This chapter discusses the prerequisites and special treatment interventions for more severe forms of mental disorders in groups. This includes patients with narcissistic structures, traumatized patients, and patients at risk of addiction. The assumed setting is that these patients are treated in mixed, analytical groups with other types of disorders. Special difficulties and variations will be examined. It turns out that under certain conditions, even more severe personality accentuations or disorders can indeed achieve an improvement in symptoms and a gain in structure within this framework.