Therapeutic change is an enormously complex process and it occurs through an intricate interplay of various guided human expiriences which Yalom called therapeutics factors.Natural lines of elevage divide the therapeutic expirience into eleven primary factors:instillation of hope, universality, inparting of information, altruism, the correective recapitulation of the primary family group, imitative behavior, interpersonal lerning, group cohesiviness, catharsis and existencial factors.

Members of inpatient groups select a wide range of therapeutic factors reflecting heterogeneous composition of groups, and differ from one another in ego strength, motivation, goals, type and severity of psychopatology.In the early stages of development, the group is concerned with survival, estabilishing boundaries and maintaining membership.In this phase, factors as instillation of hope, guidance and universality seem especially important.Factors such as altruism and group cohesiviness operate through therapy.Early in therapy, altruism takes the form of offering suggestion or helping one another. Later, it may take the form of more profound earing and "being"with.Group cohesiviness operates as a therapeutic factor at first by means of group support, acceptance and the facilitation of attendance and later by means of the interrelation of group esteem.