9195579
Description
Flashcards by Ella Middlemiss, updated more than 1 year ago
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Created by Ella Middlemiss
almost 7 years ago
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| Question | Answer |
| Aim | To give an insight into how 6 individuals with S/Z, in an out-patient group therapy, form firm boundaries which give them support during their illness. |
| Purpose of patient group | to give the patients a structure to help them cope with their illness and encourage a sense of connection with others |
| Ego boundary | a sense or awareness that there is a distinction between the real and unreal (in some psychoses the person doesn't have an ego boundary and can't differentiate his or her personal perceptions and feelings from those of other people) |
| Method | 6 ppts, 45 minute session, led by 3 researchers, group running since 1985. |
| Leaders' role | To bear the illness with the individual during the session to minimise isolation, and allow the individuals to choose their own level of intimacy and closeness during the session. These are a focus as researchers suggest that separation, isolation and intimacy are associated with psychological crises. |
| How is data recorded? | Sessions aren't tape-recorded or video-taped but instead coded. |
| What do therapists record? | Whether members express psychotic, manic, or depressed thoughts & behaviours. Emotions observed. Verbal expressions of loneliness, loss, dreams, current or past relationships, humour, illness, activity in their lives, helplessness, hopefulness, hopelessness, sexual preoccupation. Supportive or insightful comments. If members engaged or participated in the group. |
| Findings - previous data | Previous assessment of coded data (over 7 year period) suggested that when enough time, support and acceptance is offered, ppts in the group increase their maturation and functioning in a group setting |
| General Finding (names of ppts) | All 6 members had fragile ego boundaries expressed in different ways. Brett Earl Deena Dan Dillon Andy |
| Brett | Gave out Xmas cards & calendars - wanted group to be linked to reinforce group ego boundary. Divides humanity into black, white, yellow and speaks of threes - give structure to fragmented ego boundaries. Told group he received gift of CDs from his sister and would keep it wrapped on the shelf to look at - way of holding himself together over Xmas holiday. |
| Earl | Rejected gifts from Brett - underlying fear of being annihilated & accepting the gift may have triggered fragmentation fears. Showed grandiose, delusional ideas about an OPEC pipeline - delusion holding together fragmented sense of self, so symbolises a boundary between Earl's self & the self of others. Claimed to be 'a Falasha' after being treated in a Jewish hospital - porous ego boundary as he absorbed a false identity |
| Deena | Reported having nightmares for which her psychiatrist suggested she be tested for sleep apnoea. She refused & said she preferred her sleep issues to be treated in a psychological way, through thinking good thoughts before bed - her focus between being awake and asleep is blurred = fragile ego boundary |
| Dan | The previous evening had an out-of-body experience & was very scared he wouldn't be able to get his spirit back into his body - fragile ego boundary during this. Showed the group burns on his arms he had got from being distracted while cooking. He was currently trying to cope with a change in nature of his relationship with his girlfriend (former fiancee) - fragile ego boundary & asking for his relationship to be clearly defined. |
| Dillon | Agreed with a former member from a previous session about people staying in his house (an Aunt had moved in with the previous member), and that over Xmas he would struggle to cope with relatives staying. He suggested he would cope by going for a walk or shovelling snow - His ability to be aware of how much closeness he could handle shows insight. The limited tolerance to personal space indicates a fragile ego boundary. |
| Andy | Was offended by sexual references a former member had stated during a previous session. It's noted that she copes by swimming rigorously each day and limits her food intake, & she also helps several young relatives with hmw each day after school - the self-sacrificing & restrictive behaviours enables her to deal with her fragile ego boundaries. |
| Conclusion | Each group member struggles daily with the environmental, social and biological factors in their S/Z. The sessions enable development of stronger ego defences, for each member through object relations, which enables a relationship between self & others to form. The authors saw their role as allies to the patients & that the group can serve as a buffer to prevent psychological crises, breakdown & rehospitalisation. The group is serving as 'an Ego-structuring mechanism' to offer the members a stabilising force and promote psychological growth. |
| Strengths | Good mundane realism. Ideographic. Accounts from patients is valid. Ethical (no recording) Rich & detailed data. 3 researchers - inter-rater reliability. Good application - used to promote more out-patient group therapy. |
| Weaknesses | Only 1 session - snap-shot (can't track changes over time). Small sample. Subjective interpretations. Lack of recording lowers validity as coding is subjective. Therapist bias - completed coding for 7 years of previous data. Demand characteristics. Only used observation (not triangulation). Not standardised - low reliability & validity. |
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