Influence of the value-system of a psychiatric setting on behavior in group therapy meetings

A theoretical model is presented to depict the complex interrelations of some of the elements of the therapeutic process as it occurs in the setting studied, and experiments are suggested to test the model's heuristic value.

Abstract

This paper considers the influence of the overall value-system of an inpatient psychiatric setting on the behavior of patients in group psychotherapy. The treatment goals of the setting stress the return of the patient to the community with reduction of symptomatology and the restoration of ability to function in the family, with peers, and at work. Group therapy is one of the major treatment modalities employed. Using variables reflecting behavior along a number of different dimensions, comparisons were made of three types of group meetings (therapist-led, unled and multiple family) and of the meetings led by three different psychotherapists. The results indicated that there were significant differences between the three types of meetings and between the meetings of the three different therapists. In all types of meetings, and for all groups of patients, high levels were found for variables reflecting the overall value-system of the setting, especially in relation to its stress on openness and responsibility. The data collected from the individual group therapy meetings also reflected other dimensions of the service's value-system, such as the staff's interest in patients being critical of each other, and at times of the staff. Even the emotional tone that the staff presented was reflected in group meetings conducted by the patients without any staff present. The authors present a theoretical model to depict the complex interrelations of some of the elements of the therapeutic process as it occurs in the setting studied; experiments are suggested to test the model's heuristic value.