Group therapy activities for schizophrenia

Group Therapy Activities for Adults with Mental Illness

Psychotherapy is a vital part of treating mental health disorders, chronic conditions, and addiction. There are many types of activity, but patients can find unique benefits and challenges in a group setting. Group environments provide an opportunity for peers to share experiences and challenges and grow together. It’s an integral, evidence-based part of treatment that’s increasing in popularity. Read on to learn about group therapy activities for adults with mental illness.

What Is Group Therapy?

Group therapy has been a mainstay of mental health treatment for decades. It comes in many different varieties, but focuses on groups of adults sharing common experiences under the guidance of therapists. Some of the target goals of group therapy involve:

Encouraging personal growth
Providing support for group members
Developing social skills
Building interpersonal awareness
Developing self-awareness
Increasing accountability
Understanding behaviors and internal drives

Overall, group therapy creates open environments of compassion based on shared experiences and opportunities for growth. That said, growth settings may vary depending on the purpose of the group therapy.

How Are Therapy Groups Formed?

Mental health professionals target their care in a variety of ways to form therapy groups. In some cases, they may be based around a particular mental health condition (such as depression or anxiety), or common experiences (losing a loved one, suffering trauma). Oftentimes, therapists recommend group therapy as a complement to patients already in individual therapy, as it provides the previously described benefits on top of the advantages of individual therapy.

Group sizes vary based on different conditions, needs, and goals. The American Group Psychotherapy Association advises an optimal range of group size between seven to ten members This way, they are large enough to include a diverse range of input while still maintaining high levels of individual participation.

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How Do Group Therapy Activities for Adults Work?

The different types of group therapy for adults with mental illness revolves around group members providing support to each other. This gives them a safe space to discuss emotions, ideas, and new behaviors without fear of judgment. They also hold each other accountable for what they say and promise to encourage growth.

There are four main stages of group development which applies across treatment types:

Forming: Meeting and getting to know fellow group members
Storming: Allowing for different perspectives and potential conflicts to be discussed in a safe and respectful environment.
Norming: Helping group members begin to better understand themselves along with each other.
Performing: Reaching goals and thriving as a self-aware group.

The amount of time it takes to reach these stages varies upon the group dynamics and other factors. The goal, however, is not to rush through these stages, but to let them develop organically in a healthy manner.

The Shared Principles of Group Therapy Activities

One of the primary activities of group therapy is sharing significant personal information that people may be embarrassed about, as well as past thoughts and behaviors. Group therapy is based on the following principles to ensure comfort in all group therapy activities for adults with mental illness. The three cornerstones of group activity are the following:

Confidentiality: Both the therapist and groups agree to keep all shared information confidential. They cannot talk about anything shared during therapy without the permission of the group members. Patients, however, are encouraged to share their own experiences and reactions to therapy with whomever they choose. There are exceptions to confidentiality if a patient may be in danger of self-harm or may pose a threat to others.
Safety: The therapist must create a respectful and safe environment free from discrimination, harassment, and abuse. The patients need to feel safe to discuss their experiences without fear of attack.
Participation: Everybody needs to contribute to this form of therapy. Patients need to learn how to both participate and listen so they can understand the group and grow from this experience.

What Types of Activities to Expect in Group Therapy

To prevent anxiety, it’s important to know the types of things patients due in group therapy activities for adults with mental illness. During inpatient therapy, group experience may occur multiple times per day. In outpatients environments, it’s usually once per week. In either setting, group meetings usually last between 1-2 hours at rehab facilities or private practices.

Communication is a central activity for most group therapy. Physicians encourage patients to speak with each other without fear. In some cases, the therapist will initiate a topic for discussions. For others, patients may talk organically about how they are feeling, their experiences, and reactions.

In all settings, discussing emotional reactions is very important, because they provide insight into how individuals process information and the world around them. This not only allows for one patient to grow, but through observations, the entire group to grow.

Many group therapies center on a discussion between members. However, group therapy can move beyond talking in a room. Group therapy activities for adults with mental illness can include hiking, cooking, dancing, making art, and more. These types of activities help build group identity, social skills, and can serve as an icebreaker in early group stages.

What Are the Types of Group Therapy?

