Group psychotherapy levels of interventions: a clinical process commentary

Trainees may experience greater effectiveness as therapists by conceptualizing group therapy interactions as occurring at different levels of functioning. We teach group therapy trainees to be aware of and flexibly direct their interventions to three levels of the group: (a) the intraindividual level, (b) the interpersonal level, and (3) the group-as-a-whole level. Within this conceptualization, we also encourage trainees to reinforce the group structure especially related to safety and secure base and to help group members to self-reflect about their interactions within the group. In this clinical process commentary, we describe a process of pregroup assessment and preparation that includes evaluating individual core relational patterns (CRPs) and how these patterns might express themselves in the three levels of group functioning. A running case presentation provides examples of a CRP formulation, levels of group functioning, and therapist interventions that are specific to each level. Making use of each group level within every session may allow the novice group therapist to sort the complex information they receive in a meaningful way. A therapist who can flexibly attend to and work within each group level will optimize the effectiveness of their interventions.