A large group in a district general hospital

This article describes a large group in a district general hospital serving a defined catchment area. Fifteen consecutive meetings were studied and three types of meeting were observed; manic meetings, depressed meetings and, thirdly more balanced meetings not dominated by any powerful affect. The main topics discussed in the meetings included depression, illness, anxieties about treatment or recurrence, doctors, bereavement, loneliness, religion, and death, the more medical subjects possibly reflecting the medical orientation of the treatment programme. The principal themes in this meeting differ from those described in therapeutic communities, when themes of violence, rejection, sexuality and dependence conflicts figure more prominently. In the setting of the district general hospital, the character of the meeting appeared to be largely determined by the composition of the ward at the time, and patients with affective disorders. by virtue of their powerful moods, often assumed a dominant role.