Chronic Ward Inpatients' Experience of Group Therapy

Background: Treatment of people with chronic mental illness is focused more on medical and psychiatric care than psychotherapy. Although little has been researched of inpatient group psychotherapy, former studies (Gonzalez de Chavez, Gutierrez, Ducajú, & Fraile, 2000; Swarbrik, Roe, Yudof, & Zisman, 2009) show that group psychotherapy can provide emotional support to people with chronic mental illness and assist them with understanding and removing obstacles to establish fulfilling social attachments. The existing research deals mostly with acute wards, and only little of it addresses the experience of the patients themselves.  

Research goals: The study examines the experience of the participants in group psychotherapy in one of the chronic wards in one of psychiatric hospitals in Israel. The experience of the participants is examined using analysis and interpretation of the experience of the link with others in the groups’ therapeutic space: The other participants, the conductor and the group as a whole. The research is attempting to understand the experience of the therapy in relation to the unique context of its occurrence: A chronic ward in a psychiatric hospital.

Methods: Since the research question deals with the experience of participants in group psychotherapy in the context of psychiatric hospitalization, a phenomenological constructivist method of research is suited to a research of this sort. Yet, inlight of the fact that people with Schiziphrenia are having difficulties of expressing fellings and needs in a direcy manner, arised a necessity to add an interpretive dimention to the analysis. The combination of the approaches provides a profound understanding of the phenomena, including essential reference to the point of view of the patients themselves of the group psychotherapy in accordance with the verbal content of the group sessions.  

17 sessions were recorded and verbalized; transcripts were analyzed based on single statement units, and on a group interaction process level.

Analyzed statements address the interaction with other members of the group, the conductor of the group and the group as a whole. Interpretation of the group text was made using psychodynamic approaches, mainly of Object Relations theory.       

Results: The participants' experience is displayed in three levels: experience with the other members, with the group conductor, and with the group as a whole. During the first sessions, group communication was mainly conducted via the conductor. As the sessions progressed, direct interaction were formed among the members, who also started sharing powerful emotions. Feelings of anger and frustration were starting to manifest in interactions with the conductor, maily in an indirect fashion. The group still turned to the conductor for help in various issues, but these requests became rarer and different by nature. The therapeutic setting has been formed, and members state that the group has become meaningfull for them. It seems that the group therapy has provided the members a feeling of visibility and capability, and allowed them to establish interpersonal relationships within the group therapeutic space.

Contribution: The research sheds light on the place of group therapy of people with severe chronic mental illness and offers therapeutic emphases to their treatment. The research does so while analyzing and interpreting group sessions. The contribution of the research grows in light of the recent changes in the field of mental health: it presents a useful and economical rehabilitation alternative for long-term inhabitants of psychiatric hospitals.