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The change in perception of illness monitored by group psychotherapy of family members of patients with psychotic disorder

Abstract

Cilj: Opisati promjene odnosa prema bolesti kroz četverogodišnji rad grupne psihoterapije članova obitelji. U sklopu Programa rane intervencije kod prvih epizoda psihotičnih poremećaja (RIPEPP) roditelji bolesnika oboljelih od psihotičnih poremećaja uključeni su, uz psihoedukacijske radionice, i u psihodinamsku grupnu psihoterapiju. Metode: Praćenje protokola seansi koje se bilježe po sjećanju nakon održanih grupa. Rezultati: Tijekom četverogodišnjeg rada s članovima obitelji opazili smo da je postupno došlo do promjene stava prema bolesti. U početku grupnog rada uočeno je neprihvaćanje bolesti, negacija te pomak problema prema van (npr. uzimanje droga). U drugoj fazi prorađuju se osjećaji srama (bolest kao narcistička povreda) i krivnje (bolest kao kazna) te teškoće suočavanja s ozbiljnošću i dugotrajnošću bolesti. Prepoznata je i treća faza rada u kojoj članovi grupe (roditelji) fokus pomiču s djece i njihovih poteškoća na sebe (počinje prorada tugovanja). Zaključak: Grupna klima koja se tijekom četverogodišnjeg rada u grupi stvorila pridonijela je postupnom prihvaćanju bolesti te time i promjeni odnosa prema djeci. Bolja uspostava granica stvara uvjete za separaciju najprije od grupe, a kasnije i od oboljelog člana.Aim: This paper gives the description of changes in the perception of illness during the four-year involvement of the patients’ family members in group psychotherapy. Within the program of early intervention in the first episodes of psychotic disorder, parents of patients with psychotic disorder take part in psycho-educational workshops as well as in psychodynamic group psychotherapy. Methods: The method of work is based on the monitoring of session protocols noted from memory after the group therapies have been finished. Results: Unacceptance of illness, denials and outer transfer of the problem (such as drug abuse) were noticed in the beginning of the group work. In the second phase, the feelings of shame were dealt with (illness as a narcissistic injury) and guilt (illness as punishment) as well as difficulties in facing the severity and long duration of illness. The third phase was also recognized in which we noticed that the group members (parents) focused their attention from their children’s difficulties to themselves (the period of grieving process started). Conclusion: The group atmosphere which developed during the four- year period of work in the group contributed to the gradual acceptance of illness and so changed the relationship with children. Better setting of boundaries allowed separation, first from the group, and also from the inflicted family member later on

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