Episode 8: The Group

Group work is a key method of engaging patients in psychiatric care environments and has much to commend it but managing such groups is not without challenges. This is particularly true in mixed gendered groups but carefully managed group-work is proven to add a therapeutically important dimension to treatment in secure environments.

Groups offer the opportunity for shared learning and support and may engender new experiences of cooperation between patients unused to having support from others. However, skilled facilitation is vitally important in such settings so that more timid participants are not bullied, marginalized or silenced and so that some agendas do not get more of an airing than is therapeutically helpful to the majority. Language use must be carefully controlled – the shorthand use of ‘labels’ to describe a person (for example, ‘offender’, ‘prostitute’) will be challenged so that the person underneath the label might be more fully understood. Group work is demanding for both patients and the staff facilitators so that delusions and potentially manipulative behaviours are not reinforced.

This episode touches upon other opportunities open to patients in top security psychiatric care – such as education and recreational activities. Unfortunately the media have been known to challenge the appropriateness of such opportunities. It should be remembered though that patients in hospital are patients – they are people who are deemed to be ill and they are not in prison as such. Certainly, they may not leave by choice so it is a ‘jail’ of a kind but patients retain a number of important legal rights and this is a fact often willfully ignored by the press which is keen to stir up outrage about the alleged ‘luxuries’ afforded to patients in special hospitals.

Listen to Episode 8:

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