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Background: The experience gained in working with psychotic persons as well as the findings from the literature have pointed to the need for systematic inclusion of the families of affected individuals, facilitating the creation of partnership within treatment, and to the need for a better understanding of family dynamics that reflects on the psychological conditions of the patients. Aim: The aim of this paper is to explore the changes in self-esteem and loneliness of group members during the therapeutic process and whether the use of more mature defence mechanisms is the answer to the treatment of group psychotherapy. Subjects and methods: We followed three groups of 30 members (18 women and 12 men). At the beginning of inclusion in group psychodynamic psychotherapy and after 18 months of psychotherapy, members completed the following questionnaires: Rosenberg Self-esteem Scale, short version of UCLA Loneliness Scale (ULS-7) and Lifestyle Questionnaire (LSI). Results: The research results show a statistically significant increase in self-esteem, a significant reduction in loneliness, and significantly reduced use of defence mechanisms after 18 months of group psychotherapy. Conclusion: Research findings confirmed positive changes in family members who gradually feel better and safer, with less anxiety and fear, all positively reflecting on the family atmosphere, the ability to accept and understand the sick member, as well as his better quality of recovery.

Psychiatric Hospital "Sveti Ivan" in Zagreb, Croatia, offers an outpatient Early intervention programme for patients with psychotic disorders (RIPEPP), consisting of psychoeducational workshops and group psychodynamic psychotherapy. Psychodynamic group psychotherapy presents a unique conceptual format not offered by other types of psychotherapy, and it is especially useful for population of patients with psychotic disorders. During group work, gradual establishment of communication and interactions, and creating a network of relations through experiences of corrective emotional symbiosis, affect the constellation of internal objects and relationships between members, and their restructuring. The function of group psychotherapy is not only to offer relief, support, and elements of education, but also to enable internal changes. Therapeutic factors contributing to the improvement of people with schizophrenia include supportive aspects such as universality, acceptance, cohesion, hope and altruism. This paper contains vignettes from inpatient and outpatient group dynamics.

Background: Treatment of early phase of psychosis is important not only for overcoming the acute symptoms but also for the later treatment and attitude towards the illness. Psychotherapeutic approach is an integrative part of this treatment. In Psychiatric hospital "Sveti Ivan" in Zagreb, Croatia both psychotherapeutic and sociotherapeutic methods are used on the inpatient unit for young people with psychosis along with medications. The aim of this work is to present the work on the psychotherapeutic inpatient unit and to investigate whether during the hospitalisation of individuals with first psychotic episode changes occur in attitudes towards medications, quality of life, insight and self-esteem. Subjects and methods: 37 individuals with first psychotic episode (20 men, 17 women) completed the following battery of questionnaires upon hospital admission and before discharge: Drug attitude inventory (DAI-10), The World Health Organization Quality of Life (WHOQOL), Insight scale and Rosenberg’s Self-Esteem Scale. Results: Before being discharged from hospital, patients assessed their quality of life as significantly improved over time (p=0.000), especially concerning their physical health (p=0.004), psychological health (p=0.004), and satisfaction with their environment (p=0.001). Also, positive trends were observed in attitudes towards drugs and self-esteem. No changes were shown regarding patients´ insight. Conclusions: The findings are encouraging: during treatment on psychotherapeutic inpatient unit, significant improvement in quality of life was observed, as well as positive trends in self-esteem and attitudes towards medications.

The hereby presented guidelines for the use of psychodynamic psychotherapy are based on references and research in the field of individual and group therapy and they refer to psychotherapy for patients suffering from the first psychotic episode, schizophrenia, schizoaffective psychosis, bipolar disorder and paranoid psychosis. The aim was to provide an overview of present literature and to give recommendations based on current knowledge. Clinical experience and research of the outcomes of psychodynamic psychotherapy encourage positioning of such treatments among recommendations for treating various mental disorders, as well as in the field of psychotherapy of patients with psychotic disorders (PD).

Background: This study aimed to examine the relationship between some personality characteristics of patients diagnosed with psychotic disorders and the quality of their engagement in psychodynamic group psychotherapy. Given that previous research has shown that self-stigma is significantly negatively associated with the engagement of patients, the measure of self-stigma was used as a correlate of patients’ motivation to participate in group psychotherapy. Subjects and methods: A total of 48 outpatients (52.1% women; mean age 35.30 years) attending group psychodynamic psychotherapy completed The Inventory of Personality Organization, The Pathological Narcissism Inventory, The Measure of Parental Style, The Relationship Questionnaire, and The Internalized Stigma of Mental Illness scale. Results: The findings showed that patients with higher levels of self-stigma have unhealthy attachments styles, perceived their mothers´ parental style as indifferent and achieved greater scores on narcissistic vulnerability scale. They are also are prone to primitive psychological defences, have poorly integrated identity, and achieved lower scores on reality testing dimension. Conclusion: Taking into account the limitations of this study, these findings may contribute to improved understanding of the quality of participation and engagement of psychotic patients in group psychotherapy, and may help to develop more effective therapeutic approaches.

Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.