Process Intensive Group Structure

Having looked at pre-and perinatal group therapy compared to both conventional groups and individual therapy, we turn our attention to the actual structure of one modality of facilitating pre-and perinatal group process, the process intensive. In what I call the process intensive group, six to eight participants commit to work over 21/2 to 3 days, each having a turn, working with the therapist one-on-one with group support. Ray Castellino, to whom we owe a lot for standardizing this protocol, calls them process workshops. In my opinion, this is truly group psychotherapy at its finest.

In setting up a process intensive group there are a few guiding principles that help create safety and make the group beneficial for all. Remember, safety should begin at conception, the first contact. Pre-screening is a must. A form designed to pre-screen participants and give you, the therapist, valuable information that will help you support their work, is completed prior to the group. This form also helps the client become clear about their intention and orients them to the type of group and work for which they are enrolling. It should ask them about their intention, special physical considerations, their support system including therapy available after the intensive, as well as their birth history. They also agree to keep other group member’s experiences confidential. Answers to the questions will  help you as the therapist understand their history and their potential for benefiting from the group. I have used a simple form for years. Ray Castellino has a four- page form which I have adapted and now use. Thomas Verny (2002) also has an extensive pre-and perinatal history form that may be quite beneficial.

Potential group members must be able to contribute to and benefit from a group experience. This is critical to the success of the group. Participants must be physically healthy (or know their limitations) and be emotionally stable. This is not a group for someone in crisis. It is also important that the person wants to be in the group, not just attending because a partner, parent or friend wants them to.

When accepting a participant, help them orient to the space and expectations of the group therapy experience. Be clear about schedules, expectations around food and meal times and appropriate attire. Make certain the person understands that each session is different and open ended so it is important not to plan anything for the evenings or the close of the workshop. This is not only because of the uncertainty of the ending times, but because clients tend to receive the most benefit when they are able to stay with their own process and have some time for integration without outside distractions. It is usually counterproductive for a person to participate in an unrelated activity during the weekend.