Group Therapy of Alcoholic Women Ex-Prisoners

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Abstract
Female alcoholic ex-prisoners are an extremely difficult group of patients to treat in an outpatient clinic. They display volatility, oral-narcissistic demandingness, intense phobic behavior and diffuse psychotic thinking, especially when drinking. After some success in aiding these women in groups within the prison and individually on an outpatient basis, an outpatient group was formed to treat released prisoners. The membership roster included 10 women, but average attendance during 24 weeks was 2 or 3 members. The women were in their 30s and 40s with an average of 10 years of schooling. Six came from disrupted home backgrounds and another 2 had at least 1 alcoholic parent. Of 8 who had married all had experienced marital difficulties. The group meetings were marked by uncontrolled behavior on the part of some members, inability to set rules for themselves, intense feelings for the leader, rivalry for the [male] leader, and emotional exclusion of all new members. The leader''s attempt to help the members set limits, to find common issues or to discuss feelings were met with hostile rejection and withdrawal. There was no group cohesion. Demands for immediate oral gratification were constant. In spite of the difficulties in maintaining the group, 7 of 10 women were able to use the hospital and clinic facilities following its termination. Difficulties in aiding these women on an out-patient basis are discussed and alternative approaches are suggested, including the possible use of a female leader or recorder; use of cotherapists, possibly a man and woman team; and starting groups within prison, arranging for simultaneous discharge of members, and continuing the groups in an outpatient setting. Further, establishing clubs for these women is suggested. It was felt that while goals were necessarily limited, combinations of treatment methods can aid them in functioning more effectively within society.

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