Different therapists utilize unique types of therapy depending on their background and the needs of the patients. However, most group therapy can be categorized into either one of these types:

Process-Oriented: This type of therapy places primary importance on the experience of being in the group. The way members react and relate to each other and their therapies provides information and creates significant reactions. Ultimately, patients learn how their patterns of behavior can either hurt or benefit them in their daily lives.
Psychoeducational: Here, members learn about various conditions, topics, and life skills. The therapists encourage participation and create group projects and presentations to build specific skills, such as stress management and relapse prevention.

The Benefits of Group Therapy for Adults with Mental Illness

The benefits of group therapy extend beyond the specific treatment goals of a given group. While they may learn skills like coping with loss or managing stress, they are given additional opportunities. Most importantly, many people do not have an open, safe environment where they feel comfortable sharing about themselves. Group therapy provides this space for them to safely explore their feelings and behaviors.

It also gives them an opportunity to hear from a variety of different people who may be sharing similar conditions with different perspectives. These experiences can help individuals not only find support, but also develop new strategies for how to live and grow. Finally, group therapy activities for adults with mental illness gives patients the chance for old wounds to be understood and, ultimately, heal.

The Right Therapy For You

More than anything, patients need to know that they will receive the best care for them. Group therapy is an essential part of this, because it creates an open environment where individuals can find support from those who are suffering from similar conditions and have shared experiences. There are many types of therapy available at The Woods at Parkside, so reach out if you need assistance in the Columbus, Ohio area.

Call (614) 471-2552 to speak with one of our treatment specialists and learn more about our programs. Or click here to take an assessment.

MENTAL HEALTH GROUP THERAPY ACTIVITIES FOR ADULTS

Psychotherapy is an integral part of the treatment of mental health disorders, chronic illnesses, and obsession. There are many types of activities, but patients can find their own interests and challenges in groups. Group settings allow peers to share their experiences and challenges and grow together. It is a fundamental part of evidence-based treatment and its growing reputation. Read more to learn about group therapy activities for adults with mental illness.

Group Therapy

Group therapy has been the primary cause of mental health treatment for decades. It comes in different types and varieties. It focuses on adult groups sharing a common experience under the guidance of a therapist. Some of the goals of group therapy include:

Promote self-improvement
Providing support to team members
Development of social skills
Creating mutual awareness
Development of self-awareness
Strengthening responsibility
Understand behavior and internal stimuli.

Overall, group therapy creates an open atmosphere of empathy based on shared experiences and growth opportunities. Depending on the purpose of group therapy, growth settings may vary.

How are the Therapy groups made?

Mental health professionals approach your treatment in a variety of ways to build a team of therapists. In some cases, it may be based on a particular mental health problem (such as depression or anxiety) or a common experience (loss or trauma of a loved one). In many cases, therapists already recommend group therapy as an adjunct to individual therapy patients.

The size of the groups varies according to the situation, needs, and objectives. The American Association for Group Psychotherapy recommends a maximum group size of seven to ten members. Therefore, they are large enough to aggregate a wide range of contributions while maintaining a high level of individual participation.

How Do Group Therapy Activities for Adults Work?

Different types of group therapy for adults with mental illness revolve around supporting each other. It provides a safe place to discuss emotions, ideas, and new actions without fear of judgment. They also promise to take responsibility for each other for what they say and promote growth.

Group development has four major stages that apply across treatment types.

Formation: Meeting and acquaintance with fellow group members

Storming: In a safe and respectful environment, you can discuss different perspectives and potential conflicts.

Norming: Helps group members begin to understand each other better.

Performance: Achieve goals and prosper as a self-aware group.

The time it takes to reach these stages depends on the dynamics of the group and other factors. However, the goal is not to rush these steps but to grow organically in a healthy way.

Mental Health Group Therapy Activities.

