Group therapy in public mental health services: approaches, patients and group therapists

Abstract

Group therapy is used extensively within public mental health services, but more detailed knowledge is needed. All 25 health authorities in Norway were invited to describe their groups: theory, primary tasks, interventions, structure, patients and therapists. Four hundred twenty-six groups, 296 in community mental health centres and 130 in hospitals, were categorized into nine types, based on theoretical background. Psychodynamic groups were most frequent, followed by cognitive-behavioural, psycho-educative, social skills/coping and art/expressive groups. Weekly sessions of 90 min and treatment duration <6 or >12 months was most frequent. Main diagnosis for 2391 patients: depression (517), personality disorder (396), schizophrenia/psychosis (313) and social phobia (249). Patients with depression or personality disorder were mostly in psychodynamic groups, psychosis/bipolar disorder in psycho-educative groups. Cognitive-behavioural groups were used across several diagnoses. Most therapists were nurses, only 50% had a formal training in group therapy. There is a plethora of groups, some based on one theoretical school, while others integrate theory from several 'camps'. Patients with similar diagnosis were offered different group approaches, although some trends existed. More research evidence from regular clinical groups is needed, and clinician-researcher networks should be developed. More group therapists with formal training are needed.

Existential group practice run by mental healthcare chaplains in Norway: a nationwide cross-sectional study

“…This resonates well with what Ward (2006) underlines as the reality of group work in general. This is also in line with clinical Norwegian group psychotherapy as reported by Lorentzen and Ruud (2014) and with existential therapy tradition as reported by Vos et al (2015). The various group approaches identified in this study share aims and scopes with ordinary group psychotherapy and they are mainly anchored in existential and psychodynamic theory.…”

“…The thematic existential group approach did not seem to have applied a specific theoretical perspective, as was also the case for the thematic groups in general group psychotherapy in Norway (Lorentzen & Ruud, 2014). Concerning scope, existential issues such as identity, human values, shame and guilt were addressed, applying an open, reflective and dialogic "here and now" therapeutic strategy.…”

“…A Norwegian cross-sectional study by Lorentzen and Ruud (2014) exploring the Norwegian clinical field of general group psychotherapy identified nine categories of group psychotherapy: theme oriented, physical activity, psycho-educative, cognitive behavioural, psychodynamic, body consciousness, art/expressive, social skills/communication/coping and eclectic groups most frequently applying a psychodynamic approach. The general core aims and coverage of these approaches seems to be improving interpersonal relationships, reducing symptomatic distress and increasing self-knowledge.…”

“…A web-based questionnaire (Questback) inspired by Lorentzen and Ruud (2014) was developed and customized for each participant group. The questionnaire was developed and outlined as scales with different response alternatives.…”

Routine outcome measures in Norway: Only partly implemented

“…In a survey of group therapy in mental health services for adults (Lorentzen & Ruud, 2014), more than half of the 426 groups reporting data used a questionnaire as an outcome measure, and one in six used rating scales as outcome measures.…”