Background

In the UK, many mental health services rely heavily on group treatments in the care of individuals with schizophrenia; including ’activity groups’, ’support groups’, ’problem-solving/psycho-educational groups’, and ’psychodynamic groups’. However, whilst a number of studies suggest that these group treatments are effective for individuals with schizophrenia, little is understood about how these interventions work.

Critically, very little research has identified and explored group processes which are currently vaguely defined as action mechanisms inherent to group dynamics and interaction that contribute to therapeutic change. At present, it is unclear whether interactions between patients in group therapies, and/or perceived benefits of the group format are beneficial for individuals with schizophrenia.

In particular, it is unclear whether these processes are specific for a particular group approach or are shared across all group therapies for schizophrenia.

Thus, the current project aims to identify group therapeutic processes using both observer-ratings of interactive behaviour (nonverbal and verbal communicative behaviours) and patient-reported experiences of group interactions across verbal (Cognitive Behavioural Therapy oriented) and nonverbal (Body Psychotherapy, BPT) group therapies. These identified processes will then be linked with improvements in therapeutic outcomes.

Research questions

• What interactions between group members exist across talking and non-talking therapies for people with schizophrenia?
• Are the types of group interactions different between people who benefit most from group therapies, and those that don’t?

Research activities

• First, literature on the effectiveness of group therapies for schizophrenia was reviewed.
• Second, nine nonverbal group therapies (Body-Oriented Psychotherapy) and one talking therapy (Cognitive Behavioural Therapy) group was set up for people with schizophrenia living in the community and video recorded. The Body-Oriented Psychotherapy were set up as a wider trial exploring the effectiveness of this therapy for people with schizophrenia (NESS trial).
• Third, people taking part in these groups were interviewed on their experience of being in a ‘group’.
• Fourth, interactions between group members were measured from the video recordings.
• Fifth, the measured interactions and participant reported subjective group experiences were linked together.

Conclusion

• Our literature review found that people suffering from schizophrenia benefit from ‘group-based’ psychological interventions compared to no group.

Useful links:

http://www.isrctn.com/ISRCTN34757603

Staff

Stavros Orfanos

Associated papers

Priebe, S., et al. (2013). "Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia – a multi-centre randomised controlled trial." BioMed Central 13(26): 1-8.

Funder

East London NHS Foundation Trust