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Group Analysis
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Hierarchy and/or Reflectivity: the Role of Groups in the Function of Psychiatric Wards

Zoltán Terenyi

acute psychiatric ward of a county hospital in Hungary

Gabriella Kis

Child Guidance Center in Budapest

Jáanos Eszik

Terenyi, Zoltán dr., Kaposi Mór Megyei Kórház Pszichiátriai Osztály, H-7400 Kaposvár, Pf.120. Hungary terka{at}axelero.hu

Psychiatric wards in Hungary and elsewhere in Europe, even with modern concepts, possess features of totalitarian systems: controlling, maintaining a strong hierarchy in the structure, an authoritarian leadership style, regulated autonomy and reduced to one-way communication. Group therapy aims at free communication, empathic leading, cooperation and functional agreements, reflectivity. In this paper we analyze components of this apparent dichotomy in the context of contemporary psychiatric wards. A theoretical definition is given for the possible degrees of hierarchical rigidity on psychiatric wards based on decision-making procedures, the acquisition and distribution of resources and analysis of boundaries and functional features.

Key Words: psychiatric wards • hierarchical structure • patients • staff • group therapy

Group Analysis, Vol. 37, No. 1, 45-64 (2004)
DOI: 10.1177/0533316404040994
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?