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USE OF MOVIES FOR GROUP THERAPY OF PSYCHIATRIC INPATIENTS:
THEORY AND PRACTICE
This study was carried out at the Kocaeli Derince Training and Research Hospital,
Kocaeli, Turkey.
Esra Yazici, MD, Psychiatrist, Kocaeli Derince Training and Research Hospital, Kocaeli,
Turkey ([email protected])
Fuat Ulus, MD, Psychiatrist, Community Counseling Center, Hermitage, Pennsylvania, USA
Rabia Selvitop, Psychologist, Kocaeli Derince Training and Research Hospital, Kocaeli,
Turkey ([email protected])
Ahmet Bülent Yazici, MD, Kocaeli Seka State Hospital, Kocaeli, Turkey
Nazan Aydin, Full Prof, MD, Clinic Chef of the Department of Psychiatry, Faculty of
Medicine, Ataturk University, Erzurum, Turkey ([email protected])
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Author for correspondence is Esra Yazici ([email protected]).
Mail: Kocaeli Training and Research Hospital, Department of Psychiatry, Kocaeli, Turkey
Cell Phone: +905333870679
ABSTRACT
This paper reports on the use of cinema therapy at a psychiatry clinic for inpatients. The
program, “Watching Cinema Group Therapy,” was used with over 500 inpatients over the
course of one year. We found that using movies for group psychotherapy sessions encouraged
the patients to talk about their beliefs, thoughts, and feelings while discussing the characters
and stories. We also used the movies as a reward for patients who had developed a
therapeutic alliance. It motivated the patients to be active instead of simply remaining in their
rooms. As a follow-up to full-length films, it was more useful to show short scenes to patients
who had been administered high doses of drugs. Movies can be an important, positive and
productive means of treatment and teaching.
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INTRODUCTION:
Inpatient clinics care for patients with schizophrenia, bipolar affective disorder, severe
depression, addictions, and other severe and acute psychiatric disorders. Positive symptoms
of psychotic patients, such as excitation, aggression, hostility, hallucinations, and delusions,
usually are easily controlled by medication. However, some symptoms, such as refusal of
treatment, lack of cooperativeness, lack of social responsiveness or interest in others, serious
communicative impairments, failure to develop normal relationships or friendships, and other
cognitive disabilities caused by illness, need therapeutic treatment in addition to medication
(Yildiz et al., 2002). Here, group psychotherapy may support medicines as a complementary
approach. However, inpatients in groups have different diagnoses and symptoms at different
levels of severity and thus have diverse needs. Patients with forms of psychosis need to
control their impulsivity, gain insight, and override the tendency to over-excitement and
aggression, as well as other symptoms. Depressives and other neurotics need a supportive
therapeutic approach and cognitive reconstruction. These different needs require integrative
and enhanced approaches during group therapy (Yalom & Lesczc, 2005). Thus, a multi-
faceted approach may support group therapy and provide an opportunity to help these people
in areas where medicines may not be effective. Films facilitate the use of several therapeutic
tools, such as imagination, story, music, sound effects, role playing, visual and auditory
expressions of life, different viewpoints, and so on (Wolz, 2005).
Films are produced with the primary aim of entertaining people, but recently films
have been used increasingly to educate behavioral health trainees about various disorders.
Films are used to demonstrate symptoms of these disorders, patient–therapist interactions,
and various medical and psychiatric issues (Kalra, 2011). They have also been used as a tool
for teaching. They can be a powerful means of motivating and educating psychiatry trainees
as well as conducting the psycho-education of patients (Cape, 2009). The use of movies as
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part of various psychotherapies has been stimulated by the fact that technology has made film
so widely available. Hauke (2009) reported that in psychotherapy sessions, patients started to
talk about both the films they had seen and their life stories or dreams. There is a growing
body of literature describing the use of movies as a catalyst to engage patients in highly
stressful topics (Garrison, 2007). New guides for cinema therapy and related articles and
books are added daily to the literature on using movies in psychotherapy (Dermer &
Hutchings, 2000; Lampropoulos, Kazantzis, & Deane, 35; Sharp, Smith, & Cole, 2002; Ulus,
2003; Wedding & Niemiec, 2003). Formal studies of movies and the use of movies in
personal therapy have been conducted for several years (Ulus, 2010). The use of movies for
groups of outpatients and for occupational education has also been reported (Ulus, 2006).