Write a letter to someone in the future and let them know what is happening in your life. You can ask a close friend or counselor.
Make a list of the things you are trying to learn. Put the paper in a bottle or envelope and write the next date (at least one month in advance), then answer the question when you are ready. Are you sure this list exists? What will help you when you are angry or frustrated with something?
Write a letter to the time traveler who will come to see you. Please explain what is happening and write down as much detail as possible. Write in a way that you are really talking to this person. What do you think would make this person feel strange and interesting in your lifestyle?
Make a list of things you think are true and false about you. Read the list you made. Did your beliefs come true? How do the listed items work together to generate your idea? In other words, what’s more, specific about you than anything else, and why is it important?
Draw a Venn diagram with three coinciding circles. The circle should list all the skills that you think you have. The second circle should list everything you like in life, and the third circle should have attributes that describe you. What do you think fits into these categories?
Make a list of 15 things you don’t like. Are you crazy with or without someone?
Make a list of your 40 favorite things. What makes you happy? Think about the things that make you more satisfied. Is this a new relationship or something else?
Make a list of the 30 things you are obliged for.
Draw and write about any type of format you like more than others. What are you preparing? What are you trying to make? What kind of job did you put in each job?
Write down why you decided to take the road you are going on. Do you think that would be a good thing?
Write about who you think is the best president. What qualities does this person have? What does this person do to make you believe that they will be the best?
Write about the fantastic moment when you realize that no one knows your name. What are these people trying to achieve by living around you? Why is it strange that no one knows your name? Who is this person, and what are you trying to do with them?
Pull in clothes that are not yours. Make everything you wear, thin or tall, like a hero costume or a wild costume.
Write a letter to someone and tell him/her what you like about that person and how it affects you.
Write something that is new that you want to test. What are the things that represent your dream? What if you lived forever?

Benefits of mental health group therapy

Most people do not have a free and safe environment in which they feel comfortable sharing. Group therapy allows them to explore their emotions and behaviors safely.

It also allows them to hear from multiple people who are sharing the same situation with different perspectives. These experiences can help people develop new strategies for living and growing. Finally, group therapy activities for adults with mental illness allow patients to understand and ultimately heal old wounds.

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FGBNU NTsPZ. ‹‹Endogenous mental illness››

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Most domestic and foreign clinicians consider schizophrenia as an organic brain process and recognize the importance of hereditary factors in its origin. However, the clinical picture of this disease consists not only of the symptoms determined by the pathological process itself, but also includes, to a greater or lesser extent, various phenomena of a personality-psychological nature. All this, of course, is more pronounced in low-progressive schizophrenia. nine0005

Psychotherapy is most indicated for this variant of the course of the disease, while in malignant forms it is used mainly during the period of remission or during the formation of the latter, as well as in post-procedural conditions with a relatively shallow defect (residual schizophrenia).

The main tasks of psychotherapy in schizophrenia are to prevent isolation of patients in society and autism; social activation and mitigation of the reactions of patients in response to situations associated with illness and treatment; the formation of a critical attitude to the disease and deactualization of psychotic experiences; potentiation of the antipsychotic action of biological treatments; preparation of patients for discharge and prevention of the phenomena of nosocomial hospitalism. nine0005

Some foreign psychiatrists give psychotherapy a leading role in the treatment of this disease. In this regard, there have been attempts to use individual analytical psychotherapy (psychoanalysis). But its complexity, duration, high cost and lack of efficiency did not make this method popular. In schizophrenia, group forms of psychotherapy are more often used - group psychoanalysis, psychodrama, non-directive, behavioral, rational-emotional psychotherapy, etc. [Vid V.D., 1994; Enke H., 1966; Foulkes S., 1966; Schindler R., 1967].

V. M. Volovik et al. (1980) distinguish several levels of tasks and corresponding forms of group psychotherapy in low-progressive forms of schizophrenia. Solving the tasks of the first level (stimulating emotionality, social activation and establishing communication) is carried out with the help of creative activity groups (art therapy, music therapy, projective drawing, etc.), psychomotor stimulation, pantomime, simple forms of communicative-activating therapy (literary retelling, free improvisation of dialogues and their discussion). To solve the tasks of the second level (development of adequate forms of behavior, training of communication and increasing self-confidence), along with the above, methods of functional training of behavior are used. In solving the tasks of the third level (achieving a correct understanding of the disease and behavioral disorders, correcting attitudes and relationships, and optimizing communication), more complex variants of communicative psychotherapy and problem-oriented discussions are required. Finally, the fourth level of tasks (disclosing the content side of conflict experiences, restructuring the system of relationships and finding adequate forms of psychological compensation) is more consistent with the method of free verbal discussions. Its various forms can be used sequentially, simultaneously or selectively, which is determined by the totality of clinical, psychological and social ideas about the patient and his illness. nine0005

V.D. Vid (1991) includes distortions in the perception of the most important motivational structures, maladaptive psychological attitudes, and phenomena of disturbance of the internal picture of the disease among the targets of psychotherapeutic correction in low-progressive schizophrenia. Emotional support, stimulation, advice, clarification, clarification, confrontation, objectification, interpretation are indicated as the main types of intervention in individual and group variants of reconstructive psychotherapy.

