If I Ran a Mental Health Group For Psychotic People

 

I decided not to write about my selected subject for an essay today.  I am writing about this instead.


If I were a volunteer or paid worker and I were asked to run a mental health group for psychotic patients, here is what I would do.  I would make it a group focused on discussing people's beliefs that no one much is interested in outside of the group.  I learned about the concept of "mentalizing" from groups with Dr. Stuart Weir, one of the psychologists at The Monarch Community, where I am currently staying.


The idea would be, I would encourage people to discuss and debate their ideas.  The idea would be, all group discussions would not ever say "I'm positive about _____".  There would be 5 ratings for any belief expressed by a group that other people could share, along with details, about each belief:  "I'm not sure but I'm pretty sure that's not true," "I kind of don't think that's true, but maybe it is," "I'm completely undecided," "I kind of think that that's true, but maybe it isn't," and "I'm not sure but I'm pretty sure that that is true."  The idea is, each belief would be discussed and explored in depth in the group.  People who are fully psychotic would be encouraged to share "details about their world," and would be encouraged to let go of certainty, and get into the rhythm of saying, "I think that it is maybe true that ______ is happening to me."  People could challenge anything, even the idea that the sun will rise tomorrow.  Tests for how to evaluate beliefs as true or false could be developed.


I think my idea would help patients to get better from serious psychotic episodes faster and more healthily/pleasantly.  I have seen numerous patients here who do not get that much better, and I think that the concern is that the therapists here are competent, but not very "hard-hitting" or determined to fix patients' delusions.  The attitude is tolerant, but relaxed, and a sense of urgency about patients' mental health crises is lacking.  I think my idea for a group would help certain kinds of patients get better in a reasonable amount of time...they would stop feeling scared/secretive/defensive about their delusions, and start opening up a little more.  I remember one patient in particular who seemed like he didn't get much help at all...he was eventually discharged after a number of months and went home with his family, but I wasn't convinced he had improved regarding his delusions and psychosis at all.  I'm not positive though--I only talked to him a little bit after our more lengthy discussions at first.

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