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The Utilization of a Modified Fairweather Model and Group-as-a-Whole Treatment with Severely Mentally Ill Adults

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Length: 1 hour 30 minutes

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Diana Semmelhack, PsyD & Tanya Gluzerman, MA

There are few housing options for severely mentally ill individuals other than long-term care facilities (Nursing Homes) in the United States.  Recently, New Beginnings Community Services (NBCS) and National Alliance on Mental Illness (NAMI ) launched an innovative housing option using original principles of the Fairweather lodge model with modifications. Particular emphasis was placed on establishing a living environment that was compatible to community living. In addition, this modification of traditional housing made unique use of a Group-as-a-Whole framework (based on the Tavistock Model).  The Group-as-a-Whole component included bi-weekly, one hour meetings with a group consultant (psychologist) who directed comments to the whole group versus any given individual in the group.  Concurrently, group members learned social psychology concepts believed necessary for effective functioning in the community during a 15 minute didactic portion of each group.  Ultimately the house members formed a team (group-as-a-whole) geared towards problem solving and effective conflict resolution. 

An initial investigation was conducted in which ten subjects completed a 16-week evaluation period in the control group setting (standard group home) and 7 subjects were evaluated during the group-as-a-whole treatment.  Baseline measures of self-efficacy and cohesiveness before the start of treatment were compared between groups by unpaired t-test.  Significant changes from baseline were determined in each group by repeated measures analysis of variance with Tukey Tests used for post-hoc testing.  There was no difference between the control and experimental groups at baseline.  After the 16 week treatment, self-efficacy did not change in the control group but increased by 50% in the experimental group from baseline to 16 weeks.  The group-as-a-whole setting also produced a significant 35% increase in cohesiveness from baseline to 16 weeks of treatment.  The control group showed no significant change in cohesiveness. 

Following this study, more recent innovations have included the implementation of an interpersonal group therapy. This weekly group-as-a-whole treatment modality has included experiential, process-oriented, and skill based processes and exercises to facilitate awareness of boundary management, conflict resolution, self-disclosure, the awareness of healthy and unhealthy relationships, and how one defines oneself independently and in relation to others. Current research has begun to examine the effect of the treatment on the development of ego identity and social problem solving skills. Thoughts and reflections on the program as-a-whole are shared in addition to directions for future research and programming.


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