Combining individual and group therapy in an out-patient setting for patients with personality disorders—useful approach or invitation to acting out?

This chapter deals with external limitations first and then goes on to explain the difficulties in handling transference and countertransference in parallel individual and group therapy. Guidelines for outpatient psychotherapy in Germany state that "for psychodynamic psychotherapies a simultaneous combination of individual and group psychotherapy is excluded on principle". Transference and countertransference issues become more complicated when patients see two different therapists for treatment or one therapist in two different settings. In conjoint therapies at least two therapists are actively involved in the therapy of one patient. Critics of combined individual and group psychotherapies sometimes consider them an "invitation to systematic acting out" in therapy. Individual sessions at the beginning of group therapy give patients a head start in therapy. Combining individual sessions with group treatment at the beginning of therapy is also helpful in reducing early drop out rates in group psychotherapy.