First do no harm?

Abstract

Group analysts seldom write about the risk of harming their patients. Yet it is now widely recognized that all psychotherapies come with a small risk of harm and this risk has remained since it was first identified in the 1970s. In the wider group psychotherapy literature, risk of harm has been linked to the poor management of conflict and scapegoating, the misuse of interpretation, narcissistic leadership and unsuitability or lack of preparation of patients. Group analytic writers have examined each of these areas to varying degrees but not from the perspective of harm to the patient. This article highlights this ‘blind spot’ within the profession and signals the need for action.