The personal analysis of films, the use of films in psycho-education, especially for
medical staff, and the use of films in personal therapies constitute the majority of topics on
this subject. For instance, Garrison (2007) showed the beneficial effects of using movies in
facilitating family engagement in psychiatric hospitalization, and Ulus (2003, 2006, 2007)
demonstrated the positive effects of movies in cognitive behavioral group therapies, in
therapy groups for bipolar outpatients, and in therapy groups for prisoners.
Using movie clips in psychiatric group therapy and rehabilitation provides the
participants with three E’s: Entertainment creates a comfortable atmosphere with respect to
the treatment setting; Education provides insight; and Empowerment motivates patients with
respect to their therapy. Both the activity of watching a film and the role of films in group
therapy facilitate these functions (Ulus, 2003).
The dynamic dimension of psychotherapy provides the main perspective on
understanding how movies work in group therapies. In psychotherapy, movies function as
metaphors, which are used to convey meaning to the symbolic, creative parts of the brain, and
which bypass the analytic and logical parts of the brain (Sharp et al., 2002). The neuro-
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scientific perspective is also valuable in understanding how movies work in group therapy. It
has shown that the brain is influenced by watching movies, and it responds to movies in
different ways (Hasson et al., 2008). The response of an individual’s brain to a movie is
determined by his or her emotional, cognitive, and intellectual background and personal
characteristics. We are, in a sense, watching ourselves (Zacks, Speer, Swallow, & Maley,
2010). With regard to concepts of the conscious and unconscious mind, Milton Erickson
suggested that metaphors appeal to the conscious mind because they are interesting, while at
the same time they mobilize the open and automatic unconscious mind by activating
unconscious association patterns. In some cases, clients resist messages and interpretations
from the therapist by intellectualizing or refusing to consider concepts and ideas as personally
relevant. Metaphors provide a less direct form of communication that speaks to the receptive
parts of our personality (Sharp et al., 2002) (Erickson, Rossi, & Rossi, 1976).
In psychotherapy, as with the analysis of dreams, a patient’s description of a movie
scene, a story, or a character is a stimulus for the imagination and understanding of the
therapist and other participants in the group. Watching the movie may suggest a dream or
idea that the group members perceive in common, and which can be discussed. Movie scenes
are as capable of unfolding unconscious mental content and stirring emotional responses as
dreams or transference events (Hauke, 2009).
While we are watching a film, we perceive it in our particular way. Movies help to
frame life for the viewer, turning it into “art,” that is, into something he or she can take in,
reflect upon, and store. Psychotherapy enables reflection, consciousness, and the retrieval of
lives that might otherwise slip away unconsciously and wastefully into the shadows. Cinema
frames reality, which people require if they are to live it and know about what they really live
(Hauke, 2009).
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The cognitive behavioral dimension of group therapy sessions and watching films
should not be ignored. Watching a film with a group may provide a patient with an
experimental life-event that promotes behavioral tasks of social interaction. Furthermore,
each movie may serve as an individual’s independent life experiment. The behavior and
thoughts of film characters can be used therapeutically to reframe and seek alternative
thought and behavior patterns, which would align with cognitive–behavioral group therapies
(Wolz, 2005).
In sum, the experience of seeing a film does not necessarily coincide with the film’s
content. In spite of the particular intentions of filmmakers, movies provoke widely varying
responses and generate different meanings for different people. An individual can respond
differently to film each time he or she views it. Film offers self-involvement, psychological
projection, and a safe place to experience events. According to Carl Jung, “The cinema, like
the detective story, enables us to experience without danger to ourselves all the excitements,
passions, and fantasies which have to be repressed in a humanistic age” (Jung 1931, CW10.
para. 195) (Hauke, 2009).
A review of the existing literature reveals that using cinema as a tool in group therapy
for inpatients with severe psychiatric illnesses is a novel approach. The psychiatric clinic at
[NAME?], a training and research hospital in Turkey, has been providing such a program for
severely ill psychiatric patients who have been hospitalized. The present study reviews the
program, “Watching Cinema-Group Therapy,” which has run successfully for one year with
more than 500 inpatients.
Cinema Therapy for Groups: Watching Cinema and Group Therapy
Initially, all films for potential use in inpatient group therapy services were listed.
