MatissePsicoterapiadiGruppo

Introduction, Group Psychoterapy with Psychotic and Borderline Patiens

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I am honoured to present the fourth number of Funzione Gamma Journal edited by my Italian colleagues and me, about “group psychotherapy with psychotic and borderline patients “. The Funzione Gamma Journal has met with remarkable success, presenting papers coming mostly from a European tradition; with this number we establish a profitable, communicative connection with North America.

I hope that readers will find the same stimuli and interests that we felt in writing the papers contained in this issue.

Howard D. Kibel, M. D.

The papers enclosed in this number of the Funzione Gamma Journal reflect the increasing need for an exchange of clinical and theoretical experiences coming from different contexts in such a way as to permit the amplification of the cognitive instruments used in group psychotherapy. The authors illustrate, with their contributions, the practical and theoretical planning used in their clinical experience of group psychotherapy. The North American authors present models that can be linked to the institutional context and with the general problem of patient care. They have been able to elaborate models of group treatment, working in different contexts, considering how the planning of each treatment model adopted is connected to events that also happen in other levels inside a major extended treatment Read more

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The difficult patient in group: blendig the mayor psychoanalitic prespectives

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Abstract

As Horwitz (1977) noted, “Paradoxically, the very qualities and deficits that make the …patient a problematic group member are the same deficits that are often best treated in a group setting” (p.404). This is because group psychotherapy is the medium nonpareil for highlighting and ameliorating the associated relationship conflicts that these difficult patients have. It has long been known that patients with chaotic, amorphous, and fragile egos are suited to group treatment because of the diminished intensity of transference compared to individual treatment and the opportunity for patients to self-titrate the intensity of their involvement (Freedman, Sweet, 1954). The group has a social reality of its own which counteracts these patients propensity to regress. Members can be quite supportive to one another. Read more

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The use of medication groups for the treatment of patients with mayor mental illnesses

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Abstract

Medication group sessions may provide both an efficient use of time and effective treatment for chronically and severely ill patients. Such sessions may help patients avoid episodes of decompensation and enhance patient compliance with medication treatment. The group process can offer patients education, mutual support, practice in socialization, and a decrease in feelings of isolation. In medication group sessions, the therapist must focus on the use of medications as the primary goal of treatment. Patients can be mutually supportive and helpful to one another in medication compliance. A shift in group focus away from the use of medications into psychodynamic issues may be a resistance to treatment. The main purpose of the group is to enhance patients’ compliance with medication Read more

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A model of group psychoterapy for persons with cronic mental illness

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Abstract

Significant advances in the pharmacotherapy of many major psychiatric syndromes occurred in the final decade of the last millennium. However, medications neither proved to be an ultimate cure nor did they eliminate the human suffering attendant with these illnesses. As a consequence, a great number of individuals remain significantly impaired by their illness. Persons with severe and persistent mental illness generally experience their impairments in terms of ordinary living – their quality of life. From an “objective” perspective they experience deficits in financial necessities, housing, transportation, medical and psychiatric care. From a “subjective” perspective they have diminished quality and quantity of social relations and recreational activities. Group psychotherapy, focusing on problems of daily Read more

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Day treatment programs for personality disorders: a review

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Abstract

This paper is a modification of a chapter that will appear in the forthcoming volume: “Handbook of Personality Disorders: theory, research, and treatment,” edited by W. John Livesley, PhD, MD, FRCP, published by Guildford Publications: New York, release date April 2001. The original chapter will be entitled “Partial Hospital Programs.” It suggests that more partial hospitalization programs dedicated to the personality-disordered patients should become available and that more rigorous studies need to be conducted in the future, considering the main difficulties with the treatment in the day hospital, the therapeutic program to organize, the relations with the Read more

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Medication-support Groups: are they “Group Therapy”?

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Abstract

Medications and group therapy are important parts of most treatment plans but are rarely provided simultaneously. This article reviews combining these powerful modalities in medication-support groups (MSGs). Co-therapy is often necessary to lead MSGs because they require skill in group therapy and medication prescribing. Successful MSGs further group-based clinic culture. Read more

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Model-scene and Group positions in a group of young chronic psychotic patiens

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Abstract

The authors show the utility of using two important concepts together – the Position Sequence and the Model Scene – in group therapy for young psychotics in a residential institution. [Model scenes are phase-specific metaphors; they persist over time and are referred to repeatedly by the group members]. A transition is observed from an initial position of non-differentiation, to a stage of partial recognition of differences among patients. In this second stage – called “self-reflectiveness position”- the patients begin to ask for appreciation and visibility, and manifest a greater awareness of themselves; this process is necessary to the individual’s development, but very dangerous for the unity of the group. The authors believe that the Model Scene takes on different features and functions, depending on Read more

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The elaboration of depression in the group

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Abstract

The experience of loss, in time, repeats itself in many ways in the analytical group. It seems that depressive emotions in the group are on one hand avoided and on the other slowly built, just until they can be lived and worked-trough. In a group when the depressive position emerges from an orderly leave-taking, or from a collective burial rite it can deeply transform the mental and Read more