Group psychotherapists: professional and cultural differences

Objective: The aim of this survey is to explore the differences in certain salient aspects of the practice of group therapy between psychiatrists and psychologists and between the two cultural regions of Switzerland. Psychiatrists and psychologists,who differ in their training and forms of professional activity, might also differ in their practice of group activities and their theoretical orientations. In the same way, with the probable existence of diverse schools of thought according to region, group therapists might present differences according to whether their cultural heritage is Germanic or Latin. Methods: A brief questionnaire, comprising questions concerning the therapists and the main group they were handling, was sent to the members of the Swiss Psychiatric Association and the members of the Swiss Federation of Psychologists. This survey covers the therapists who indicated that they practised group psychotherapy (n = 533). Results: Psychologists constitute three-quarters of group therapists, while psychiatrists only represent a quarter. Two-thirds of these therapists live in the German-speaking region and one-third in the Frenchor Italian-speaking region.The overall results show that there exists a sort of basic practice and common theoretical reference in both the professions considered herein and in both cultural regions of Switzerland. The groups that these therapists are handling are mainly small, made up of adults, with diagnoses of depressive, anxiety or personality disorders, and often taking place in psychiatric institutions. Questioned about their principal theoretical orientation, group therapists first mention a psychodynamic approach, then systemic and cognitive-behavioural orientations. Beyond this set of features which are common to both professions and both regions, the main differences appear between psychiatrists and psychologists. Psychiatrists, who are in the majority men, more frequently conduct adult, long-term groups, in private practice. They have a more marked psychodynamic profile than psychologists. In contrast, psychologists, who tend to be younger, are mainly women.They spend more time on group therapies than psychiatrists and they more frequently deal with children and adolescents, sometimes in non-medical settings. More eclectic in their theoretical references, they more often endorse systemic and/or humanist orientations. There is little differentiation between the two cultural regions, nevertheless eclecticism and the choice of a systemic orientation appear more frequently in the German-speaking region of Switzerland than in the region where French and Italian are spoken. Conclusion: Several of the features described for the groups handled by psychologists indicate the practice of family therapies.Thus, it seems that this form of therapy is currently more the domain of psychologists than of psychiatrists. Psychiatrists more often practise a type of group therapy which has been used since the end of the Second World War (with adults, a longer duration, in private practice and with a psychodynamic orientation). In the future, new norms for training, growing economic pressure and a tendency to favour shortterm therapies rather than long psychodynamic therapies will undoubtedly influence the evolution