Treatment of patients with schizophrenia can be carried out in therapeutic groups that include patients with other psychoses and borderline conditions (including patients with neuroses). Groups can be heterogeneous not only in terms of nosological composition, but also in terms of age, sex, education, duration of illness and "psychotherapeutic experience". The heterogeneity of groups according to all the indicated characteristics in some cases can have a very positive effect on patients with schizophrenia.

If it is necessary to minimize the time of the patient's stay in the hospital, in many cases it is advisable to have short-term psychotherapy that sets realistic goals, in particular, explaining to the patient the reasons and mechanisms for the deterioration of his condition and helping him gain experience that will allow him to better cope with a difficult situation in the future. The behavior of the psychotherapist in these cases should be active, directive and, at the same time, responsible for the adequacy of such behavior of the patient's condition and the possibilities of his adaptation outside the hospital. nine0005

Of interest is the experience of treating patients with chronic psychoses who have been in closed psychiatric hospitals for a long time, using the method of group psychotherapy conducted outside the hospital - mobile psychotherapy. For example, patients are taken for a walk in the park and asked to behave in such a way that their behavior does not give grounds for others to see them as patients in a psychiatric hospital. This form of group therapy allows them to identify potential opportunities for changing their behavior and is sometimes very effective. nine0005

The effectiveness of group psychotherapy in acute psychotic states is very doubtful, and in newly admitted patients, its results are usually negative.

Group Art-Gestalt Therapy of Schizophrenia - Dr.

Ermakov's Psychotherapy Center

In recent years, most experts tend to conclude that both purely sociogenetic and purely biological models of mental illness are imperfect; historically emerged concepts that psychoses are caused by biological, and neuroses - by sociopsychological factors seem to be unduly simplified and do not correspond to the current state of knowledge. Therapy of any kind may be only part of a general approach to the treatment of schizophrenia. That is why psychiatry, in principle, cannot exist without psychotherapy. The most relevant to the modern systemic understanding of schizophrenia, apparently, is the model of stress diathesis formulated by J. Zubin. Vulnerability is manifested in the fact that the stressor acts on the already altered ability of the patient to resist it, so the absolute value of the stressor becomes relative (14). We inform you that our Center in Novosibirsk provides group psychological therapy, trainings and classes with a psychologist in groups. nine0005

The study of stress has shown that the processes are not limited to the psychosocial sphere, invading the activity of biological and humoral processes, including the dopamine system, and the phenomenon of neuronal plasticity confirms the morphological basis of psychosocial phenomena. Neurons respond to repeated stimuli with functional (electrophysiological) and anatomical (growth of dendrites) changes, which are the morphological basis of the dynamics of a person's mental life. The biological, entering the personality of a person, becomes social. Brain pathology can generate in the subject, in the structure of his personality, a biologically determined predisposition to the formation of certain psychological characteristics of the personality, the implementation of which subsequently depends on the influence of social factors. Thus, the theoretical understanding of the nature of schizophrenia, of course, leaves room for psychosocial and psychotherapeutic approaches in the treatment strategy for this disease (2). nine0005

We also draw your attention to the fact that our Center in Novosibirsk conducts group art therapy with a psychologist.

The psychotherapy of schizophrenia has been intensively developed since the 1920s in European clinics and the USA. The main trends in its development are associated with the general humanization of the approach to the patient as a suffering person, capable of fighting the disease and cooperating. Back in the 30s, G.S. Sullivan noted that patients with schizophrenia often showed extreme sensitivity and actively reacted to their environment, although these reactions were often indirect or non-verbal (hidden) in nature. He received sensational results - out of about 300 patients with schizophrenia who underwent psychoanalytic therapy, 61% showed a significant improvement. nine0005

