Abstract

Relatively little has been written in the literature about the final phase of the therapeutic process in groups of patients with psychosis and about the ways in which an individual patient leaves the group. Due to the nature of the psychotic process that disrupts the functioning of personality in all aspects (emotional, cognitive, volitional-instinctual) and especially in terms of interpersonal and social functioning, the goals of long-term analytical group psychotherapy can be divided into the early and late phases of treatment. In the early phase of treatment, the goal is the stabilisation of the disease, disappearance of symptoms, critical attitude towards the disease and the need for treatment, acceptance of psychopharmacotherapy and processing of traumatic experiences of hospitalisation and stigmatisation for one to two years. In the later phase of treatment, we strive to consolidate the self, achieve constancy and higher levels of object relationship, reconstruct defence mechanisms and gain insight into internal conflicts. The completion of group psychotherapy with psychotic patients is a highly individual process in which the patient, other members of the group and the therapist(s) participate. For most psychotic patients, achieving the goals of the first phase of treatment means the end of therapy, and for patients with greater capacity for psychotherapeutic work and interest in psychology it is possible to achieve higher levels of object relations and functioning. In this paper, we present the experiences obtained in a long-term group analytical therapy of patients with psychotic disorders from the outpatient programme of the Psychiatric Hospital Sveti Ivan. Different ways patients (group members) leave group psychotherapy are described where the common feature is the absence of processing separation regardless of the length of participation in the group, the progress made and the therapeutic agreement.