Interpersonal Relationships and Group Therapy in a Residential Eating Disorder Treatment Center: Experiences of a Treatment Community Beyond the Diagnosis

Melanis Rivera-Rodriguez_PsyD_Primary Therapist

Primary Therapist Melanis Rivera-Rodriguez, PsyD co-facilitates a weekly process group at Oliver-Pyatt Centers. She shares about the use of Yalom’s therapeutic factors in her work with group therapy.

When it comes to the treatment of eating disorders at a residential level of care, a sense of community and ways of one patient relating to another can be weaved into the daily focus of treatment and recovery. The concept of community and relationships dates back to our ancestors, and from a scientific perspective speaks of the gregarious nature within the instincts of survival and collaborative work that humans possess. From a therapeutic stance, Irvin Yalom, an existential psychiatrist, speaks of 12 therapeutic factors defining them as “the actual mechanisms of effecting change in the patient” (Yalom, 1995) in a therapeutic community and/or group therapy setting.

In my experience as a primary therapist, and in co-facilitating process group once a week at Oliver-Pyatt Centers, a sense of community can be observed being established among the women in which several of Yalom’s therapeutic factors can be identified in the group dynamics. Being attuned and aware of these factors has aided in facilitating not only the group process but the individual process as well. Yalom’s therapeutic factors consist of:

  1. Universality – feeling of having problems similar to others and not being alone.
  2. Altruism – helping and supporting others in their recovery process.
  3. Instillation of hope – encouragement that recovery is possible.
  4. Guidance – nurturing support and assistance.
  5. Imparting information – teaching about a problem and recovery.
  6. Developing social skills – learning new ways to communicate about feelings, concerns, and new ways of relating.
  7. Interpersonal learning – finding out about themselves and others through group feedback.
  8. Cohesion – feeling of belonging to the group and valuing the group.
  9. Catharsis – release of emotional tension.
  10. Existential factors – life and death are realities.
  11. Imitative behavior – modeling another’s manners and recovery skills.
  12. Corrective recapitulation of family of origin issues – identifying and changing the dysfunctional patterns or roles one played in primary family.

From the previously listed therapeutic factors, universality seems to inherently facilitate connections in which possibly the treatment experience creates an exchange among the women that may enhance empathy, compassion and self-awareness. Additionally, the elements of time (length of stay) and environment (24/7 care) seem to play crucial ingredients as the women begin to navigate treatment for their specific struggles with an eating disorder and/or other co-occurring issues. Change can be identified not only cognitively and behaviorally, but also holistically, in which the integration of these factors, insight of recovery and relationships might parallel the woman’s circumstances outside of treatment possibly facilitating change in deeper, consistent and meaningful ways in the path of recovery from an eating disorder.


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