The cinema therapy team (the authors of this article) and the psychiatry clinic staff
contributed to the film selection. Staff and authors compared their notes about films’ issues,
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usage and suitability by e-mail and in weekly meetings. Films that contained aggressive,
sexual, or stigmatizing scenes were excluded. The DVD formats of the films selected were
then procured, and the screenings were given in the mornings through a projection system.
Sessions usually started with a short introduction of the film, which emphasized that it was
important to understand the message and therapeutic topic of the film. Patients with all
diagnoses were allowed to view the films, except those with symptoms that might have led to
unacceptable behavior that day (e.g., agitation, excitation, severe elevation of mood, etc.)
The patients were instructed to watch the film closely and, if required, ask that
certain scenes be replayed for better understanding. A therapist attended each session and
took notes concerning reactions by the patients (e.g., laughing, crying, sleeping, clapping,
anger, etc.) to the scenes in the film. These notes then became a tool for the therapist to
elaborate during the group therapy sessions.
The group therapy sessions, which were moderated by psychiatrists, were held in
the afternoons. During each session, the participants were informed about the purpose of the
group therapy and the use of cinema in psychotherapy. A review then took place, with
specific attention to the subject of the film. Because of the heterogeneous diagnoses and
conditions of the inpatients, a film usually evoked many associations, which resulted in a
wide variety of topics. Thus, the group decided on the topic or scene to be discussed. If
necessary, the film was paused at scenes that depicted different aspects of the chosen topic,
such as a psychiatric condition or a patient–therapist relationship, to encourage further
discussion. The patients were expected to comment on their thoughts and feelings about the
film and, if appropriate, the relationship of these thoughts and feelings to their real life. Titles
of the films used are listed in Table 1, and the topics of the group sessions are listed in Table
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Below is a series of points that we believe to be positive aspects of this program.
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1. First, watching a film is an activity of “normal” people. In this program, patients with
severe psychiatric diseases perform a normal activity, which encourages them to feel
integrated in an ordinary social life at least for a few hours. The patients sometimes
expressed that they missed doing “something normal” and expressed their gratitude
at the group feedback session.
2. It is very hard for these people to go to the cinema or find friends with whom they can
watch a film. This program provides a social experience that is almost impossible in
their real life. Most patients came to the first session of cinema therapy in their usual
clothing, but at the second and following sessions of cinema therapy, we observed
that the patients had taken extra care with their appearance, as if they had prepared
for a social outing. The female patients had combed their hair and had put on
makeup. Eventually the patients commented on these changes in external appearance
and complimented each other.
3. Watching films in the group also promoted the behavioral education of the patients.
They experienced joining a group, joining an activity (watching cinema), interacting
with others, controlling their behaviors, observing the behaviors of others, and
observing their responses and those of others to the films.
4. We observed that these activities motivated the patients to talk about their beliefs,
thoughts, and feelings while discussing the characters and stories. These were
projective clues for the therapists. The patients were asked to understand and define
the thoughts, feelings, and beliefs of the characters and compare them with their
own. Thus, the films served a catalytic function for recognizing and announcing
feelings and thoughts, which comprises the first and basic stage of the journey
towards cognitive, emotional and behavioral transformation and healing.
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5. Patients who had refused to talk about personal issues with the therapist during clinic
visits shared their ideas about the films at group therapy sessions, sometimes
tentatively and sometimes openly. Thus, at the end of the group session, the needs
and feelings of the patients had been verbalized, leading to a therapeutic alliance.
Patients who joined the groups were observed to have a better relationship with the
clinic’s staff.
6. Patients who watched the same film and then joined the same groups (most patients
talked, and they all listened to each other) were observed to have better relationships at
the clinic. Some patients were in conflict with others and refused to talk if they were near
their opponents. However, because the films provided a topic for shared discussion,
which did not require them to discuss their special world, even these patients stayed and
contributed to the group. Tension between patients was often eased toward the end of the
group session.
7. With regard to schizophrenic and schizoaffective patients, whose avolition, apathy, and
social indifference required treatment, watching the films and participating in the group
therapy sessions provided occasions for social interaction. The films and group therapy
sessions also provided these patients with opportunities to learn to contribute to a group,
such as waiting for a suitable time to talk or respond, talking about themselves, listening,
and understanding. Trying to remember the films and to describe and think about them
also became a useful cognitive exercise.
