Complications in Working with AIDS Patients in Group Psychotherapy.

Numerous research studies have documented that for patients coping with chronic illness, social support is extremely important in facilitating adjustment to the illness. The support may come from organized therapy and self-help groups or from interpersonal relationships outside a group. However, Acquired Immune Deficiency Syndrome (AIDS) is a chronic illness with characteristics that seriously interfere with patients receiving social support of any kind. Three factors: the threat of a drastically shortened life, an unpredictable illness course, and stigma, not only interfere with AIDS patients receiving sustained social support from the outside world but can dramatically influence the process of a psychotherapy group. The factor of early death, which can impact group cohesion, can be dealt with by encouraging mourning and facilitating accurate interpretation of group process. The factors of an unpredictable illness course can impact group cohesion by helplessness, making continuity across sessions difficult, and by excessive focus on individuals. These factors can be dealt with by encouraging expression of feelings, and focusing on the present and on group process. The factor of deviancy/stigma can impact group cohesion by rejection/hatred of self and others, but can be dealt with by providing unconditional acceptance. Therapy is often a matter of helping the patient appreciate life's complexities - to enlarge his/her cognitive worldview and spectrum of emotional functioning. (ABL)