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O presente trabalho pretendeu sistematizar a teoria e a prática de Grupo Operativo, a partir de uma experiência de coordenaçäo desta modalidade grupal no Hospital-Dia do IPUB-UFRJ, utilizando a metodologia de pesquisa-açäo

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Os autores analisam a sua experiência como co-terapeutas em grupos de casais sob o ângulo de identificaçäo. Usam, como referenciais em seu estudo, os papéis complementares masculino/feminino, forte/ fraco, dominante/submisso, afetivo/distante e ativo/passivo para estabelecer a sua posiçäo referente ao "casal terapeuta" (homem/homem, homem/mulher, mulher/mulher). Revisam a literatura no tocante a essa questäo, discutem-na e terminam por afirmar que, igualmente como nas psicoterapias individuais, os papéis säo atribuídos pelos pacientes aos seus terapeutas, independentemente de sua condiçöes humanas reais

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In this paper, ideas and methods for working in group psychoterapy with hemiplegics and post-heart-attack patients in a general hospital in Mexico City are outlined. With hemiplegics support therapy is used and with heart-attack-patients, learning therapy. Both groups meet once a week.

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An operational group is defined; how operational groups theory was applied at an ISSSTE clinic is described. It is underlined how operational groups promote change around the corerstone of a "task". The vicissitudes of an operational group with four psychiatrists who worked in community psychiatry at the ISSSTE, are described.

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At the ISSSTE, a community psychiatry program was created and is being developed in two areas: the population of beneficiaries who attend two clinics and groups of employees of those same clinics at their respective places of work. The main purpose is to carry out prevention in mental health. In this report only the work in the first session of eight employee operative groups is reported. The method, the difficulties and the characteristics of the groupings are explained. Some theoretical aspects are shown. Results showed: 1. Little correspondence between the internal reality of the beneficiaries. 2. Difficulties in communication which produce differences of criteria with the clinic. 3. Difficulties in the internal distribution of power. 4. Unnecessary expenditure of energy. 5. Suggestions to solve the problems handled in the group. 6. Resistance against responsibilities.

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Since most of the patients who attend for psychiatric consultation at a clinic are little motivated for psychotherapy, analytic group therapy was attempted, with basis on studies on psychological genetics, on groups management, and on the theories of Freud, Klein and Bion. Several open groups were handled, with the following achievements: 1. A decrease in anxiety, and increase in the objective vision of reality and in increase in the ability to see past and present conflicts. 2. A greater tolerance to agressive and sexual instincts and to frustration. 3. A greater personal acceptance, ability to sublimate productively and elimination of clinical symptoms. Varying degrees of improvement, and lesser need for psychiatric medication and hospitalization were obtained. Several problems were encountered: a) Desertion of 30% of patients from the sessions, due to the disapearance of symptoms buth with no character changes (resistances). b) Temporary absence or habit of arriving late to the sessions (resistances). c) Overwhelming passivity. The groups were handled in cotherapy and the work was supervised with experienced therapists. To attempt solving the above mentioned problems a better selection of patients was made, complete clinical histories were elaborated, a battery of psychological tests was made, and diagnosis, dynamics and prognosis of each case were outlined; this allowed the evaluation of middle and long term treatment. It was suggested to change the technique to that of operative groups.

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