empathy is a critical component of experiential family therapy.

The therapy encourages family members to understand and validate each other's emotions

and experiences. Developing empathy for one another helps in resolving conflicts and

improving emotional connections.

7. Improving Problem-Solving Skills: The therapy aims to equip family members with

effective problem-solving and conflict-resolution skills. By enhancing their ability to

address issues constructively, families can work together to find solutions to problems and

reduce recurring conflicts.

8. Fostering Individual Growth: Experiential family therapy recognizes the importance of

individual growth within the context of the family. The therapy encourages each family

member to develop personally, pursue their goals, and express their unique identity while

still being part of the family system.

9. Creating a Supportive Family Environment: The goal is to establish a supportive and

nurturing family environment where family members can lean on one another during

challenging times. This includes providing emotional support and encouragement to all

family members.
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10. Enhancing Family Resilience: Experiential family therapy aims to make families more

resilient in the face of life's challenges. By improving emotional expression,

communication, and problem-solving, families can better navigate difficult situations and

adapt to change.

Overall, the primary goals of experiential family therapy are centered around improving

family relationships, emotional expression, and communication, as well as addressing unresolved

issues to create a more harmonious and supportive family system.

5. Describe two or three therapeutic techniques used in treatment when using these

approaches. Give applied examples:

Existential Therapy Technique: Existential Paradoxical Intervention

Existential paradoxical intervention is a technique in which the therapist encourages

clients to embrace and confront their anxieties or fears directly. Instead of attempting to

reduce or eliminate the existential anxiety, the therapist invites clients to consider what would

happen if they fully embraced and lived with these anxieties.

Example: Suppose a client is struggling with a fear of death, which is causing significant

distress. The therapist might employ this technique by asking the client to imagine fully

accepting the reality of death, asking questions like, "What would your life look like if you

lived with the awareness of death every day?" This can lead to deeper exploration of the

client's values and priorities, ultimately helping them find meaning in life in the face of

mortality.

Experiential Family Therapy Technique: Emotionally Focused Therapy (EFT)

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Emotionally Focused Therapy is a widely used technique in experiential family therapy. It

focuses on understanding and reconfiguring emotional responses within the family. The

therapist works with family members to identify and express their emotions and to understand

the underlying emotional needs. The goal is to create a secure emotional bond and resolve

conflicts.

Example: In a family where a couple is experiencing marital issues due to poor

communication and unresolved conflicts, the therapist employing EFT would guide the couple

through a process of identifying and expressing their underlying emotions. By facilitating

open and emotionally honest conversations, the therapist helps the couple to address their

fears and unmet emotional needs. This process can lead to a more secure emotional

connection and the resolution of conflicts, ultimately strengthening the marital bond.

Existential Therapy Technique: Socratic Dialogue

Socratic dialogue is a technique in existential therapy that involves a structured and

exploratory conversation. The therapist uses open-ended questions and discussions to help

clients clarify their beliefs, values, and personal meaning. This technique encourages self-

examination and reflection.

Example: A client is grappling with a sense of purposelessness and a lack of meaning in their

life. The therapist uses Socratic dialogue to ask questions like, "What is important to you in

life?" and "What activities or experiences bring you a sense of fulfillment?" Through this

process, the client can gain greater clarity about their values and what gives meaning to their

existence, helping them develop a more purposeful and fulfilling life.

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These therapeutic techniques in existential therapy and experiential family therapy are

designed to encourage self-exploration, emotional expression, and understanding of core

issues, ultimately facilitating personal growth and improved family relationships.

6. What are the strengths and weakness of humanistic, experiential and existential

psychotherapy? What are some differences between them?

Humanistic, experiential, and existential psychotherapies are often grouped together due

to shared principles, but they each have distinct characteristics and applications, along with

their own strengths and weaknesses.

Humanistic Psychotherapy places the client at the center, with a strong focus on empathy,

unconditional positive regard, and active listening. It emphasizes personal growth, self-

actualization, and self-discovery, encouraging individuals to reach their full potential. A holistic

approach is taken, considering the emotional, cognitive, and physical aspects of the client's

experience. However, it can be criticized for its non-directive nature, which may pose challenges

for clients who prefer more structured interventions. Additionally, humanistic therapy might not

be suitable for individuals with severe mental health issues, and it has faced criticism for its

perceived lack of empirical evidence supporting its effectiveness.

