ABSTRACT
Dear Consultant: The attendance and membership of my ongoing group has been unstable lately. One patient, Jack, was hospitalized for depression and substance abuse two weeks ago (I expect him back in two weeks), and a month ago another left permanently with Lou Gehrig’s disease. A third patient, Marguerite, comes to group erratically, and no matter what intervention I make, seems to have a hard time committing to weekly attendance. This is new behavior over the past few months (prior to that she attended group almost religiously). She says that she has been unable to come regularly because of work commitments, but I have a sense that something else might be going on. Along with the two people who have just left, another patient, Suzanne, has complained for some time now that the group is not helping her (even though she gets more time each week because of the limited membership). She berates me each week for my failing her, and then she tries to get other patients to side with her and further criticize me. They say that I don’t talk enough in group, and that they are not making progress on their issues. When they are feeling particularly critical, they use Jack as an example of how unhelpful I am. They say if I was really a good therapist, he wouldn’t have needed hospitalization, which I am beginning to feel myself.
