Book Review
Psychotherapy 
Group Psychotherapy for Psychological Trauma Robert H Klein, Victor L Schermer, editors. New York: The Guilford Press; 2000. 364 p. US$50.00
Reviewer
rating*: Excellent
Review by: Paul Ian Steinberg, MD, FRCPC
Edmonton, Alberta
This comprehensive text on group psychotherapy for psychological trauma passes what is for me the most important test of an edited book: the quality of the writing is smooth and consistent from chapter to chapter, and the chapters follow each other in a logical manner without redundancy or obvious omissions. Part one, “Concepts, Theories, and Strategies,” comprises 5 chapters that include an introduction and chapters on initiating, screening, and maintaining groups for traumatized patients; on managing trauma-related affect, defenses, and dissociative states; on whole-group dynamics in work with traumatized patients; and on countertransference reactions in trauma groups. Part 2, “Special Populations and Trauma Groups,” has 8 chapters. Several chapters discuss group psychotherapy for individuals with symptoms of posttraumatic stress disorder, for survivors of sexual and physical abuse, and for those suffering the psychological trauma of prolonged, severe, and (or) terminal illness. Other chapters discuss group intervention and support after disaster, group treatment of children suffering from trauma and loss, group treatment for victims of political torture and other forms of severe ethnic persecution, group treatment of dissociative identity disorder, and finally, group treatment of severe clinical disorders, personality disorders, and substance abuse disorders.
This organized and lucid book offers a comprehensive and thoughtful approach to the subject. The authors are clearly highly committed and expert in their field. Summaries at the end of each chapter are useful additions. Some of the writing assumes that readers have some familiarity with psychoanalytic terminology, which might challenge naive readers. That said, each chapter engages the reader, and the authors offer sound psychodynamic bases for their suggestions. This text successfully integrates psychodynamic principles with techniques specific to the treatment of traumatized patients. Implicit in it is a convincing argument for the efficacy of group psychotherapy.
The authors frankly acknowledge the limitations of the treatment they describe and what should be realistic goals for their patients. I did, however, find some suggestions curious, such as the ideas of reading a children’s book aloud, in a group setting, to a patient in a dissociative trance; or having modelling clay available to reveal themes for exploration; or having a basket of helpful objects available. The authors do not make it clear that these techniques should be restricted to the more supportive, initial, Stage 1 groups (which would make these approaches more understandable in the context of the book’s generally psychodynamic approach). Objects in the basket, for example, might be understandable as transitional objects for patients to take home to help soothe themselves, but this was only implied. Another technique that is hard to understand is the suggestion that the therapist should buy each group member a candle to be lit during the therapist’s vacation, at the usual time of the group meeting. Further, I can only describe some ideas as “hokey”—for example, the suggestion that, when a group member leaves, others should be given a balloon to release into space with good wishes for the departing member. A final comment: I believe that the use of the term “antisocial” should be restricted to individuals displaying traits of antisocial personality disorder as opposed to the deliberate social isolation that frequently accompanies trauma and dissociation.
In general, this book is excellent. well-edited, and impressive, especially given its multiple authors. A single reference was missing in Chapter 1. Further, in Chapter 4, Ramon Ganzarain omits Sheidlinger’s important work in a discussion of the group as a maternal metaphor, using the phrase “mother group” without attribution—a minor complaint—and there was one ungrammatical sentence, the meaning of which could not be understood. In sum, this text is essential reading for anyone contemplating group psychotherapeutic treatment for individuals with psychological trauma, which would include, in my opinion, most patients with a diagnosis of a severe personality disorder. I warmly recommend this book to all group therapists, who will find much of value in it.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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