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Published Online:https://doi.org/10.1176/ajp.108.10.771

Successful treatment of patients in groups requires consideration of the needs of the individual patients as well as the group as a whole. Understanding of these needs may be aided by the identification and study of behavior patterns shown by patients in early group meetings. These patterns often reflect the patients' habitual ways of dealing with important personal issues, and may strongly influence the group's functioning. As such, they seem to be more closely related to the therapeutic process than are clinical diagnoses in terms of symptoms. This paper outlines a method for identifying such patterns and describes two of them. That of the "help-rejecting complainer" consists essentially of constantly demanding help while denying its usefulness, and seems to express both the patient's feeling that he needs help, and his distrust of all potential help-givers. The " doctor's assistant" stresses his own competence, gives advice, and refuses to admit weakness as ways of claiming superiority. This pattern seems to represent these patients' way of dealing with their conflicting attitudes toward authority. The therapeutic problems posed by these patterns for both the patients and the group in early meetings are discussed.

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