Four-step Integrative Model
For Group Psychotherapy
The contemporary form of group psychotherapy in Egypt was first practiced in the late 1960s at Cairo University. It was a great inspiration to its two main conductors/founders; Yehia Rakhawy and Mohamed Shaalan.
The two Egyptian pillars of group psychotherapy worked together for some years until, they started working in two separate and parallel streams that resulted in the foundation of two group-oriented associations: the Evolutionary Psychiatric Association and Work Group, founded by Y. Rakhawy in 1979, and the Egyptian Scientific Society for Group Training, founded by Shaalan in 1987.
Rakhawy followed an “extended evolutionary biomedical model” with an integrative dynamic approach (Shaalan, 1983), which was applied to patients with almost all psychiatric diagnoses in various psychiatric settings, such as governmental and private clinics, day hospitals, and therapeutic milieus. The last is created on the basis of diverse therapeutic group activities.
Shaalan, on the other hand, highlighted the importance of group psychotherapy in the non-patient population. He followed the socially oriented “growth model” believing that group psychotherapy closely mirrors social processes and could serve this end. Shaalan was more inclined to practice psychodrama and gestalt techniques, deal with the group as a whole, and adopt a more permissive leadership style (Shaalan, personal communication, June 30, 2011).
In 1973, Rakhawy, Shaalan and Refaat Mahfouz laid the foundation for the first milieu therapy hospital in Egypt, Dar Al Mokattam for Mental Health. This is a venue that has been providing training, supervision, and practice of group psychotherapy and group activities, including weekly group sessions and activities such as the arts, work therapy, and outdoor journeys, since 1973.
On 1991, Refaat Mahfouz integrated more theoretical and clinical elements to Rakhawy’s Model and developed “The Four-step Integrative Model for Group Psychotherapy” in Minia, Upper Egypt. Focusing on a structured evidence-based practice of group psychotherapy training and research, Mahfouz (2000) initiated a positive wave in Upper Egypt that later on resonated in different areas of the country.
The Four-Step Integrative Model for Group Psychotherapy developed by Mahfouz and his team defines a certain hierarchy for working through clients’ psychological difficulties. The model targets four levels of a person’s psychological functioning, namely: 1. needs, 2. wants, 3. rights, and 4. decisions.
The Four-step Model integrates its basic theoretical constructs from many schools of psychological thought and is imbued with local cultural and social norms, values, and expectations. It has been influenced by interpersonal and psychodynamic group therapy, object relations theory, self-psychology, transactional analysis, gestalt therapy, re-decision therapy, cognitive behavioral therapy, existential psychotherapy, and transpersonal psychology (Mahfouz, Taha, & Ishak, 2015).
More Readings:
Books/Book Chapters:
– Taha, M. and Mahfouz, R (2008). Psychotherapy as a Creative Process: Theoretical and Clinical Perspectives. VDM Verlag: Germany.
– Taha, M. and Mahfouz, R. (2011). The Four Levels Therapeutic Game: A New Approach for Facilitating Therapeutic Change. In: D. Bloom & P. Brownell (Eds.) Continuity and change: Gestalt therapy now. Cambridge Scholars Publishing: Newcastle, England.
– Mahfouz, R., Taha, M. and Ishak, W.W. (2015). The Four-step Integrative Model for Group Psychotherapy: Description, Development, and Application in Egyptian Culture. In H. Derrickson (Ed.), Group Therapy: Theory, Practices and Effectiveness (first edition, pp 1-18). New York: Nova Publishers.
Journal Articles:
– Taha, M., Mahfouz, R. and Arafa, M. (2008). Socio-Cultural Influence on Group Therapy Leadership Style. Group Analysis, 41(4): 391-406. SAGE: London.
– Mahfouz, R. and Taha, M. (2010). Is Psychotherapy as Creative Process: Applying the models of creativity on the process of psychotherapy. European Psychiatry: 25 (supplement 1): 1066.
– Taha, M., Abd-El-Hameed, M.A., Kamal, A., Hasan, M.A. and Mahfouz, R. (2010). Power of Love and Love of Power in Group Psychotherapy. Group Analysis, 43(2): 155-169. SAGE: London.
– Hinshelwood, B. (2010). Comment on “Power of Love and Love of Power in Group Psychotherapy” by Mohammed Taha et. al. Group Analysis, 43(2): 181-184. SAGE: London.
– Pines, M. (2010). Comment on Taha et al.’s ‘Power of Love and Love of Power’. Group Analysis, 43(2): 190-191. SAGE: London.
– Verhagen, P. (2012). Waar is de ‘vader’? Groepen, (2): 52-63. NVGP: Utrecht.
– Rakhawy, M., Taha. M and Sabry N. (2015). Group psychotherapy in Egypt: Past, present and future. International Journal of Group Psychotherapy, 65(4), 595–605.