Lived experiences of psychiatric patients with mood disorders who attended group therapy facilitated by professional psychiatric nurses

Abstract

Background: According to the World Health Organization (WHO), up to 25% of people worldwide will develop mental health disorders during their lifetime. Patients admitted to acute inpatient units for mood disorders experience emotional distress. Group therapy has the potential to foster the therapeutic change through specific therapeutic mechanisms. Psychiatric nurses working in inpatient units are in a unique position to offer group therapy.Objectives: Explore and describe stabilised acute psychiatric patients with mood disorders’ lived experiences of group therapy facilitated by psychiatric nurses. Make specific recommendations for psychiatric nurses to facilitate constructive group therapy for stabilised acute psychiatric patients with mood disorders in an inpatient unit.Method: A qualitative, exploratory, descriptive and contextual design was used in the study. A purposive sample of all patients with mood disorders older than 18 years admitted to inpatient units who participated in group therapy was made. Data were collected through conducting phenomenological interviews, observation and field notes. Interviews focussed on the following open question: ‘How did you experience group therapy facilitated by the psychiatric nurses?’ An independent coder analysed the data by using thematic coding. Measures to ensure trustworthiness were applied. The following four ethical principles were adhered to: autonomy, non-maleficence, beneficence and justice.Results: Three themes emerged from this study. Theme 1 entailed the psychological experiences of patients attending group therapy. Theme 2 highlighted the interpersonal experiences of patients. Theme 3 evolved around patients’ experiences outside group therapy. Patients initially experienced attending group therapy as anxiety provoking. However, negative psychological experiences soon transformed into positive psychological experiences.Conclusion: The findings of this study were used to make specific recommendations to facilitate constructive group therapy for patients with mood disorders.

Patient perspectives on psychological interventions provided in adult psychiatric inpatient wards: A thematic synthesis

“…The total number of participants across the studies was at least 192, as one study was unable to provide the exact number of individual participants (Pownell et al, 2023). Four studies comprising 36 participants (Chen et al, 2018;Messari & Hallam, 2003;Small et al, 2018;Visagie et al, 2020) reported ethnicity as follows: Chinese (n = 15), White British (n = 8), African (n = 4), Asian British (n = 2), Mixed descent (n = 2), White (n = 2), African-Caribbean (n = 1), Black African (n = 1) and White Irish (n = 1). In the remaining studies, ethnicity was either not reported (n = 8), reported as 'multiple ethnicities' (n = 1) or was unable to be determined as the ethnicity of participants who had completed qualitative feedback was not distinguished from participants who either did not complete treatment (n = 3) or were staff participants (n = 1).…”

“…'Sometimes the class was in a little bit of chaos and I felt irritable towards the group members who were speaking loudly and dominating the group' (Chen et al, 2018) '[Ask facilitators to] silence annoying patients who disrupt the group, they ruin the whole emphasis of the message that the psychologist is trying to get across' (Pownell et al, 2023) Groups did not always feel safe for some participants (Fife et al, 2019), and speaking about difficult experiences in front of others could be anxiety-provoking (Visagie et al, 2020). Some participants commented on groups feeling uncomfortable when peers did not contribute (Harris et al, 2021;Radcliffe & Bird, 2016) or were explicitly disrespectful, for example, laughing inappropriately (Chen et al, 2018).…”

“…Participants in the two studies also spoke about feeling disrespected or patronised by facilitators of the intervention (Messari & Hallam, 2003;Visagie et al, 2020).…”

“…were rude sometimes when asking them for help or telling them I'm not feeling well. I was afraid of telling them"' (Visagie et al, 2020) 'Some commented that they found the delivery of the sessions to be a challenge: "Please respect that it may come over patronising"' (Pownell et al, 2023)…”

“…'I came in rather stressed but by the end of the session and listening to people's experiences I feel a lot more positive' (Pownell et al, 2023) 'There was a feeling of peacefulness in the room' (York, 2007) 'The majority of participants reported that the program reduced their feelings of embarrassment, shame, and confusion regarding their illness' (Chen et al, 2018) Emotional shifts were not always experienced as positive for participants and focussing sometimes led to unpleasant emotions such as anxiety (Owen et al, 2015;Visagie et al, 2020) or fear (Sharma et al, 2022). For others, the idea of moving on beyond the psychological support and the ward environment was anxiety-provoking.…”