Trauma Group Therapy

October 18th, 2010

“The Group Trauma Recovery Model of therapy can be used either alone or as an adjunct for victims who are engaged in individual therapy. The following assumptions form the philosophical basis of trauma group therapy:

They are based on the STAIR Model, developed by Marylene Cloitre, where patients are taught techniques conducive to new learning rather than fragmenting on exposure to the trauma trigger.
This is crucial for synthesis of the trauma narrative that will be explained in a separate article.
  • A group environment is formed consisting of 8 to 12 trauma victims
  • Two co-therapists lead the group once to twice weekly over a period of about 8 weeks
  • The victim group should be as homogeneous as possible, e.g. groups should distinctly comprise victims of rape, child abuse, spousal abuse, terrorist attacks, and so on.
The common cause of trauma binds the victims, who now recognize that they share a common experience. During the first stage, trauma narration is discouraged because not all members have yet acquired the coping skills to absorb trauma narrations which trigger their own trauma recollections. The prevailing “ground rule” is that each victim’s sense of safety has to be respected. Until all members feel ready to process trauma-laden material, they must learn various coping skills (e.g. boundary preservation and interpersonal respect); grounding techniques (e.g. controlled breathing); and use of soothing self–objects, including any symbolic objects that reactivate early comforting experiences and feelings of well being.
For some victims, the group provides a safe haven removed from a world dominated by fear triggers. The group is taught a vocabulary to label their trauma symptoms. If a particular group member feels agitated, then others must obtain verbal permission from that victim to use physical touch as a form of comforting. 
Co-therapists identify distressed victims and try to facilitate the group’s capacity to heal. By providing a safe environment, the therapists’ function, to some extent, is a caretaking or even parenting role. The therapists should also meet separately, and quite frequently, to assess the progress of the therapeutic group process. They decide at which point the group is ready to enter the “trauma narrative” phase of therapy. The therapists attempt to educate the trauma group about how to replace maladaptive feelings and behaviors with more functional behaviors and an enhanced sense of calmness and well being.
When good parenting skills are used to create a safe holding environment, then healing can begin to take place via bonding and vicarious learning. Victims begin to feel less isolated about the secrets of their personal burdens when they learn about each other’s experiences. For instance, during the first few weeks following a rape, most victims will have very distressing levels of arousal. But years later, they lack vitality and may appear burned-out and emotionally absent.
Follow-up studies of traumatized victims show that most “intrusive” symptoms in the immediate aftermath of a trauma are replaced by numbing, constriction, social avoidance, and physical symptoms over time if left untreated. This can be prevented by a timely referral to a support group for various trauma populations, such as victims of physical or sexual assault.
Within the safe holding environment created by the therapists, victims can gradually emerge from their protective shells and begin to socially reengage.”

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