Cultic Studies Journal, Vol. 9, No. 2, 1992, Page 6
than is characteristic among individual therapy clients. Outside contacts between group
members that provide emotional and practical support can be very beneficial. They can also
lead to coalitions, subgrouping, and romances that confound the privacy and central
emphases of therapeutic involvement (Lakin, 1986). Therapists sometimes have clients in
both individual and group therapy at the same time, raising questions of which information
disclosed in each setting will be used in the other.
In the groups under study, by contrast, relationships with multiple dimensions are not only
tolerated but sanctioned and pursued. The group is viewed as a new family, providing for all
the clients‟ social and personal needs (Boland, 1989 Hart, 1972 Singer, 1979 Span, 1988
Temerlin &Temerlin, 1986). This intensified involvement is often perpetuated by ensuring
that when clients finish therapy or “graduate,” they are promoted into staff or therapist
positions within the group (Conason &McGarrahan, 1986 Hassan, 1988 Mithers, 1988). In
some groups, therapists and staff are not excluded from the requirement that they continue
to receive therapy (Ayella, 1985 Boland, 1989 Conason &McGarrahan, 1986 Hennican,
1988).
In these environments, therapists take on numerous roles in their clients‟ lives including
employer, business partner, financial advisor, spiritual leader, and lover (Temerlin &Temerlin,
1982, 1986). In particular, sexual involvement of the therapist with clients can create an
incestuous dynamic in which the client feels a need to protect the therapist from exposure or
scrutiny (Pope &Bouhoutsos, 1986 Schoener, Milgrom, Gonsiorek, Luepler, &Conroe, 1990
Temerlin &Temerlin, 1986). This intensifies the role reversal where the therapist is now
depending on the client to meet personal needs.
In these groups, clients are typically encouraged to take on a new identity (Ayella, 1985
Hochman, 1984 Temerlin &Temerlin, 1982). Ayella (1985) describes the emphasis in one
group on open expression of feelings that became taxing and disruptive of members‟ outside
relationships. This commonly leads to what Bainbridge (1978) described as a transition to a
“culture of narcissism” and a concomitant alienation from previous relationships. This collapse
of the client‟s social network and outside relationships is facilitated indirectly by the intensity
of the new relationships and the new standards clients are encouraged to impose on
themselves and on all of their relationships.
Other authors have written of the ways that clients in these groups are encouraged to end
other relationships (Boland, 1989 Conason &McGarrahan, 1986 Hochman, 1984 Ofshe,
1976). Several observers reported the imposition of periods of time in which clients have
been prevented from communicating with outsiders (Ayella, 1985 Hochman, 1984 Mithers,
1988 Temerlin &Temerlin, 1986). This is different from therapeutic encouragement to
terminate dysfunctional relationships because the only criterion that is utilized to determine
who is or is not acceptable is whether they are or are not members of the group. This
enmeshed quality in relationships within the group readily leads to social isolation, which
potentiates the development of internal relationships characterized as “psychological incest”
(Temerlin &Temerlin, 1986) and “group think” (Janis, 1982).
Informed Consent
Therapists are now expected to provide prospective clients with accurate information about
the goals, content, procedures, and risks of therapy so they can decide freely whether to
become involved (APA, 1989 ASGW, 1983 NASW, 1990). Barriers that can impair the clarity
and freedom of this judgment include the urgency clients normally feel to get on with doing
something about their problems (Lakin, 1986) and the prevalence of psychotherapy jargon
that clients do not understand (Temerlin &Temerlin, 1986). Careless or unethical group
therapists can violate this standard by failing to provide adequate information and unbiased
opportunities for clients to ask questions and weigh their alternatives. They can continue the

Cultic Studies Journal, Vol. 9, No. 2, 1992, Page 7
violation by treating initial consent to involvement as consent to all future events and
activities in the group and by pressuring members to participate in these regardless of their
reservations (Corey, Corey, Callahan, &Russell, 1982).
In the groups under study here these violations are often taken to extremes. Clients are lured
by false advertising offering low-cost treatment or quick cures (Ayella, 1985 Bainbridge,
1978 Boland, 1989 Mithers, 1988). Clients use social contacts to recruit new members into
the group (Hochman, 1984 Ofshe, 1976). The goals of having new members commit to “the
work” of long-term intensive therapy and even lifelong involvement are hidden (Ayella, 1985
Boland, 1989 Hochman, 1984 Ofshe, 1976). Risks and liabilities of participation are not
discussed at all. Group pressure is used with increasing directness to overcome any
reluctance to submit to the therapy process, its ideology, and the group‟s standards of
conduct (Hochman, 1984). Threats of retaliation or physical violence to members who
threaten to leave have been reported in some cases (Anson, 1978 Mithers, 1988 Ofshe,
1976 Span, 1988).
Competency
Mental health professionals are responsible under their codes of ethics to be cognizant of the
limitations of their individual competence and of the therapeutic techniques they employ
(APA, 1989 ASGW, 1983 NASW, 1990). Common violations of these assumptions involve
accepting clients for which one is not prepared, using techniques in which one is not
proficient, and not recognizing the extent to which some clients will benefit from a particular
approach while others may not. In discussing the formation of groups, Yalom (1985)
acknowledges the reality that the difficulty of finding enough participants often overrides
considerations of appropriate fit. Safeguards intended to limit potential harm to clients in such
situations include pregroup screening interviews, informed consent to the purposes and
procedures of the group, therapist protection of clients from excessive group pressures, and
protection of the freedom of the client to exit from the group at any time (Lakin, 1986).
Groups under study here are described as taking very different approaches to these
questions. Accounts of their recruitment practices imply that they commonly take all comers.
Their conduct suggests that they believe that their brand of treatment can be practiced
without consideration of the individual characteristics and needs of clients. They appear to
believe that the treatment itself is so powerful that any limitations are ignored (Ayella, 1985
Kottler, 1982). The therapy is standardized and applied to all clients, who are expected to fit
into a very restrictive treatment framework (Ayella, 1985 Boland, 1989). Clients are
encouraged to blame themselves for lack of progress. Such failure is cited as proof of the
need for further therapy (Temerlin &Temerlin, 1986). This uniformity is reinforced by the
reported common practice of promoting clients to positions as staff members or therapists
based on their work in therapy (Boland, 1989 Ofshe, 1976), often without regard for their
educational or professional qualifications (Ayella, 1985 Black, 1975 Conason &McGarrahan,
1986 Mithers, 1988).
In the context of this belief in the efficacy of the leaders and their approach to therapy, Ayella
(1985) and Rubins (1974) have both noted a high degree of inconsistency and
unpredictability in the interpretations cult leaders make about what is therapeutic or healthy.
This unpredictability is combined with an “absolutist attitude” about what is right and wrong
(Rubins, 1974). The effect of these shifting interpretations is to require clients to attend
closely, to induce confusion, and to intensify the tendency to blame the unsuccessful patient
(Temerlin &Temerlin, 1986).
Dependency and Autonomy
Fundamental to the protections of client welfare are the protection of freedom of choice and