Skin Deep: A Mind Body Program for Healthy Skin by Dr. Ted A. Grossbart - HTML preview

Health insurance has made psychotherapy a practical possibility for many. Check

your policy (you may have to call the company for clarification) to answer three key

questions: Does insurance pay for outpatient mental health services? Which

therapists does it pay? How much does it pay?

Your policy may pay for psychotherapy but not hypnosis, biofeedback, or

relaxation, because these are considered "experimental techniques." (Often you'll be

reimbursed if these techniques are billed under the general heading

"psychotherapy.") It may pay for therapy performed by a psychiatrist or psychologist

but not a clinical social worker. It may insist that you be referred by a physician.

Most policies have a yearly or per-session limit on coverage, and some exclude

many problems as "preexisting conditions." If psychotherapy is not covered or

inadequately reimbursed and finances threaten to become a hardship, consider

therapy at a clinic or mental health center with a sliding scale based on your income.

Group therapy is less expensive and in some cases more useful than individual

sessions.

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APPENDIX III

The Power of the Group

Groups have a fundamental power. They speak to our origins as primates, our

dependency on others as children, and our basic need for one another. Groups can

hurt or kill – they can also soothe and heal. If the thought of being in a group puts you

off, it likely means that you have suffered in one and may need a good group

experience all the more.

Groups formed for a specific purpose are a major resource. They come in so

many shapes, sizes, and types that it is hard to be an educated consumer. Let's look at

the options and consider which groups are most likely to give you what you need.

There are three main types of groups: psychotherapy groups, professionally led

support groups, and self-help/mutual help groups. All are briefly described below. I

have also included a nationwide listing of support groups for various types of skin

disorders in Appendix IV. Since local support group information changes so

frequently, I have provided only the national office addresses and telephone numbers

of the various organizations. You can contact them to obtain a current listing of local

support groups.

1.

Psychotherapy groups: These are much more than individual psychotherapy

with more people in the room. With one (or possibly two) mental health

professionals leading, these groups typically have four to twelve members and meet

once or more times a week. The group may begin and terminate at the same time for

everyone or continue indefinitely with members entering and exiting on their own

timetable. There are groups for all ages, for couples, and for all levels of psychological

health. Group members may have common or different therapy agendas and may

also be in individual psychotherapy.

Group therapy would be a tool to address the emotional issues under your skin

and other life issues more than the specific skin symptoms. If the whole idea of

working in a group is uncomfortable for you, that likely suggests you are a good

candidate for a group. While group treatment can focus on any issue, it has special

advantages for certain problems.

When someone has realized that old ways of acting are unhelpful, a place to

refine and practice new approaches that are not yet ready for "prime time" is helpful.

Group provides the safe testing or practice field. It offers a similar advantage to

someone who has been socially isolated. Do you find that situation after situation

does not work out as hoped? At first, you probably focused on the specifics, bad luck,

or a malevolent view of the universe. A common second step is, "It must be a least

partly something I'm doing, but what?" This question can be answered by looking at

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past situations or seeing yourself do the same problem behavior with the therapist in

individual treatment. If not, group psychotherapy may be the best tool for the job.

Inevitably, the same problems will crop up, but you have a room full of people who

are committed to identifying and correcting the problem rather than simply playing

out the same game one more time.clxxix,clxxx

2.

Support groups: These groups are run by people with special training in the area

for people who share a common problem, issue, or goal. It might be a group for adult

children of alcoholics, parents of kids with disabilities, men with career crises, or

whatever. The eczema group in chapter 11 is another example.

Skin support groups are described in the medical literature at least as far back

as the 1940s. They usually focus on support per se and are affiliated with hospital

dermatology departments.

3.

Self-help or mutual help groups: The distinctive characteristics of these groups

may make them just what you are looking for. They are comparable to

neighborhoods or extended families; with no professional leader, their emphasis is

on the exchange of resources and knowledge. Every member must have experienced

the problem personally. (In addition to the group meetings, they may publish

newsletters and informational pamphlets and sponsor hot lines, activities and social

events, or educational seminars.) Alcoholics Anonymous (AA) is the best known of

these groups; some other groups follow its 12-step format. Skin groups do not

pattern themselves on AA.

