Yalom

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Yaloms Therapeutic Factors

• By
• Patti Higgins

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Yaloms Therapeutic Factors

• Yalom (1995) defined therapeutic factors as "the
  actual mechanisms of effecting change in the
  patient" (p. xi).
• Yalom identified 11 factors that influence the
  processes of change and recovery among group
  therapy clients.

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11 Therapeutic Factors

• Universality - feeling of having problems similar
  to others, not alone
• Altruism - helping and supporting others
• Instillation of hope - encouragement that
  recovery is possible
• Guidance - nurturing support assistance

• Imparting information - teaching about problem
  and recovery
• Developing social skills - learning new ways to
  talk about feelings, observations and concerns
• Interpersonal learning - finding out about
  themselves others from the group

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11 Therapeutic Factors

• Cohesion - feeling of belonging to the group,
  valuing the group
• Catharsis release of emotional tension
• Existential factors life death are realities
• Imitative behavior modeling anothers manners
  recovery skills

• Corrective recapitulation of family of origin
  issues identifying changing the dysfunctional
  patterns or roles one played in primary family

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Assessment of factors

• Yalom Q-sort assesses patients perceptions of
  therapeutic factors and consists of 60 statements
  representing 12 categories of therapeutic
  factors. A ranking of 1 to 60 is produced.
• Bloch, Reibstein, Crouch, Holroyd and Themen's
  (1979) assessment uses independent raters to
  judge presence of therapeutic factors.

• Therapeutic Factors Inventory (TFI) - empirically
  derived comprehensive assessment of the presence
  or absence of the 11 therapeutic factors in a
  group (Lese MacNair-Semands, 1997)

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Navajo sweat lodge study

• Colmant and Merta (1999) explored the Navajo
  sweat lodge ceremony as a culturally relevant and
  therapeutic approach to group therapy. They
  compared the sweat lodge ceremony used at a
  residential treatment center for Navajo males
  aged 6-15 years old with disruptive behavior
  disorders, to modern group work with Yaloms
  therapeutic factors.

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Differences among factors values

• Older women in an outpatient therapy group ranked
  existential awareness as the most important
  therapeutic factor (McLeod Ryan, 1993).
• Morgan Ferrell (1999) found therapists'
  perceived interpersonal learning, universality,
  imparting info highest for group of incarcerated
  males.
• Schwartz and Waldo (1999) found imparting of
  information and development of socializing
  techniques most valuable in educational groups
  for batterers.
• Campbell Page (1993) found recovering drug
  addicts ranked highest information
  dissemination, corrective recapitulation of the
  primary family, development of socializing
  techniques, imitative behavior, interpersonal
  learning, group cohesiveness, and catharsis.
• Mawson Kahn (1993) reported women in career
  counseling group rated cognitive and affective
  components as most valuable.
• Tomasulo, Keller Pfadt (1991) found
  psycheducational groups therapeutic.
• Kivlighan Goldfine (1991) found guidance
  increased across the stages of group,
  universality and hope decreased, and catharsis
  increased in beginning.

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Yaloms adages

• Therapy group is a social microcosm and a
  reenactment of the primary family.
• Therapists should listen to their patients.
• Patients should listen to and learn from one
  another.