8. This approach was also useful for bipolar patients, for whom it is hard to control
behaviors, such as impulsivity, logorrhea, excitation, and aggression. Watching films and
participating in group therapy sessions gave the appropriate bipolar patients opportunities
to practice controlling their behaviors. The effort of these patients in concentrating on the
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films and focusing on the issues at the group sessions was noted. Their varying levels of
success were good indications to the therapists about these patients’ clinical status.
9. The supportive component of the groups was considered more important for
depressive, anxious, and other neurotic patients. They were also more successful in
concentrating on watching the films, expressing their feelings, listening to friends, sharing
thoughts, and complying with the group rules.
10. Patients who did not share their thoughts and feelings during personal visits
sometimes shared their thoughts about the film in the context of the group atmosphere.
For example, a patient with bipolar depression who never talked about his suicidal ideas
in personal visits revealed that he kept a string for suicide under his pillow at the group
therapy session following the film, The Pursuit of Happyness,. Most patients in this group
had a history of suicidal attempts. In connection with hope and depression, they talked
about their previous attempts, and this particular patient promised to talk about any future
attempt at suicide. The effort of the patients to convince him to stay alive was remarkable.
11. The therapeutic group factors described by Yalom were observed in the patients
participating in this study. These factors include the instilling of hope, universality, the
imparting of information, altruism, the corrective recapitulation of the primary family
group, the development of socialization techniques, imitative behavior, interpersonal
learning, group cohesiveness, and catharsis.
12. We also rewarded patients who formed a therapeutic alliance with the opportunity to
watch films as entertainment. Patients with aggressive behavior were excluded from the
groups. When they succeeded in managing their anger and destructive behaviors they
were accepted to the sessions. So contributing to watching a film session with friends
became a reward for them
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13.In following up the films, short movie scenes were found more useful for patients who
had been administrated high doses of drugs.
14. The group therapy sessions were also psycho-education classes. The film A Beautiful
Mind (Ron Howard, 2001), for example, helped teach the diagnosis, symptoms,
treatment, and drug side effects of psychosis. The film was also a tool to normalize, share,
and understand the patients’ symptoms, thus encouraging self-insight and increasing their
willingness to enter therapy. The film As Good As It Gets (James L. Brooks, 1997) raised
the possibility of discussions concerning obsessions, compulsions, romantic relations, and
the concept of a therapeutic alliance. Similarly, the Pursuit of Happyness (Gabriele
Muccino, 2006) and a shortened version of Holiday (Nancy Meyers, 2006) were used to
generate discussion concerning depression, suicide, guilt, learned helplessness, and hope.
Films in a foreign language were dubbed in Turkish.
15. One film usually generated more than one topic. For example, The Bucket List (Rob
Reiner, 2007) raised the issues of therapeutic alliances, depression, suicide, and romantic
relations. This outcome was expected because all the patients watched the films through
the lenses of their own life experiences and thus construed them in their own ways.
16. Most patients expressed gratitude for the beneficial effects they received from
watching the films and participating in the group therapy sessions. They reported that
both had led them to feel better.
Below is a list of challenges in administering the program
1. Patients who had been given high doses of antipsychotic and sedative drugs often had
difficulty staying awake during the film session. Patients who had active
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hallucinations and delusions or were suffering from anxieties or other symptoms
were sometimes unstable during the film sessions.
2. Films depicting aggression or sexuality were excluded from the therapy program.
Some short scenes containing sexuality were permitted, such as a scene of a naked
woman in Forrest Gump (Robert Zemeckis, 1994) or a sexual dialogue in Anger
Management (Peter Segal, 2003). These made some of the patients angry, and we
talked about that response in the group session. However, we decided to be more
careful about such scenes in the future.
3. The group therapy and psycho-education sessions were challenging to manage
because of the presence of inpatients who had different diagnostics, therapeutics, and
prognostics, including schizophrenia, mania, OCD, and depression. Thus, every
session needed careful management to avoid undesirable outcomes.
4. Patients did not want to watch subtitled films. They liked animated films as well as
fiction films and usually did not want to watch films they had viewed previously.
5. It was hard to select a film about a condition or an illness during this period. The
therapists could not guess what would be discussed in the group. Every group was
unique, and every session was an adventure because of the nature of the inpatients.