According to RW Lang, the term "schizophrenic personality" refers to an individual whose experience value splits in two directions: first of all, it is the breakdown of his relationship with the outside world and, secondly, the breakdown of his connection with himself. At the same time, a person cannot feel hopelessly lonely and isolated from others. Such a person does not feel like a whole person, but as if “split” into different parts. The areas of the “I”, separated by the process of splitting, pass one into another without sharp boundaries. The boundaries between the divided areas are partially permeable (9). The confusion of experiences of such a person is aggravated by the fact that in the "crowd" of the listed images-figures there may be images of other people. The abundance of overflowing images leads to the fact that the real external world is no longer perceived as it really is. Split fantasy endows the external world with imaginary images through projection. In parallel with this, images of actually experienced “external” personalities are introjected, “inside”, which, thus, are part of the structure of one’s own personality. This inevitably leads to serious violations of behavioral, mental and sensory functions, as a person becomes disorganized and confused, losing the opportunity to concentrate on what is happening directly “here and now” (P. Kutter, 1997) (2). Since the center of schizophrenic disorder is a violation of interpersonal relations, in psychotherapy the question of restoring genuine human contact with the patient, and thereby the problem of transference, comes to the fore. Patience and endurance are required of the therapist, as well as the ability to recognize in the patient the desire to find contact and at the same time the fear of it and resistance to it, in order to use these conflicting desires therapeutically by one's own behavior and mode of action. When, at last, contact is found and the therapist is recognized by the patient as a person in all its reality, the patient's love or hatred is often revealed in such a violent and boundless form that it confronts the doctor with difficulties no less than the patient's former inaccessibility. Not only the need for love is transferred to the therapist, but also massive destructive and hostile longings. For a long time, all these contradictory affects are still in a state of chaos, there are fluctuations from one extreme to another, as a result of which direct physical threats can be replaced by just as specific love outpourings. Thus, the doctor-patient relationship takes on a completely different character here than in the treatment of neuroses (10). nine0005

Gestalt therapy focuses on actual relationships as such. If the patient is angry with the therapist, this may be important, for example, in terms of how the patient perceives these feelings now or what he is going to do about it. The transference interpretation distracts the patient from the integrity of his experience, clouding the power of actual feelings and behavior, replacing "now" with "a long time ago." The new ideas underlying in Gestalt therapy are as follows: the source of power is the present; experience matters most; the therapist himself is an instrument of therapy; therapy is too good to be limited to treatment (I. Polster, 1973) (11). Each person controls his energy in such a way as to maintain good contact with the environment, or resist such contact. Specific ways of interrupting interaction with the environment determine the style of a person's life when he sets his priorities. There are five main ways of resistance (11):

In introjection, a person passively accepts what the environment offers. He makes little effort to determine his needs and desires. This is expressed in the fact that he is not critical to what is happening or lives in a favorable environment for himself. When the environment is hostile to him, he directs all his energy to keep the situation satisfied. nine0050
In the case of projection, a person does not recognize any of his qualities, attributing them to the environment. If the environment is varied enough, in some cases, of course, he will be right. But more often than not, he will make serious mistakes and feel unable to change anything.
With retroflection, a person refuses any attempts to influence the environment in which he feels himself a separate self-sufficient entity. He transfers his energy inward, severely limiting the connection between himself and the environment. nine0050
In the case of diflexia, a person engages in communication with the environment at random. Most often, he makes mistakes at the same time, and if he hits the target, then by accident. That is, either he does not invest enough energy to get a significant return, or he invests it at random, and it “gets cloudy” and disappears. He gets desperate, getting no return, and ends up "bankrupt".
In confluence, a person "goes with the flow". It requires little energy at personal choice, he only needs to help a little with the current that picks him up and carries him. This stream may not be the direction he would like to go, but his random companions consider the chosen direction to be the right one, and he also accepts it as the right one. Besides, it doesn't cost him much, how can he complain? nine0050

A schizophrenic personality mainly uses primitive defenses, which are characterized by two qualities associated with the preverbal stage of development - insufficient connection with the reality principle and insufficient consideration of the separation and constancy of objects that are outside one's own Self. projection and retroflection, to a lesser extent introjection, originating from the period when "I" and "other" were not yet fully differentiated. These forms of psychological protection allow the patient not to perceive the relationship between the contradictory properties of the same object, prevent anxiety that would arise due to the impossibility for the patient of their integral, integrated perception and, thereby, delay the psychotically determined disintegration of the personality. In psychotic exacerbation, such mechanisms play a dialectically positive role, but outside it they reduce the flexibility of social functioning and the adaptability of patients. It must be remembered that people functioning at the symbiotic level, which is typical for schizophrenia, even without obvious psychotic manifestations, are constantly in a state of panic, experiencing a sense of insecurity in this world (6). Virtually any psychotic projection represents certain, often denied, aspects of the patient's own self; that the psychotic reality is more predictable for the patient in the sense that it reflects the surface layer of his system of safety and survival in a hostile world. Patients with schizophrenia are characterized by a central violation of the identity of the ego, that is, the continuity of the sense of one's own representation in time apart from objects, despite the flow of external and internal impulses of information. This means that in contact with a paranoid patient, one should exclude excessively confrontational value judgments, work with affects, and not with their content, maintain strict therapeutic limits, and be predictable and consistent in the psychotherapeutic process (10). nine0005

