Description: Providing a cost-effective treatment model that is respectful of patients' needs, their strengths, and their limitations, this volume presents the first dynamic and coherent approach to group treatment for people with chronic mental illness. By structuring members' variable attendance, the flexibly bound model, which utilizes group dynamic principles to maximize therapeutic opportunities, respects the actual behavior of many chronically ill persons, making this treatment format available to a broad portion of this population. The author focuses on the impact and opportunities of group treatment to help members overcome inhibitions in expressing their needs, asserting themselves, and managing the inevitable hurts and disappointments in their relationships. The group functions as a transition point from which members can learn new ways of interacting and then apply them in their everyday lives. Illustrated with numerous case vignettes, the book outlines the elements of supportive treatment and therapeutic goals and then describes in detail specific strategies and interventions. Special elements related to problems of attendance, core and peripheral members, extragroup contact among members and with the therapist, and provision of medications are thoughtfully examined. Attention is also paid to elements in the system that will enhance the likelihood of success: administrative support, clinician education and sustenance, obtaining referrals, screening and preparing prospective members, and collaboration with those who provide members' other basic needs. Illuminating the broader issues involved in a group program for the chronically mentally ill as well as the details of everyday problems inestablishing and maintaining a group, this volume is useful to the beginner and the seasoned practitioner alike. Inexperienced clinicians will learn how to utilize the flexibly bound group approach to work with this population, while experienced professionals will appreciate the work's theoretical sophistication, its detailed attention to systems issues, and the clinical wisdom it imparts. Written in an accessible style, the volume also serves as a basic text for anyone who plans to work with the persistently ill and as a supplementary text for advanced courses in group therapy.

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