Generally the illness of the majority of patients (schizophrenia, bipolar disorder,
depression, etc.) determined the development of the group’s common topic, but
sometimes only one manic or histrionic patient influenced the group to choose an
unrelated topic. In this situation, the flexibility and creativeness of therapist may
have brought the group back to the planned topic, but sometimes it was impossible.
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DISCUSSION
Because those attending inpatient group therapy sessions represented a diverse range
of needs and behaviors, it was difficult to find a common activity or approach suitable to
them all. However, films provided an activity that was suitable for almost all patients. For
many of the patients, talking about a film that the group had watched together was similar to
talking about a shared dream in psychotherapy.
Because patients with a severe psychiatric illness are in the hospital, they think,
behave, feel, or believe in a disordered way. Staff generally (try to) teach them what to feel
and what to do, but they do not ask the patients what they think. However, patients in the
cinema therapy groups were asked questions, such as “How are you? What do you think or
feel? What would you do if you were that film character? What should the character do at
that stage?” In this program, they talked and told others other how to feel, think, and behave.
They made decisions, solved problems, and asked for help. The cinema therapy program gave
patients the opportunity to move from the role of a sick person toward that of a healthy
person. They increased in self-worth, felt empathy and gained insight, rehabilitated cognition,
and behaved in a healthier manner.
Psychiatrically ill patients, even psychotics, despite their lack of insight, may feel
distanced from other people and stigmatized. Because watching a film with a group is a
normal, healthy activity, the program helped patients to feel that they were part of the world.
The increased self-care of patients, which was observed at the cinema therapy sessions, was
representative of their wish to be “normal.” The compliments shared among the patients
encouraged social interactions and supported the feeling of acceptance and approval by the
group, and even by the community. Psychiatric patients are known to have attention and
memory deficits during periods of severe illness. Schizophrenics and chronically ill patients,
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in particular, may have cognitive deficits and need time to prepare thoughts and speech in
order to talk in front of a group of people. Watching films helped to stimulate the thoughts of
such patients so that they found it easier to remember and convey their thoughts at the group
therapy sessions.
Movies related to their clinical symptoms (e.g., A Beautiful Mind for schizophrenia)
gave the patients the chance to look at a situation from outside, after which they could then
seek to identify a connection between the situation depicted in the movie and similar
situations they had experienced in their own lives. This process then became a means of
gaining insight into psychosis. Similarly, cognitive distortions could be discussed in the same
way in appropriate groups. The movies served as extended metaphors in the therapy sessions.
They thus helped to create a better understanding and to promote different ways of expressing
thoughts.
It seems that the movies represented a mirror reflecting the inner world of the patients.
When a person is watching a movie, the barriers between the viewer and the technical aspects
of the movie become invisible because the viewer is absorbing the images into his or her
unconscious mind (Damjanovic, Vukovic, Jovanovic, & Jasovic-Gasic, 2009). Group therapy
sessions become a means by which the unconscious thoughts and feelings are brought to the
surface, after which further therapeutic steps can then be taken. We found that the movies
were valuable tools for reaching patients’ thoughts and needs because it was easier for them
to talk about a character’s beliefs, feelings, thoughts, and needs than to share their own. The
comments patients made concerning the characters gave hints to the therapists about the
patients’ inner lives. Moreover, the patients would often go on to talk about their personal
needs and feelings.
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Our patients preferred to watch Turkish productions to international films. They could
relate to Turkish films, which evoked their traditions and childhood memories and thus
provided a mirror for self-refection. Initially we were hesitant about showing animated films
because we thought that the patients would not like them, but the film Ice Age was very well
received by patients and provided a good vehicle for discussing interpersonal relationships.
Scenes of sexuality caused strong reactions in our groups. It was thought that this
response reflected the traditional values of Turkish society. These patients were part of a
community, albeit a “small community sample” in inpatient services. They slept, ate, talked,
walked, worked, (daily work is part of the treatment program for inpatients) and watched
films together. Had they watched a film alone, maybe it would not be as bad as watching
with friends of the opposite sex, and they would not have had such a reaction to sexuality in
films. The reactions of groups to sexuality and other issues in films may reflect the reactions
of this small community sample.
