A model of time-effective group psychotherapy for patients with personality disorders: the clinical model

Interpersonal problems of persons with personality disorders and group outcomes

This article examines the interpersonal problems of 42 persons referred for brief group treatment at a community mental health center. Measures of symptom severity, self-esteem, and interpersonal problems were administered pre- and posttreatment. Study participants' scores were analyzed to determine possible differences in the interpersonal problems experienced by those diagnosed with personality disorders and those without them. Results revealed that both groups improved significantly on the overall measure of symptom severity. Findings further revealed that self-esteem improved significantly more for those diagnosed with personality disorders. Analysis of interpersonal problems scores revealed differences between the two groups in the areas of support and involvement prior to treatment, but not after. Possible explanations for these differences and implications for treatment are discussed.

The team meeting on a rapid turnover psychiatric ward: clinical illustration of a model for stages of group development

This article illustrates stages of group development in a semi-structured team meeting of staff and patients in an inpatient psychiatric unit. Clinical material drawn from such a group at the Massachusetts Mental Health Center is presented in support of the view that, even in a rapid-turnover ward, group process in a mixed-level, mixed-diagnosis "ward meeting" follows some predictable lines and responds to the articulation of certain predictable concerns. Garland's (1981) model of group development is adapted to show the cyclical nature of group process in a teaching hospital, where doctors as well as patients may make only brief stays. Effective leadership strategies are suggested.

The advanced-stage therapy group

Many authors describe a stage of maturity in the development of groups, but each highlights a different dimension. This article describes the characteristics of the advanced stage and the main axes along which it develops (internalization and containment, symbolization, self and self-other development, differentiation and individuation). It also offers a conceptual explanation for these developments and attempts to identify the conditions necessary for the emergence of this stage of maturity. An understanding of this stage and the conditions required for its development can be used by the group leader as a compass to help him or her navigate the group toward this objective.

Group psychotherapy and managed behavioral health care: current trends and future challenges

The rising cost of health care within the private and public sectors has created an increased demand for the management of benefit dollars. This trend has significant implications for group psychotherapists, as group modalities offer cost-effective ways of delivering services to traditional outpatient and inpatient populations. Continued cost-containment pressures and increasing attention to outcome studies will fuel trends toward briefer, manualized group treatments and intensive group outpatient programs as alternatives to hospitalization. Quality-based demands will challenge payors to (a) address biases against group psychotherapy among providers and patients and (b) integrate recent process-and-outcome research in determining the appropriateness of group versus individual modalities for particular patients and presenting problems.