Difficult Patients: Their Construction in Group Therapy

Gans, Jerome S.; Alonso, Anne

doi:10.1080/00207284.1998.11491545

Cited by 38 publications

(14 citation statements)

References 8 publications

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“…Following the introduction of the notion of narcissism into the field of organizational behavior, some studies have found that many leader behaviors are actually influenced by the narcissistic personality traits of the leaders ( de Vries and Miller, 1985 ). Ouimet (2010) pointed out that narcissistic leaders exhibit charisma, excessive pursuit of self-influence, false motives and, in the process, suppress employee performance.…”

Section: Theory and Hypothesesmentioning

confidence: 99%

Supervisor Narcissism and Time Theft: Investigating the Mediating Roles of Emotional Exhaustion and the Moderating Roles of Attachment Style

et al. 2018

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Although some studies have begun to explore the factors influencing employees’ time theft, it has not been uncommon to link employee time theft to leader personality traits. Based on the conservation of resources theory, this paper examines the influence of supervisor narcissism on employee time theft. It is found that supervisor narcissism positively affects employee time theft via the emotional exhaustion of employees. Further, employee’s attachment styles moderate the mediation effect of emotional exhaustion between supervisor narcissism and employee time theft. This study adds important insights into employee time theft, leader negative traits and the theory and practice of organizational management.

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Section: Theory and Hypothesesmentioning

confidence: 99%

Supervisor Narcissism and Time Theft: Investigating the Mediating Roles of Emotional Exhaustion and the Moderating Roles of Attachment Style

et al. 2018

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“…In their seminal text, Yalom and Leszcz (2005) dedicate an entire chapter to identify common problematic group members and provide clinical recommendations for working with these members. Importantly, group researchers have also sought to identify factors that lead to problematic group member behavior (Brown, 2006;Gans & Alonso, 1998), as well as examined problematic group processes, such as negative working relationships (Krogel et al, 2013) and negative group climate (Johnson, Burlingame, Ol-This article was published Online First December 2, 2019.…”

mentioning

confidence: 99%

“…sen, Davies, & Gleave, 2005;Mackenzie, 1981). Group researchers note the role of the other group members, group dynamics, and the group leader as important sources that contribute to problematic member behaviors in addition to intrapsychic factors (Brown, 2006;Gans & Alonso, 1998;Yalom & Leszcz, 2005).…”

mentioning

confidence: 99%

Problematic systems: Applying a multicultural orientation framework to understand “problematic members”.

Rigg

Kivlighan²,

Tao

2020

Professional Psychology: Research and Practice

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Within the group therapy literature, individuals who behave in ways that are perceived as negatively impacting the group dynamic or process have commonly been referred to as problematic group members. Largely, this research has identified intrapsychic and interpersonal reasons for challenging client behaviors and provided clinical recommendations for challenging group work. However, this work has not considered a sociocultural and systems approach to understand the impact of systems of privilege and oppression on members' in-group behaviors. In this paper we argue that members' "problematic" in-group behaviors may in fact be a recapitulation of problematic systems of privilege and oppression that occur outside and within the therapy group. We provide evidence of the impact of cultural processes, and by extension, the impact of systems of privilege and oppression on group processes and outcomes. Finally, we provide clinical recommendations for addressing members' problematic in-group behaviors from a multicultural orientation framework. Public Significance StatementTo date, group psychotherapy research has theorized 'problematic' group members (e.g., members who disrupt group dynamics through interpersonal patterns like silence) are doing so because of intrapsychic and interpersonal reasons such as a personality disorder or other mental illness. Because this conceptualization has not fully considered the impacts of oppression on interpersonal behaviors, we used the multicultural orientation (MCO) framework to reconceptualize 'problematic' group members in order to allow clinicians to view members interpersonal styles as potential responses to systems of privilege and oppression. Finally, we provide recommendations for clinicians to address disruptive group member behaviors using the MCO framework.

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“…Exposing such feelings in a group setting was likely intolerable, and he instead sought safety by attempting to wrest control of the group. The "difficult patient" in group therapy usually has accomplices: group dynamics influenced by therapists and other group members often coalesce with the individual's problematic behavior to coconstruct the difficulty (Gans & Alonso, 1998). In this case, group members may have been unconsciously relying on Ron to do the "storming" (Tuckman & Jensen, 1977) work on their behalf, expressing their collective anxieties with an aggression that may have felt somewhat empowering.…”

Section: Morrismentioning

confidence: 99%

When it is not a good fit: Clinical errors in patient selection and group composition in group psychotherapy.

Kealy¹,

Ogrodniczuk²,

Piper³

et al. 2016

Psychotherapy

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Group psychotherapy provides unique opportunities for clinical errors in the selection of patients and composition of therapy groups. This article introduces some of the difficulties and complexities that can be associated with group composition and patient selection errors. Clinical vignettes from psychodynamic/interpersonal psychotherapy groups are used to illustrate three variations of group composition and selection errors. The first vignette depicts an error in selecting a disruptive patient into a fledgling group. The second vignette portrays an unsuccessful integration of a withdrawn, inhibited patient into an active, exploratory group. The third scenario illustrates challenges associated with poor quality of object relations in homogeneous group composition. Although research on group therapy composition and patient selection is limited, relevant empirical literature is integrated in our discussion of clinical implications and recommendations. (PsycINFO Database Record

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Difficult Patients: Their Construction in Group Therapy

Cited by 38 publications

References 8 publications

Supervisor Narcissism and Time Theft: Investigating the Mediating Roles of Emotional Exhaustion and the Moderating Roles of Attachment Style

Supervisor Narcissism and Time Theft: Investigating the Mediating Roles of Emotional Exhaustion and the Moderating Roles of Attachment Style

Problematic systems: Applying a multicultural orientation framework to understand “problematic members”.

When it is not a good fit: Clinical errors in patient selection and group composition in group psychotherapy.

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