Watching violence has been shown to have negative effects on socio-emotional
functioning (Fitzpatrick, Barnett, & Pagani, 2012) and lead to aggressive behavior (Muscari,
2002). Except some containing soft aggression and brief sexuality, which offered a chance to
discuss and reframe these topics, films containing violence and sex were excluded from the
list used in the therapy program. Sexuality is not a suitable subject for heterogeneous
inpatient groups. Responses to these scenes were more difficult to manage in the film
sessions than in the group therapy sessions. Humorous films have been shown to have a
beneficial impact on the anxiety and depression scores of schizophrenia patients (Gelkopf,
Gonen, Kurs, Melamed, & Bleich, 2006). Patients found it easier to be stable for lengthy
periods while watching humorous movies, so we selected these whenever possible.
The program was successful because of the patients’ diverse perceptions of the films.
They expressed different views and commented on different points in the same film. This
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showed the patients that there are “different ways of thinking,” and some of the group
discussions were conducted under this very topic. Previous studies have shown that movies
are a good tool for teaching psychiatric trainees (Jukic, Brecic, & Savic, 2010; Kalra, 2011;
Kuhnigk et al., 2012). We observed that they are also a valuable tool for teaching patients.
The fast turnover of inpatient clinics does not allow patients to participate in more
than a few consecutive sessions (usually 2-4 sessions). It is thus difficult to measure the
clinical effect of groups or films in a formal way. This study relates the experiences and
observations of practitioners in the hope that it will lead to systematic studies of the role
movies play in the treatment of psychiatric inpatients.
CONCLUSION
Group therapy and psycho-education sessions can become hard to manage because of
the diversity of issues that the inpatients have. It is thus important to have experienced and
seasoned therapists to ensure that these sessions are managed properly and carefully.
Inpatient groups consist of individuals that present a diverse range of psychiatric disorders
and different levels of symptom severity. Therefore, an enhanced approach to the
management of such groups is required. The movies watched before the therapy sessions
gave the patients a “shared dream” and rich metaphors, which they could use to talk about
their own issues during therapy. Using films as a therapeutic tool generally seemed to lead to
better management of the sessions and improved outcomes for the patients. Cinema therapy is
a creative approach on the part of healers and educators in mental health.
The use of films opens an entertaining and valuable way to reach the unconscious of
patients during group therapy sessions. It allows them to establish a therapeutic alliance and a
safe context in which to convey their beliefs, thoughts, and needs.
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REFERENCES
Cape, G. (2009). Movies as a vehicle to teach addiction medicine. Int Rev Psychiatry, 21(3), 213-217.
doi: 10.1080/09540260902747094
Damjanovic, A., Vukovic, O., Jovanovic, A. A., & Jasovic-Gasic, M. (2009). Psychiatry and movies.
Psychiatr Danub, 21(2), 230-235.
Dermer, S.B., & Hutchings, J. . (2000). Utilizing movies in family therapy: applications for individuals,
couples, and families. Am J Fam Ther, 28(2), 163-180.
Erickson, M.H., Rossi, E.L., & Rossi, S.I. . (1976). Hypnotic realities: The induction of clinical hypnosis
and forms of indirect suggestion. New York: Irvington.
Fitzpatrick, C., Barnett, T., & Pagani, L. S. (2012). Early exposure to media violence and later child
adjustment. J Dev Behav Pediatr, 33(4), 291-297. doi: 10.1097/DBP.0b013e31824eaab3
Garrison, D. (2007). The use of movies to facilitate family engagement in psychiatric hospitalization. J
Am Acad Child Adolesc Psychiatry, 46(9), 1218-1221. doi: 10.1097/CHI.0b013e318095a3c4
Gelkopf, M., Gonen, B., Kurs, R., Melamed, Y., & Bleich, A. (2006). The effect of humorous movies on
inpatients with chronic schizophrenia. J Nerv Ment Dis, 194(11), 880-883. doi:
10.1097/01.nmd.0000243811.29997.f7
Hasson, U., Landesman, O., Knappmeyer, B., Vallines, I., Rubin, N., & Heeger, D.J. . (2008).
Neurocinematics:The Neuroscience of Film. Projections: The Journal for Movies and Mind 2,
2(1), 1-26.
