Median and large art psychotherapy group theories offer facilitators within psychiatric settings understanding of the benefits of larger regular group membership; something desired but often absent in art psychotherapy groups, and also various groups run within the psychiatric services such as activity and community meetings. Instead, sporadic, ever changing membership is familiar with the result that thinking and reflection is frequently kept on each individual member. To keep the focus predominantly on the group can result in steady membership and provide the opportunity for institutional, societal, cultural, class and political concerns to be considered.