In the healthy people group

22/07/2019

(adapted version of an article published in PostSkriptum, publication of the St. Gallic Psychiatry Services South, No. 1 / May 2018)

The English psychiatrist of German descent SH Foulkes was one of the founders of the group analysis therapy method. The evening after his first meeting with patients in the waiting room at his Exeter practice in 1940, he told his wife, "Today was a historic moment for psychiatry, but nobody knows about it".

Since then, the situation has changed completely, as the effectiveness of group psychotherapy has been repeatedly proven by numerous studies. For many mental disorders, group treatment even proves superior than individual therapy. Unfortunately, these results are only occasionally included in the current treatment guidelines, and group therapy remains often considered to be subordinate to individual therapy.

The effectiveness of a therapy group depends primarily on general factors such as the inducement of hope, the possibility of emotional communication in a safe atmosphere, as well as the experience of mutual interaction and learning. These positive factors are known to us all from our own non-therapeutic group experiences (in the family and in the circle of friends, at the workplace, from associative life). In addition, Foulkes speaks of the so-called "ego training in action", i.e. a continuous interaction with repair effect among group participants.

In terms of composition, a group may be open, semi-open or closed. In principle, closed groups are homogeneous, limited in time, and seek well-defined goals. The more open a group, the more it develops into a long-term project, where dealing with boundaries and differences plays an important therapeutic role. The Norwegian psychiatry professor and group therapist Steinar Lorentzen speaks of a supportive-activating dimension of group interventions, which combines supportive, relieving and educational elements with expressive, instructive and revealing ones.

By entering a therapy group, patients often gain first positive experiences and reduce fears related to therapy. As a rule, the group leader holds a preparatory discussion before the group starts. Outpatient psychotherapy groups usually happen on a weekly basis, ideally with seven to nine participants, and for up to 90 minutes.