Hauke, C. (2009). Turning on and tuning out: new technology, image, analysis. J Anal Psychol, 54(1),
43-60. doi: 10.1111/j.1468-5922.2008.01756.x
Jukic, V., Brecic, P., & Savic, A. (2010). Movies in education of psychiatry residents. Psychiatr Danub,
22(2), 304-307.
Kalra, G. (2011). Teaching diagnostic approach to a patient through cinema. Epilepsy Behav, 22(3),
571-573. doi: 10.1016/j.yebeh.2011.07.018
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18
Kuhnigk, O., Schreiner, J., Reimer, J., Emami, R., Naber, D., & Harendza, S. (2012). Cinemeducation in
psychiatry: a seminar in undergraduate medical education combining a movie, lecture, and
patient interview. Acad Psychiatry, 36(3), 205-210. doi: 10.1176/appi.ap.10070106
Lampropoulos, G., Kazantzis, N., & Deane, F. P. (35). Psychologists' use of motion pictures in clinical
practice. Prof Psychol Research and Practice, 35(5), 535-541.
Muscari, M. (2002). Media violence: advice for parents. Pediatr Nurs, 28(6), 585-591.
Sharp, C., Smith, J. V. , & Cole, A. . (2002). Cinematherapy: metaphorically promoting therapeutic
change. Counsel Psychol Q, 15(2), 269-276.
Ulus, F. (2003). Movie Therapy, Moving Therapy (First ed.). Victoria,Canada: Trafford Publishing
Ulus, F. (2010). Psychiatry in Cinema, Cinema in Psychiatry (M. Bilici Ed. First ed.). Istanbul: Erenkoy
Training And Research Hospital.
Ulus, F. ( 2006, october 2006). Using Motion Pictures and Film Clips in Group Movie Therapy Paper
presented at the APA Institute of Psychiatric Services Annual Meeting, New York City, NY.
Wedding, D., & Niemiec, R. M. (2003). The clinical use of films in psychotherapy. J Clin Psychol, 59(2),
207-215. doi: 10.1002/jclp.10142
Wolz, B. (2005). E-Motion Picture Magic: A Movie Lover's Guide to Healing and Transform. Colarado:
Glenbridge Publishing.
Yalom, I. D., & Lesczc, M. . (2005). The theory and practice of group psychotherapy. New York: NY:
Basic Books.
Yildiz, M., Yazici, A., Unal, S., Aker, T., Ozgen, G., Ekmekci, H., . . . Eryildiz, M. (2002). [Social skills
training in psychosocial therapy of schizophrenia: a multicenter study for symptom
management and medication management modules]. Turk Psikiyatri Derg, 13(1), 41-47.
Zacks, J. M., Speer, N. K., Swallow, K. M., & Maley, C. J. (2010). The Brain's Cutting-Room Floor:
Segmentation of Narrative Cinema. Front Hum Neurosci, 4. doi: 10.3389/fnhum.2010.00168
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Table 1: Samples of Movies (or Clips) Shown in the Groups
A Beautiful Mind (Ron Howard - 2001)
As Good As It Gets (James L. Brooks - 1997)
Pursuit of Happiness (Gabriele Muccino - 2006)
Holiday (Nancy Meyers - 2006)
Anger Management (Peter Segal - 2003)
Forest Gump (Robert Zemerickis - 1994)
Ice Age (Chris Wedge - 2002)
Patch Adams (Tom Shadyac -1998)
Usta (Bahadır Karakaş - 2009) (Turkey)
Neşeli Hayat (Yılmaz Erdoğan -2009) (Turkey)
Vizontele (Yılmaz Erdoğan - 2001) (Turkey)
Çok Film Hareketler Bunlar (Ozan Açıktan - 2010) (Turkey)
Dondurmam Gaymak (Yüksel Aksu - 2005) (Turkey)
Devrim Arabaları (Tolga Örnek - 2008) (Turkey)
Aşk Tesadüfleri Sever (Ömer Faruk Sorak - 2010) (Turkey)
Ya Sonra (Özcan Deniz - 2011) (Turkey)
20
20
Table 2: Topics of Group Therapy Sessions
Fear, anger, abstain
Stigma
Romantic relations
Problem solving skills
Suicide
Relationships with family
Depression
Relationships with neighbors and friends
Being hospitalized
Schizophrenia
Psychosis
Therapeutic compliance
Drugs
Side effects of drugs
Preventing illness
