I like balancing the needs of patients with a variety of psychopathologies in one setting. I find this challenging and interesting. I ran groups with the topics of coping skills, wellness, family issues, emotional exploration, self-esteem and music therapy (my music group was blast on the inpatient unit - I chose 2 songs, printed out the lyrics, we listened to the song as a group and extracted concepts/ideas that were relevant to each...sometimes very thought-provoking discussion came from this task). The group members decided which groups to attend (or it was suggested to them by their clinician), we set the ground rules at the beginning of each meeting, and discussed & tag teamed off of each others' comments. There were individuals who were combative but it was indicative of their pathology. For 45 minutes, I was on my toes (so to speak) encouraging engagement and tempering narratives that were too long or irrelevant or straying off-topic. Overall, the patients "did the work," and I facilitated in a way that may introduce salient issues in certain individuals who had not yet explored those issues among others (like the realism of addiction that one may identify with when hearing another's story) or bring resolution to an issue with the groups' opinion (patient reveals he can't maintain a relationship because he is "repugnant," whereas the group may voice different, more supportive opinions to counter the patient's previous thoughts...all of which are novel experiences in the identified patient's life).
There is a ton of layperson philosophy floating around in group therapy (as a clinician we sometimes want to say what we are thinking but cannot because it is not 'therapeutic' or the timing is off...however, other group members may say whatever is on their minds & it is sometimes helpful to lay it out on the table), but it is the job of the clinician to make it apply to the group in a way that confronts some issues, but becomes safe enough to be revealed to others and sometimes validated. (An example, I've had patients tell other patients that they were "rude" or "inconsiderate," and then identified patient may find this intriguing because his/her point-of-view is different, and a giant discussion ensues with the result being that those patients who shared their feelings becoming more cordial to the one behaving rudely, and the "rude" patient becomes grateful for the insight - which could end up being efficacious treatment for shorter lengths-of-stay on inpatient units, but I don't have the data to back up that statement right now...meanwhile I'm working on making sure the conversation doesn't become counterproductive with patients leaving the session with a more depleted sense of self than when he/she arrived to the group.)
These are my experience in a nutshell. Also, if you look at DBT, the skills training groups are a pretty important component. It is the opportunity to contemplate actions outside of your own experiences but in a way that can relate to similar others (or should I say those with similar psychopathologies?). And if you think about the types of personalities disorders that require DBT, half of the work is exposing these patients to others' ideas in a way that has never been received before (i.e., family members may tiptoe around these folks, but a co-member of group will say it like it is). Then, the patient has the opportunity to discuss how the group personally impacted him/her in his/her individual therapy.
