Role of dynamic group therapy in psychiatry

Group psychotherapy is one of the most widely practised treatment methods in psychiatry, with an extensive literature, but it has long been regarded as the poor relation to individual therapy. Nineteenthcentury ideas about the primacy of the individual, taken up by psychoanalysis, continue to dominate Western culture. Mrs Thatcher’s famous remark “I don’t believe in society. There is no such thing, only individual people, and there are families” (Women’s Own, 31 October 1987) typifies the extreme view in which the self and the individual’s needs are paramount and are set above those of the group. Foulkes in the 1950s had put forward the opposite position, arguing that there is no such thing as an individual that exists apart from and outside the social (Foulkes, 1948; Foulkes & Anthony, 1957). Most recent psychotherapy theorising has moved away from the drive-based view of the individual to a more intersubjective, relationship-based model where the quality of early attachments is seen as being of fundamental importance. Dynamic group therapy lends itself to this view and is a rich and productive arena for developing these ideas. The trend of administering in group settings and semi-manualised versions treatments originally described for use with individuals has spurred on dynamic group therapy researchers, who until relatively recently had been slow to develop an evidence base for their therapies. For example, both cognitive–behavioural therapy (CBT) and psychoeducational cognitive therapy were originally described for individuals and are now increasingly being provided to groups. There are now robust research findings showing the effectiveness of dynamic groups as a powerful intervention for a number of disorders, including depression, personality disorder and anxiety states (Robinson et al, 1990; Budman et al, 1998). This paper describes the range of group therapies currently practised and reviews the theory, indications and effectiveness of dynamic group therapy.