Threat to psychotherapy services run from Guy's and St. Thomas's Hospitals

Description of and rationale for the Group Psychotherapy Service

This offers once weekly psychodynamic group analytic therapy. There are ten groups running at this time with up to eighty patients participating. Most groups are time limited for a minimum of two years. The groups are facilitated by qualified therapists or by trainees in groupwork who are supervised weekly in the Unit in addition to their supervision within their training organisation.

In each group up to eight patients are treated together. The basic techniques of individual psychodynamic psychotherapy are used but the groups provide some additional therapeutic factors. First, individuals lend group support to one another, thus helping members through difficult periods in treatment or in their lives outside. Second, each patient has the opportunity of learning from others, for example how others in the group have dealt with or overcome problems similar to his or her own. Third, patients can test ideas against the opinions or experiences of others. Fourth, they can practise new forms of personal and social behaviour. Irving Yalom has listed ten curative therapeutic factors in group psychotherapy. These are:-

  1. Instillation of hope (others getting better/possibility of self getting better)
  2. Universality (shared experience/not alone)
  3. Imparting of information (learning from others, sharing knowledge experience)
  4. Altruism (helping others/feeling valued)
  5. Corrective recapitulation of the primary family group (chance to re-correct or change old patterns of behaviour)
  6. Development of socialising techniques (learning new social skills actively within safe context)
  7. Imitative behaviour (learning from others)
  8. Interpersonal learning (learning from and sharing with others)
  9. Group cohesiveness (feeling of belonging/shared enterprise)
  10. Catharsis (opportunity for radical, positive change through interaction)

Group members are enabled to begin understanding their personal difficulties and to explore new ways of thinking and behaving within the group therapeutic context. They learn about themselves and others through dynamic interpersonal interaction. In group psychotherapy close relationships develop between patients as well as between each patient and the therapist. An important task of the therapist is to ensure that these relationships do not become too intense outside of the group therapy context. The group therapist has to ensure that the setting is safe and containing.

Group psychotherapy has proved to be an effective treatment for quite disturbed patients, for example those who have made serious suicide attempts and those classified as 'borderline'. (Dick, British Journal of Psychiatry 1975; Pines: Group Analysis 1987). Our experience in the Psychotherapy Unit suggests that patients, who have been sexually or physically abused in childhood, benefit from the extended length of group therapy and from the support and containment offered by the group.

Many patients in the Psychotherapy Unit have been through the C.A.T. programme or have had some therapy elsewhere, for instance in the Psychology Department. Often patients will engage better if they have had this preparation prior to joining a group. At the present time there is very little waiting time for a group placement but this depends on the availability of trainees and appropriate vacancies.

If the Psychotherapy Service is cut there is no suitable alternative NHS treatment available for these patients.