Therapeutic Factors in Patient Groups with Psychosis

Abstract

Therapeutic factors in group therapy are a series of action mechanisms that contribute to change in therapeutic processes. They are inherent to group dynamics and interaction, yet are not necessarily associated with a therapist’s intervention. These factors are elemental components of a therapeutic change phenomenon derived from the group matrix. We present five studies that thoroughly evaluate these therapy factors within groups of patients diagnosed with psychosis. All factors are measured with the Yalom Q-sort questionnaire that defines factors based on their value given by the patients. We evaluate and report these value differences between group context, patient diagnosis, and therapeutic orientation. Therapeutic factors act independently of diagnoses, theoretical framework, and classification; they are intrinsic components of unique group dynamics. In general, the factor claimed to be most important in patients with severe mental disorders was the instillation of hope.

Are Group Psychotherapeutic Treatments Effective for Patients with Schizophrenia? A Systematic Review and Meta-Analysis

“…As argued by Kanas [66], ‘the group experience itself' (p. 10) appears to be clinically useful for this population who are often isolated and relate poorly with others. Given the effectiveness of group psychotherapeutic treatments across different therapeutic orientations as compared to TAU and the absence of a significant effect as compared to active sham groups, the findings are are consistent with the hypothesis that beneficial group mechanisms are non-specific [20,26]. In support of the ‘contextual' model of psychotherapy of Wampold [23], these findings support the view that the benefit of group therapeutic mechanisms is due to common factors.…”

“…This supports the idea that the benefit of group psychotherapeutic treatments, in terms of negative symptoms at least, is independent of a particular therapeutic approach [20]. Furthermore, there was no evidence to suggest that the degree of ‘diagnostic homogeneity' moderated the effect of group psychotherapeutic treatments on negative symptoms.…”

“…The inclusion of non-verbal therapies and more precise statistical techniques may account for this difference. Furthermore, results from this review are not consistent with the notion that group processes can be effective in aiding the restructuring of false beliefs around delusions or hallucinations [15,71] in the treatment of positive symptoms [20,23,26]. As suggested by Wykes et al [7], it might be difficult for therapists to flexibly respond to a wide variety of individual therapeutic needs when addressing positive symptoms in groups.…”

“…Despite the potential cost benefits and clinical advantages of a group setting, little methodologically robust research has explored whether group psychotherapeutic treatments have a benefit for people with schizophrenia [20,21,22] and whether they are effective across specific therapeutic orientations [23]. At present, too few studies are available to test the effectiveness of group treatments as compared to individual treatments for each psychotherapeutic treatment of schizophrenia [22].…”

From feelings of imprisonment to group cohesion: A qualitative analysis of group analytic psychotherapy with dual diagnosed patients admitted to an acute inpatient psychiatric unit

“…Among these; establishment of hope, altruism, universality, expression of feelings and group cohesion, might appear as elements to be explored in inpatient settings (MacKenzie, 1987). The establishment of hope is not only the most commonly observed factor (González de Chávez, Gutierrez, Ducaju, & Fraile, 2000), but it is also considered critical in the recovery of patients, and at the same time, a key element for group adherence, a necessary condition for the achievement of further objectives (García-Cabeza, Ducaju, Chapela,& González de Chávez, 2011).…”