The task of the Gestalt therapist is to help the patient realize his need, make it clearer (form a Gestalt) and neutralize it, complete it, and ultimately help the person get out of the impasse. Thus, the main goal of Gestalt therapy is to awaken the latent possibilities of a person by encouraging awareness of their needs and facilitating their progress along the path to maturity (5). Gestalt therapy includes the following main components: expansion of awareness, integration of opposites, increased attention to feelings, work with dreams (fantasy), taking responsibility for oneself, overcoming resistance. Each person is able to express his internal conflicts in visual forms, and then he becomes verbally clearer to himself, it becomes easier for him to tell, explain his experiences (8). nine0005

Art Gestalt therapy has common features that allow us to speak of it as a well-defined area of psychotherapeutic activity, namely: the use of visual materials for the patient to express the content of his inner world; creation of special conditions for this; the presence of a psychotherapist next to the patient in the process of his pictorial activity and the use of certain techniques that help the patient express his feelings and thoughts in an artistic form and realize the connection of pictorial production with the content of his inner world (1, 3). nine0005

Work using a group approach was carried out at the stationary stage. Thematic sessions were held twice a week and lasted for 1.5 hours. The group consisted of 5 to 8 people. The sessions had the usual structure for thematic group art gestalt therapy and included three main stages: introduction and warm-up; the stage of choosing a topic and pictorial work; and the stage of discussing drawings, individual gestalt experiments and feedback, and closing the session.

We used the following blocks of topics and exercises:

Assuming different forms of work with visual materials and aimed at activating patients, improving their sensorimotor skills and developing associative thinking.
Designed to train active attention and memory.
Allowing patients to express their thoughts and feelings in an artistic form, including those related to significant problem situations and relationships for them, and to develop non-verbal communication skills; nine0050
Helping patients to better understand their feelings and needs, aimed at strengthening their identity and developing psychological defense mechanisms, as well as at understanding patients of their system of relationships, including their attitude towards themselves. Specific Gestalt techniques: awareness and resistance work, including: amplification technique, hot chair technique.

In addition, other techniques were used:

Guided visualization technique in combination with visual work. nine0005

Various techniques of multimodal art therapy and gestalt therapy, offering a combination of visual work with elements of body-oriented therapy and psychodrama, using poetic and prose texts.

During 12 months of using art-gestalt therapy, 57 patients with various endogenous pathologies of the schizophrenic spectrum participated in the groups. The groups were open and mixed by age (from 14 to 48 years) and gender (44 women and 13 men). Many patients during the period of work in the art-gestalt therapy group were at the stage of remission or its formation, or at the stage of relative compensation of the condition. It was also taken into account that all patients, in addition to undergoing art-gestalt therapy, received other types of treatment, primarily psychopharmacotherapy. The comparison was made with a control group consisting of 50 patients who received only psychopharmacological treatment, similar drugs and dosages, with approximately similar pathology, sex, age and educational composition. nine0005

Contraindications for participation in the art-gestalt therapy group were: acute mental disorders, in the form of active delusions and the presence of intense perceptual deceptions. This is due to the patients' loss of the ability to control their behavior and observe the basic rules of group work, and prevented them from establishing productive contact with others, as well as difficult understanding of their experiences, in connection with which the participation of such a patient can lead not only to disorganization of the work of the group, but also adversely affect the patient's condition. nine0005

OBJECTIVES OF ART-GESTALT THERAPEUTIC GROUP WORK IN A HOSPITAL:

At the initial stage of inpatient treatment, the main task of group psychotherapy was to facilitate the possibility of continuing drug therapy and establishing contact with the doctor. The main direction of work is the correction of the internal picture of the disease, the development of motivation for treatment, including the continuation of psychotherapy in the post-hospital period. It is important to form in patients a consciousness of responsibility for the outcome and an emphasis on the analysis of interpersonal relationships "here and now". nine0050
Further tasks were set: elimination or weakening of the existing symptoms associated both with the mental disorder itself and with their reaction to it, optimization of their mental state and social functioning.
Achieving a higher level of psychosocial adaptation of patients. Achievement by patients of a better understanding of the characteristics of their condition, the causes and mechanisms of the development of the disease. Formation of active self-regulation skills in patients. Development in patients of the ability to express their feelings and thoughts both verbally and non-verbally. Strengthening patients' sense of "I", improving their ability to make decisions, forming a stable system of socially significant connections, interests and hobbies. nine0050

