Tese de Doutoramento Biomedicina 2023 Faculdade de Ciências Médicas, Universidade NOVA de Lisboa

With this thesis and given the scarcity of clinical information in this area, it is intended to contribute to a greater dissemination and greater knowledge of groupanalysis and group psychotherapy with a groupanalytic approach, at national level, through three studies. All studies involve group psychotherapeutic treatment of groupanalytic orientation in groups of different sizes, small and medium, with the main investigator as the only psychotherapist. The first study, nationwide, of a descriptive and cross-sectional nature, intends to survey and characterize the technicians with groupanalytic training, taught by SPGPAG, and their clinical practice, through a quantitative investigation, using a survey as a method for collecting data, through a questionnaire in digital format. This was a pioneering study in its area, using a non-probabilistic sample, sequentially selected by a convenience method and according to the objective of the study, composed of 95 respondents trained or undergoing training at SPGPAG. According to the results obtained, the majority of Portuguese groupanalysts are female, married and with children, active and working in the public sector, caucasian, portuguese, natives of the Lisbon region, with degrees in Health’s field, predominantly Psychology and Medicine. Regarding clinical practice, they work mostly with Psychotherapeutic Groups of Group Analytical Orientation, predominantly in the public sector, each respondent had an average of two small, heterogeneous weekly groups, with 90- minute sessions, treatments with an average duration of four years, composed of people with the following diagnoses: depressive, personality, psychotic, affective, anxiety and psychosomatic disorders. The second study, also pioneering at national level, of a qualitative nature with an essentially phenomenological approach, intends, using the Thematic Categorical Content Analysis, to know, through the feedback of the participants, which mental dimensions involved in the passage of a psychotherapeutic small group for a medium group, evaluating whether the psychotherapeutic treatment would be perceived by the users in a significantly different way. For this purpose, a non-probabilistic convenience sample for the study was used, consisting of 12 users followed in the outpatient consultation of a public hospital in the city of Lisbon. According to the results, it can be stated that, in addition to not existing a significant difference between psychotherapeutic treatments in small and medium groups according to the perception of users, there is a difference in terms of Interactivity, with a greater Dynamism among the elements of the middle group, and also at the level of Temporality, through the prevalence of the idea of Evolution among users of that same group. The third study, also pioneering at national level, of quasi-experimental (intervention), analytical, prospective and longitudinal nature, intends to study whether the therapeutic effectiveness varies depending on the size of the psychotherapeutic groups, small versus medium, over three evaluation moments: at the beginning of treatment, at the end of three months and at the end of six months of treatment, through the application of two self- administered questionnaires, SCL-90-R and EBEP, in a public hospital in the city of Lisbon. It was a non-probabilistic sample, consisting of 132 users, divided into two psychotherapeutic groups and a control group. The results showed no differences either at the level of the general index of symptoms or at the level of the general index of psychological well-being in relation to the psychotherapeutic groups, that is, both groups, small and medium, proved to be therapeutically effective. Even so, the average psychotherapeutic group showed a significant decrease in psychopathological symptomatology from the third to the sixth month of treatment, showing that the group psychotherapeutic intervention with a groupanalytic orientation is quite effective in a group of this size after 6 months of treatment. The study also had some limitations - the composition of the experimental groups proved to be heterogeneous regarding the variables gender, marital status, work, diagnosis, and number of hospitalizations - which allowed for critical and constructive reflection within the scope of this clinical research. In terms of final considerations, the importance of the studies presented was highlighted, not only due to the lack of them at the national level and hence the contribution to a greater dissemination and greater knowledge of Group Analysis and Group Analytical Psychotherapy, but also due to the scarcity of research internationally in this specific area. Particularly noteworthy was the contribution given to the study of medium-sized psychotherapeutic groups as an effective therapeutic alternative in a hospital context. Some reflections were also made on the role of the psychotherapist versus the researcher in a public institutional context