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The Axis II group: treating severely characterologically disturbed patients.
R H Klein1, J F Orleans, C R Soulé
1Department of Psychiatry, Yale University School of Medicine.
International Journal of Group Psychotherapy
|January 1, 1991
Summary
This study addresses outpatient treatment for chronically mentally ill patients with severe personality disorders and substance abuse issues. It offers recommendations for effective group therapy, focusing on safety and therapeutic dynamics.
Area of Science:
- Psychiatry
- Clinical Psychology
- Addiction Medicine
Background:
- Chronically mentally ill patients often present with complex comorbidities, including severe personality disorders and substance abuse.
- Outpatient treatment settings face unique challenges in managing these complex patient populations.
Observation:
- This article examines therapeutic and management issues for outpatient clinicians treating patients with schizophrenia, other psychotic illnesses, severe personality disorders, and co-occurring substance abuse.
- Key considerations include dual diagnosis treatment, patient and therapist safety, boundary setting, splitting dynamics, and countertransference.
Findings:
- Effective outpatient group therapy requires specific resources and clinician preparedness.
- Addressing dual diagnosis and managing transference are critical for successful treatment outcomes.
Implications:
- The findings provide a framework for enhancing outpatient group therapy for individuals with severe mental illness and substance use disorders.
- Recommendations aim to improve patient safety, therapeutic alliance, and overall treatment efficacy in complex psychiatric care.