Typical skin groups have a national organization providing written information,

research sponsorship, and lobbying for governmental support of research. The

mutual help group meetings are run locally. Some local groups also have newsletters,

hot lines, social events, or informational lectures.

I routinely refer people to all three types of groups. Try the following approach:

Research which of the three types of groups are available and affordable in your area.

Psychotherapy and support groups usually charge, but fees may be flexible and there

is a good chance your health insurance will be helpful. Mutual help groups are usually

free, sometimes with modest dues ($20 to $30) to join the national organization.

LEVEL OF COMMITMENT

At one end of the scale, a long-term psychotherapy group might require a three-

month weekly commitment. Most mutual help skin groups meet monthly and have

members coming and going. Support groups might follow either policy or be

somewhere in between. Whether required or not, think about how much time and

energy you are willing to devote. The old cliché may well apply that "you get out of

something what you put into it."

Quality and availability are probably more important than category. It is a rare

person who could not get a real benefit from a first-rate group of any of the three

types. Don't put a lot of energy into the nonexistent group that would be perfect for

you if only it was a real option. Shop and get references and recommendations.

Remember that a group can be a disappointment in some ways but still helpful in

others.

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DO IT YOURSELF

If the right group isn't available, don't become discouraged. If you want a mutual help

group, start your own. The following organizations can provide useful literature on

the subject:

The Massachusetts Cooperative Extension

Robert Helgesen, Director

Boston, Massachusetts

It offers a publication entitled Starting a Mutual Help Group, originally published in

the spring of 1990 by:

The Massachusetts Clearinghouse of Mutual Help Groups

℅ Warren Schumacher, Division of Home Economics

113 Skinner Hall, University of Massachusetts

Amherst, MA 01003

American Self-Help Clearinghouse

Saint-Clares-Riverside Medical Center

25 Pocono Road, Denville, NT 07834 (201) 625-7101

It publishes The SelfHelp Sourcebook: Finding & Forming Mutual Aid SelfHelp Groups,

compiled and edited by Edward J. Madara and Abigail Meese.

If you want a professionally led group the same message still applies. Approach

a professional who you'd like to work with and make a proposal.

Appendix IV contains a listing of various skin support groups nationwide.

clxxix The American Group Psychotherapy Association, International Journal of Group Psychotherapy

(Madison, Wis: International Universities Press). A good general source, this is the official publication of the

American Group Psychotherapy Association.

clxxx I.D. Yalom, The Theory and Practice of Group Psychotherapy (New York: Basic Books, 1970).

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APPENDIX IV

Support and Mutual Help Group Directory

Most groups have a national office to coordinate activities, such as fund raising,

producing educational materials, lobbying for research funding, sponsoring

conferences, and putting out a newsletter.

The local groups usually sponsor the group meetings and may also host social

events and provide informed individuals with the problems who are available to talk

with you.

Since local support group information changes so frequently, I have provided

only the national office addresses and telephone numbers of the various

organizations. You can contact them to obtain a current listing of groups available in

your area.

SUPPORT AND MUTUAL HELP GROUP DIRECTORY

Get the latest information about support and mutual help groups at:

http://grossbart.com/groups.html

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Notes

I. The Story Behind Your Skin

1. Your Skin:

Sensing and Responding to the World Around You

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CONTACT DR.

GROSSBART

I'm available to answer your questions.

You may want help finding a local therapist with

special skills, have reached an impasse, or just

want to let me know how it's going.

In addition to my Boston practice, I work by

telephone with people around the world. Working

together, it is quite likely we can get you the relief you've been hoping for.

Ted A. Grossbart. Ph.D.

Harvard Medical School

Email:

ted@grossbart.com

Web:

http://www.grossbart.com

Phone:

(617) 536-0480

BUY THE BOOK

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paperback from Health Press.

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