Group therapy on state hospital chronic wards: some guidelines.

The provision of psychotherapeutic services to the most impaired and treatment-resistant chronically mentally ill (CMI) patients has been relatively neglected in the literature. These patients most often reside on the chronic wards of state mental hospitals where they often receive only custodial treatment and medications. This article discusses the provision of group psychotherapeutic services in such settings, and delineates five levels of group involvement through which patients progress before they graduate to a less-restrictive environment.