Innercity Day Treatment Population

The group leader worked in an inner city, day treatment program for adult chronically mentally ill substance abusers. He had been leading a psychoeducational group for monolingual and bilingual Spanish-speaking members, with the focus on current events.

One morning, the administrator of the clinic spoke with the group leader and informed him that a decision had been made to shift the name and focus of the group to "Enhanced Communication Skills." This was told to the group leader without warning or discussion.

The leader felt perplexed as he entered the group room, where the usual ten to fifteen members sat seated around a table in the room. One floridly psychotic group member kept his chair away from the others and against the wall, as he had for the previous three years that this group had been in existence and led by this leader.

Feeling a need to say something which would stimulate communication among the group members, the leader thought for a moment as to how best to intervene and came up with the following: "Como communicar un bebe antes que el quido usar palabras" (how does a baby communicate before it can use words?"). For the next two months, the group, which met once a week, tackles this question, with a variety of responses from the group members. The leader felt a sense of satisfaction that some communication was occurring in the group, but was also filled with a sense of boredom and frustration. The members of this group were compliant in answering a question posed to them and responded in ways that they felt were meaningful. These communications were primarily from the client to the person of the. group leader but in this particular group, rarely, was there any interpersonal dialogue among the members during the entire group session.

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