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The British Journal of Psychiatry (1971) 119: 59-69. doi: 10.1192/bjp.119.548.59
© 1971 The Royal College of Psychiatrists
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A Study of Patients who Lapsed from Group Psychotherapy

E. R. SETHNA M.B., B.S., M.R.C.P., D.P.M., D.T.M. & H.1 and J. A. HARRINGTON M.A., M.D., M.R.C.P., D.P.H., D.P.M., D.I.H.2

1 Consultant Psychiatrist, All Saints' Hospital, Birmingham, 18
2 Medical Director, Uffculme Clinic, Birmingham, 53

This investigation is a direct sequel to the work on evaluation of group psychotherapy already published in this journal (Sethna and Harrington, 1971). It is a study of 37 patients who while undergoing group psychotherapy lapsed or discharged themselves against medical advice.

The causes of lapsing were ascertained by comparing the 37 patients who lapsed with the 53 patients who were discharged on completion of their treatment. The commonest cause of lapsing was found to be the threat associated with active participation in group psychotherapy. Another important factor was the diagnosis; patients with hysterical features lapsed far more frequently than those with obsessional ones. The other factors which influenced lapsing were the group to which the patient belonged, transference problems of the group, personality of the therapists, sexual involvement between the group members, in-patient or day-patient status, the source of patient's referral, and the patient's age, sex and marital status. The remaining less frequent causes of lapsing were listed as `threat of facing change', `elimination by the group' and `flight into health'.

Despite differences in approach, considerable agreement was found between our findings and those of other published studies. Because of the present high rate (30 per cent to 50 per cent) of lapsing in group therapy, and because lapsing is considered prejudicial to those who lapse as well as to those who continue in the group, ways and methods of reducing lapsing have been suggested.

Submitted on September 8, 1970




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Copyright © 1971 The Royal College of Psychiatrists.