일 정신과 병실 내의 공동사회 모임ᅳ 3년간의 경험에 대한 분석

Community Meeing in a Psychiatric Ward- An Analysis of Three-Year Experience

The community meeting is an essential program to practice, enculturate, and educate the egalitarianism of the milieu, so it is usually called the keystone of the therapeutic community. We organized and have been operating a community meeting for three years in a 30-bed psychiatric inpatient ward of a university hospital which is a modified therapeutic community with patients of mixed diagnostic entities. Based on the analysis of verbatim scripts of 143 sessions for last three years, we have illustrated a modified format as a model and reviewed it’s vissisitudes and some problematic areas of our experience such as the therapist’s role, topic distribution, resolution of crisis and conflict, and several specific dynamic features of the large group. We also discussed some issues occurring in our community meeting which are summarized as follows: 1. The format of a community meeting can be varied according to ward policy, patient population, goals, and especially leadership pattern. In this respect, our format is a structured one directed by patients and passively supported by nurses. 2. The community meeting has two therapeutic aspects according to the type of topic􀆮 systemmaintaining and large group psychodynamics. These two aspects should be disitrbuted in adequate proportion for successful session. 3. The most stressful therapeutic impact on the community meeting usually occurs through the revelation of conflict and crisis and their resolution. Continuous efforts to understand countertransferential reactions and to gain introspect into the therapists’ own feelings are of prime necessity. 4. The community meeting as large group therapy has several important dynamics that can be neglected in small group therapy and we should understand them fully to utilize them􀆮 role functioning, the anxiety of being isolated and anonymous, the mechanism of splitting, and the feeling of pseudoegalitarianism.