The role of didactic group psychotherapy in short-term psychiatric settings

Abstract

In recent years, new approaches to inpatient and milieu treatment have posed a problem for group therapists. Many inpatient units now follow a crisis intervention model, where patients remain on the ward for brief periods of time, often less than a month. For much of this time, the patients are acutely psychotic. Once their overt symptoms clear, they are discharged for outpatient treatment. The problem facing the group therapist working in such a setting is to define a role for group therapy where (a) potential patients are acutely psychotic, and (b) those patients are usually available for only a brief period of time, and (c) group membership keeps changing. In this paper, it is proposed that didactic group pyschotherapy in which patients are taught concepts pertaining to psychological functioning can be useful in such a short-term treatment setting. Those who lead groups with psychotic patients (Day & Semrad, 1971; Ogara, 1959; Standish & Semrad, 1963) have stressed that group therapy involves a process through which various issues are discussed in the context of a relationship with a therapist and a group that extends over time. This approach to group therapy has difficulties when used in a short-term program. First, the psychiatric state of the patient may be such that he is not ready for the intimacy, confrontation, and direct personal relationships that develop in group therapy. Stotsky and Zolik (1965) state that acutely psychotic, paranoid, and chronic schizophrenic patients cannot be treated in group psychotherapy. However, these are just the patients most often seen on short-term wards and in day treatment programs. Second, the time necessary for the group process to unfold is most often not