Hub Group: an innovative approach to group therapy in a short-term inpatient adolescent unit.

Two and one-half years of Hub Group have shown that short-term, ward-based, heterogeneously mixed adolescent groups can work. Backed by a behaviorally based privilege system, Hub Group contracting methods facilitate rapid investment in group therapy, are flexible enough to accommodate change, and provide a meaningful ritual that involves all group members in promoting change for the individual. Hub Group's method of self-rating and rewards promotes objectivity in self-evaluation. The contracts' images are compact, but all encompassing, providing a continuum along which to move in developing greater responsibility and productive functioning for the adolescents. There are distinct advantages and disadvantages to mixed levels of functioning within the same group. The nurturance and tolerance for others fostered by Hub Group is a primary advantage. Despite the obvious disadvantages of rapid turnover, common issues such as acceptance, attachment, and separation are ever present to be addressed. Leadership must be either supportive or confrontive, but always active in these groups. Hub Groups have shown that with the support and supervision of IDTU's administrative staff, diversely trained staff can comfortably perform multiple roles within the unit and be effective as group leaders.