Experiential Psychotherapy is distinguished by its emphasis on emotional exploration and

expression. This makes it particularly useful for individuals dealing with emotional issues. The

approach is often effective in addressing family or relationship problems as it centers on

emotional expression and communication. Experiential therapy offers a rich array of therapeutic

techniques, such as empty-chair work, role-playing, and art therapy, adding to its versatility.

However, it may lack the same level of empirical research support as more established therapeutic
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approaches. Some clients may struggle with deep emotional work, and specialized training is

required for therapists, potentially limiting its accessibility.

Existential Psychotherapy provides a framework for exploring profound existential

questions and dilemmas, which can be transformative for clients open to this exploration. It

encourages individuals to take responsibility for their choices and actions, promoting personal

growth. Existential therapy is also flexible and can be adapted to various cultural and belief

systems. However, the focus on existential concerns can be overwhelming for some clients,

particularly those not ready to confront these profound questions. The approach is generally less

structured and may not provide clear guidelines for therapists. Similar to other humanistic

approaches, existential therapy also has less empirical evidence supporting its efficacy.

The key differences among these approaches lie in their respective emphases. Existential

therapy focuses on existential concerns like freedom, responsibility, and meaning. Experiential

therapy places a particular focus on emotional expression and exploration, whereas humanistic

therapy, although empathetic, may not delve as deeply into emotions. Additionally, humanistic

therapy is often non-directive, allowing clients to lead the session, while experiential and

existential therapies may employ more directive techniques or interventions. Experiential therapy

is frequently used in family and couples therapy to address relationship issues, whereas existential

therapy tends to focus more on individual existential concerns. Ultimately, the choice between

these approaches depends on the client's needs, the therapist's approach, and the specific goals of

therapy.
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7. Demonstrate the clinical uses of the genogram by applying one of the following

approaches to one of the families described in McGoldrick et al Ch. 9.

A. Clarifying family patterns

B. Detoxifying and reframing family issues

C. Using genograms to transform relationships

In the scenario provided by McGoldrick et al., the therapist decides to employ the genogram

technique to clarify the family's patterns related to addiction and codependency. The genogram

serves as a visual representation of the family's history, relationships, and recurring patterns of

substance abuse within the family.

Creating the Genogram: The therapist constructs a comprehensive genogram encompassing

multiple generations of the family. This includes documenting not only John and Mary's addiction

but also tracing back to any history of substance abuse in previous generations. By doing so, the

genogram illustrates how the family's relationship with addiction has been handed down through

generations.

Identifying Patterns: With the aid of the genogram, the therapist can pinpoint patterns of

substance abuse across family members. It facilitates a clear understanding of how this issue has

influenced multiple family members over the years. For instance, the genogram may reveal that

John's father and Mary's mother also grappled with addiction.

Engaging in Family Discussions: The genogram initiates crucial discussions within the family.

The therapist utilizes it as a conversation starter, encouraging open dialogues about the impact of
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addiction on different family members. Through these conversations, family members come to

understand how addiction has shaped their behaviors and relationships.

Breaking Down Denial: The genogram proves invaluable in dismantling denial within the

family. It helps family members recognize the extent of the problem and illuminates how

codependency and enabling behaviors have sustained the cycle of addiction within the family.

Treatment Planning: Armed with a comprehensive understanding of the family's addiction

patterns, the therapist collaborates with the family to formulate a treatment plan. This plan

addresses the unique needs of each family member while recognizing the collective imperative to

break free from the cycle of addiction.

Benefits:

 The genogram serves as a visual aid that facilitates family members' comprehension of

their role in the addiction cycle.

 It aids in the identification of recurring patterns and interconnections within the family,

illuminating the influence of past generations on the present situation.

 As a therapeutic tool, the genogram encourages open communication, the

acknowledgment of issues, and a cooperative approach to dealing with addiction and

codependency challenges within the family.

By employing the genogram to clarify family patterns, the therapist empowers the family to

gain insights into their history of addiction. This serves as a crucial initial step toward addressing

the issues and working collaboratively toward transformation and healing.

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References

Corey, G. (2023). Theory and Practice of Group Counseling (10th Ed.) Belmont, CA

Brooks/Cole Cengage Learning.

McGoldrick, M., Gerson, R. & Petry, S. (2008). Genograms: Assessment and

Intervention (3rd Ed.). NY, NY: W.N. Norton & Company, Inc.

Nichols, M.P. (2017). Family Therapy: Concepts and Methods (11th Ed.) Boston:

Pearson Education.