From Isolation to Interaction: A Novel Group Counseling Approach to Addressing Negative Symptoms in Schizophrenia and Bipolar Disorder

This study aimed to evaluate the effectiveness of an empathy-expanding in-depth group counseling program for the recovery of negative symptoms (such as avolition, social withdrawal, and isolation) in individuals with bipolar disorder and schizophrenia who were in a relatively stable phase (with an average illness duration of more than three years) while concurrently receiving outpatient medication. A total of 24 anonymous volunteers (including 3 duplicate participants) were recruited with the cooperation of the Korean Schizophrenia Recovery Association (Simjihoe). Approximately half of the participants were referred to the program involuntarily by their family members. Participants were divided into four groups of six individuals each and engaged in the program for three sessions, meeting once per week for two hours via mobile chat-based counseling. The program was conducted sequentially across the groups and was implemented over a four-month period.To validate the program’s effects, both self-reported feedback and observations from family members were collected through surveys and text messages, and additional phone and face-to-face interviews were conducted to enhance data reliability. At the end of the third session, 78% (n=18/23) of participants reported positive changes in their daily lives, with approximately 40% specifically experiencing improvements in their interpersonal relationships. Furthermore, follow-up assessments conducted three to six months later confirmed that 70% (n=14/20) of participants maintained these positive changes. These findings suggest that this novel approach—digital, empathy-expanding in-depth group counseling—effectively mitigates depression and anxiety in individuals with severe mental disorders while facilitating lasting improvements in interpersonal relationships and external activities. Notably, the participant-friendly design and the significant behavioral changes observed despite the program’s short duration underscore its substantial social and psychological implications.