OBJECTIVES OF PSYCHOTHERAPY: Open inpatient short-term group gestalt therapy makes the following objectives achievable (12):

Involvement of the patient in the therapeutic process.
Demonstrates that talking helps.
Identification of problems.
Insulation weakening.
An opportunity for the patient to be useful to others.
Relief of hospital anxiety. nine0050

SESSION REGISTRATION, DYNAMIC ASSESSMENT METHODS OF ART-GESTALT THERAPEUTIC WORK AND ITS EFFECTS included: assessment of vital activity (on the 5th axis) in points for a time interval of 12 months before admission to the hospital and 2 months after the end of therapy.

Periodic clinical and psychological assessment of their condition using a series of tests (semantic personality differential, Luscher test, situational and personal anxiety questionnaire). nine0050

Oral reports of patients on the most significant changes they observed in their condition.

Evaluation of group dynamics and relationships within the group, as well as the relationship of patients with the psychotherapist.

Assessing the interests, hobbies, activities and relationships of patients with other people outside the psychotherapy group.

Evaluation of patients' visual products using formal and substantive criteria.

Retrospective assessment of vital signs 2 months after the end of therapy revealed the following results:

Improvement of psychosocial functioning on average by:

20 points on the scale of psychosocial adaptation in 56% in the main group and 22% in the control group.

The results showed an increase in the indicators of psychosocial adaptation in participants in the psychotherapeutic group compared with patients in the control group who received only psychopharmacotherapy.

According to the results of the clinical and psychological assessment: according to the findings of the conducted personal differential, there was an increase in the level of acceptance by the members of the psychotherapeutic group of each other, convergence of real and expected assessments, and a decrease in dependence on the psychotherapist. Patients of the main group showed lower rates of situational anxiety compared with patients in the control group. nine0005

In their self-reports about the factors that had the greatest influence on the improvement of their condition, patients who underwent psychotherapy indicated in the first place: communication and support for people with similar problems, in the second place: authoritative help and self-disclosure of the psychotherapist, in the third place: interest in the topics of the classes. In general, after the end of the course of psychotherapy, patients of the main group showed a higher level of criticality to their disease and condition in general, and higher compliance rates, subject to the doctor's prescriptions. Some patients continued to engage in visual arts after the end of the course of psychotherapy. nine0005

Based on the data obtained, the following conclusions can be drawn:

A comprehensive assessment of the characteristics of the contingent of patients, the tasks of art-gestalt therapy work in a psychiatric hospital allowed us to choose the most adequate model of an open thematic art-gestalt therapy group.
Thematic group art-gestalt therapy at the inpatient stage of treatment of patients with long-term mental disorders achieves the following goals: to involve the patient in the therapeutic process, to demonstrate the help of talking therapy, to identify current problems, to reduce isolation, to enable the patient to be useful to others, to reduce anxiety, associated with hospitalization. nine0050
An important part of the art-gestalt therapy work should be considered the creation of conditions conducive to the generalization and maintenance of the achieved psychotherapeutic changes. These include the development in patients of the skills of active self-regulation and expression of their feelings and thoughts, strengthening their identity and independence, as well as the formation of a stable system of socially significant connections, interests and hobbies.
According to the results of the work performed, higher rates of psychosocial adaptation, lower rates of situational anxiety, increased critical abilities and the level of compliance were revealed in patients who participated in group psychotherapeutic work compared with patients who received only psychopharmacotherapy. nine0050
When analyzing the work performed, it was found that patients with schizophrenia most often use projective and retroflexive methods of border regulation, as a result of which the Gestalt therapist built his work by removing projections from himself and from group members, stimulated contacts and dialogues between group members, as well as the expression of feelings . The cycle of need in most cases was interrupted at the stage of contact. The dominant self functions in the group were id and persona.

LIST OF USED LITERATURE:

Burno M. E. "Therapy with creative self-expression" ed. "Medicine" Moscow 1989
View VD "Psychotherapy of schizophrenia" ed. "Piter" St. Petersburg 2001.
Kopytin AI "Theory and practice of art therapy" ed. "Piter" St. Petersburg 2002.
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