Group psychotherapy of paranoid patients implies gradualism in achieving therapeutic goals. Establishing reality is the first therapeutic goal, and acquiring insight and understanding of the current conflicts in the situation here-and-now connected with conflicts from the past in the situation there-and-then is the second one. Five Small psychotherapeutic groups of paranoid patients were included in our study. We measured the participation of the therapist's communications in group communication structure and the structure of the therapist's interventions. The therapist's communications in the group were determined using Bales’ category system. The therapist's interventions were determined according to the Scale of therapist's interventions. We made two measurements: at the beginning and after a period of two months. The total score of the therapists’ communications in the first measuring (38.2%) was significantly higher than in the second measuring (25.79%) (p < 0.01). In the structure of the therapists’ communications, a high level of the emotionally positive communications was maintained in the first (55.45%), as well as in the second measuring (41.17%). Explanations, clarifications and alternative solutions could be found in the beginning of the group therapist's interventions. The most frequent therapist's interventions in the second measurement were interpretations and confrontations. In the therapeutic process, members of the group were taught to observe communication and to search for its meaning together. The group responded to the reality of its world and defined reality for every single member. Communications brought new meanings to old experiences and enabled the acquisition of new experiences with meaning.