Self-Esteem Research, Theory, and Practice Toward a Positive ...

A Two-Factor Self-Esteem Enhancement Program 189treatment issues are likely to crop up more frequently with this population.Combining non-clinical and clinical populations into one group isnot recommended, because the latter population often moves at a muchslower pace than the former. In either case, I have had the most successwith groups by having a male and female working as co-therapists, butthis practice is not necessary in order for the program to work. My cotherapistshave been social workers, counselors, and substance abuse specialists,so the program is designed for interdisciplinary use.The other general parameters of the program are as follows: First, itsbasic structure consists of a series of at least five meetings, each of whichis about 2 hours long. This length of time for sessions is within recommendedlimits for group psychotherapy (Vinogradov & Yalom, 1989).Such a period is long enough to allow people to warm up to the sessioncomfortably, engage in some real encounter or dialogue, and also allowssome “working through” to occur. Each session is divided into approximatelytwo 1-hour blocks with a short break between them, if necessary.I have neither run the group with people under 16-years-old, nor have Irun it with clients who have less than average intelligence. It may be thatsuch populations would do better with shorter and more frequent sessions,as Pope, McHale, and Craighead (1988) and Shrik and Harter(1999) found with their programs for children and adolescents. Second,the standard number of 2-hour sessions is five. They should be spreadevenly over time, such as by meeting once per week.How long a program should be is always an important question.The 5-week period seems to be optimal in terms of making a compromisebetween having enough time to work on self-esteem in a way that allowsfor some change to occur and for maximizing attendance in an outpatientor educational setting. On one hand, we know that changing self-esteemtakes consistent time and effort. On the other hand, the simple fact isthat most adults have busy lives and going beyond a limited number ofsessions is likely to create problems with attendance, which wouldimpede the group processes and diminish results. I present the programas a 5-week approach but often offer the possibility of a sixth session asa follow-up meeting. It is important to realize that although the programseems short in terms of time or length, its 10-hour treatment requirementis well within the short-term therapy format. More importantly, althoughthe program has been shown to result in measurable change during thistime period, the real aim is to teach people a set of skills that allows themto work on self-esteem well after the program stops, perhaps for a lifetime.However, people can go through the program more than once ifthey have such a need or interest. Thus, the criticism that the approach is“too short to help” reflects a basic misunderstanding of the program andneeds to be reconsidered in this light.