Neurol Neurocir Psiquiatr. 1977;18(2-3):141-55.
Since most of the patients who attend for psychiatric consultation at a clinic are little motivated for psychotherapy, analytic group therapy was attempted, with basis on studies on psychological genetics, on groups management, and on the theories of Freud, Klein and Bion. Several open groups were handled, with the following achievements: 1. A decrease in anxiety, and increase in the objective vision of reality and in increase in the ability to see past and present conflicts. 2. A greater tolerance to agressive and sexual instincts and to frustration. 3. A greater personal acceptance, ability to sublimate productively and elimination of clinical symptoms. Varying degrees of improvement, and lesser need for psychiatric medication and hospitalization were obtained. Several problems were encountered: a) Desertion of 30% of patients from the sessions, due to the disapearance of symptoms buth with no character changes (resistances). b) Temporary absence or habit of arriving late to the sessions (resistances). c) Overwhelming passivity. The groups were handled in cotherapy and the work was supervised with experienced therapists. To attempt solving the above mentioned problems a better selection of patients was made, complete clinical histories were elaborated, a battery of psychological tests was made, and diagnosis, dynamics and prognosis of each case were outlined; this allowed the evaluation of middle and long term treatment. It was suggested to change the technique to that of operative groups.
由于在诊所接受精神科咨询的大多数患者对心理治疗的积极性不高,基于心理遗传学、团体管理以及弗洛伊德、克莱因和比昂的理论研究,尝试了分析性团体治疗。开展了几个开放式团体治疗,取得了以下成果:1. 焦虑减轻,对现实的客观认知增加,洞察过去和当前冲突的能力增强。2. 对攻击性和性本能以及挫折的耐受性提高。3. 个人接纳度更高,有更有效的升华能力,临床症状消除。患者有不同程度的改善,对精神科药物和住院治疗的需求减少。遇到了几个问题:a) 30%的患者退出治疗,原因是症状消失但性格未改变(阻抗)。b) 临时缺席或有迟到的习惯(阻抗)。c) 极度被动。团体治疗采用联合治疗法,并由经验丰富的治疗师进行督导。为试图解决上述问题,对患者进行了更严格的筛选,详细记录完整的临床病史,进行了一系列心理测试,并概述了每个病例的诊断、动力学和预后;这有助于评估中长期治疗效果。建议将治疗技术改为操作性团体治疗。