Vol.:(0123456789) 1 3 Community Mental Health Journal https://doi.org/10.1007/s10597-018-0329-6 BRIEF REPORT The Importance of Structure and Connection for People Living With Schizophrenia: A 33-Year Outpatient Group Experience Danielle B. Rice 1,2  · Alexandra Zorn 2  · Maxine Sigman 1,2,3 Received: 15 December 2017 / Accepted: 17 August 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract This paper evaluates an outpatient group for persons living with schizophrenia. Qualitative changes and psychiatric admis- sions among group members were reviewed to measure recovery. Thirty-two members have attended sessions for up to 28 years. Meaningful interactions (e.g., supportive comments) have increased and hospitalizations have decreased. The sup- port of the therapists and the other group members has allowed for personal recovery and developing and maintaining social connections. Prior to starting the group, 67% of members had > 1 hospitalization and 26% had none. During the group, 63% of members had no hospitalizations. Vignettes of change, peer support, fewer hospital admissions, and signs of recovery in the face of crises suggest that members beneft greatly from this outpatient group. Keywords Schizophrenia · Psychiatric rehabilitation · Long term group therapy Introduction Persons with serious mental health disorders such as schizo- phrenia often experience a number of difculties including increased mortality rates, disorganized thinking, distorted perception (e.g., hallucinations), and emotional difcul- ties (American Psychiatric Association 2013; Kring and Caponigro 2010; Kring and Moran 2008). To cope with the consequences of living with a chronic mental illness, psychotherapy is one approach that aims to decrease psy- chotic symptoms and restore functionality to improve quality of life (Haller et al. 2014). Practical issues, however, have been identifed when trying to provide therapy to outpatients with serious mental illnesses due to the chronic relapsing and remitting nature of these disorders (Berry and Haddock 2008; Haller et al. 2014). This paper evaluates the useful- ness of a real-world outpatient supportive group facilitated by a psychologist among persons with chronic mental health disorders. Background of the group structure, barriers to the initiation of the group, summary of early outcomes, and long-term outcomes, and potential mechanisms of change of an existing outpatient group are presented with both quanti- tative and qualitative information. The Thursday Group Structure and Goals in Group Formation The Thursday Group began in 1985 for people living with chronic mental health conditions including those diagnosed with schizophrenia. The group occurs weekly and the struc- ture is consistent, each session begins at noon and continues for 45 min. Entry into the group requires a referral from a professional in the department of psychiatry at the Jewish General Hospital, located in Montreal, Quebec. All group members receive psychiatric follow-up, while social work- ers and occupational therapists are also available as part of standard care. Once referred, each potential member is asked to call the group leader, a psychologist, as an indication of their motivation. Membership in the group is open-ended, whereby, members can remain in the group indefnitely but are asked to call the group leader if unable to attend a meeting. Since 1997 the leader has had 1–2 psychology interns’ training as co-therapists. To date, over 50 interns * Danielle B. Rice danielle.rice@mail.mcgill.ca 1 Department of Psychology, McGill University, 2001 McGill College Ave, Montreal, QC H3A 1G1, Canada 2 Jewish General Hospital, 3755 Chemin de la Cote-Sainte Catherine, Montreal, QC H3T 1E2, Canada 3 Department of Psychiatry, McGill University, 2001 McGill College Ave, Montreal, QC H3A 1G1, Canada