Élaboration méthodologique dans la conception d’un dispositif thérapeutique de groupe en institution

Abstract

ObjectivesThis article highlights how the creation of a group psychotherapeutic setting in an institution constitutes a subject of elaboration before the clinical experience itself. Our hypothesis is that the psychotherapeutic dimension and the dynamic power of a group are determined by the conception that clinicians have of their setting. MethodUsing the examples of several clinical situations (in an institutional setting) that we either created or inherited, we have distinguished different fields or objects of analysis. These objects are in mutual interface and make the therapeutic project a creation of the clinician. ResultsDifferent relationships can thus constitute internal obstacles to the creation and implementation of different types of therapy. We will distinguish: – the relationship of clinicians to their team and to their institution; – the relationship of the therapeutic project to the institutional framework; – the relationship of the therapeutic project to the different groups to which clinicians belong; – that of clinicians to their customary field of practice. DiscussionThe examples proposed here show how, according to the conditions of specific arrangements between clinicians, their professional affiliations, their team and the institutional situation, different points may appear as elements of suffering, confusion, or conflicts to be elaborated, discriminated, or resolved. ConclusionThe elements that make up the clinician's conception of their therapeutic initiative do not necessarily need to be explored before the project's implementation but potentially constitute objects of elaboration that might appear before or in the early stages of the clinical experience.