Group Therapy in a County Tuberculosis Sanatorium

A Psychologic Approach to the Problem of the Chronically Ill Confined Patient

¹ The Department of Medicine (Neuropsychiatry), Stanford University, San Francisco. Consulting psychiatrist, San Mateo County Tuberculosis Sanatorium. Consultant to Division of Chronic Disease and Tuberculosis, United States Public Health Service.

Group therapy is proposed as a means of helping hospitalized chronically ill patients with enduring physical handicaps. For two and a half years tuberculosis patients have been seen in group psychotherapy. Small groups of eight to 15 patients were seen at weekly intervals for 12 to 15 sessions. Groups were composed of mixed sex and race. Factors dealing with problems of emotional adjustment and acculturation were dealt with in the group.

Additional group work was carried out in professional and non-professional staff meetings, with family and visitor groups and also the entire sanatorium population which was ambulatory. Group attendance and interest was good.

There seemed to be an increase in hospital morale, amelioration of individual patients' anxiety and depression and a decrease in number of patients with positive sputum leaving AWOL. Certain changes in hospital routines and staff attitudes have occurred.

The group leader should be a psychiatrist or specially trained professional person.

A necessary prerequisite for successful group therapy is an interested and relatively non-rigid hospital administration, willing to adopt a scientific attitude.

It is possible by group therapy to reach a large number of patients with relatively small expenditure of time and effort. The goals of this type of group therapy are not to cure patients of their neuroses nor make them happy, overly complacent patients, but to help them adjust to the necessary ordeal of sanatorium confinement. It is a technique with definite limitations and advantages, and will not appeal to all patients.

Patients themselves, more than the therapist, help one another in the groups. Realistic acceptance of membership in a small group permits easier acceptance of membership in the large hospital group, and possibly a more mature acceptance of the disease and its meaning to the patients' family and friends as well.

This is a preliminary report and no significant claims are made. Further study in several different sanatoria should be undertaken.

The conceptual program could be utilized with other medically ill non-psychiatric patients confined in hospitals.