Therapy with older adults | NURS 6650 – Psychotherapy With Groups and Families | Walden University

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Group psychotherapy is a psychotherapeutic treatment modality in which a group of people with the same or similar psychological and/or psychiatric disorder are composed and come together in a group, with the guidance of a professional therapist, to help one another to effect behavioral and/or personality change. “It is a modality that employs a professionally trained leader who selects, composes, organizes, and leads a collection of members to work together toward the maximal attainment of the goals for each individual in the group and for the group itself.” In group psychotherapy, certain group properties such as mutual support can be used to help provide relief from psychological and/or psychiatric disorders/problems and also afford support to group members with feelings of isolation and desperation. 

Group therapy with older adults can be a challenging moments owing to the fact that aging can be a moment or stage in the development of humans which is marked by a decline in not just the physical well-being, but it is also characterized by multiple social, emotional and psychological impairments. “This focus on extraordinary losses and the potential for diminished functional capacity may be a major hurdle in confronting our own biases and countertransference reactions as group psychotherapists working with older adults.” Despite the various types psychotherapeutic approaches in group psychotherapy, certain core principles as well as assumptions remain peculiar to it and these core principles and assumptions must be respected for a therapeutic progress to be made. 

Group Description.

The psychotherapy group is made of 4 participants who started psychotherapy group with a duration of 10 weeks. Group members met once a week with each session lasting for about 45 minutes. Group members had diagnosis with a DSM-5 criteria ranging from Schizophrenia, bipolar disorder, anxiety disorder, major depression. Age ranges between 60 to 70 years old. two of the group members had attended a group psychotherapy before while the rest were all new to group psychotherapy. Yalom, notes “Although the frequency of meetings varies from one to five times a week, the overwhelming majority of groups meet once weekly.” the group was a closed group because once it’s creation was done, no new membership was allowed.

Stage of group.

This psychotherapy group was at the norming  stage because group members had become more aligned with the group, and can work together toward the realization of the group goals common to all members and to the group in general. Wheeler, K. (2014) note “Group members become more aligned as a whole, and identify and work to a common goal.” Members at this stage of group existence have developed a sense of trust for each other and among group members. At this stage, members were contributing ideas and helping one another with their problems. They shared ideas on their individual problems and how they manage to solve their own problems. At this stage of the group, some members may form cliques and so exclude some other members of the group. The psychotherapist must be vigilant at this time to discourage the formation of such subgroups for the interest of the group.

Challenges or Issues of the group.

When people come together in a group, there is bound to be some form of challenges or problems within the group. Some of the challenges faced by psychotherapy group include the perceived goal incompatibility. The fact that different people with various psychological problems entails a different set of goals which may nit be compatible with the goals of the rest of the group members. “One important source of perplexity and discouragement for clients early in therapy is perceived goal incompatibility.” Yalom, D.I (2005). In such situation, group members may may not align the group goals with their individual goals. Some other challenges in group therapy may include lack of immediate comfort. “Clients may be frustrated by not getting enough air time in the first few minutes.” Yalom, D.I (2005). Subgrouping and extragroup socializing is another challenge that may be experienced at any stage of a group psychotherapy. The psychotherapist has the responsibility in such situations to acknowledge the differences that might exist within the group, encourage members to focus on the group goals as well as model group activity towards creative problem-solving approach. 

Therapeutic approach employed in the group.

Psychotherapeutic approaches used included cognitive behavior group therapy, in which group members had the opportunity to verbalize feelings, contribute to the problem-solving and group cohesiveness. The psychotherapist also help and guide group members through psychoeducation so group members can understand the effect of maladaptive thinking or thought process on individual behaviors. knowledge sharing among group members was also used to help group members achieve group goals. 

Recommendations.

In group psychotherapy, the therapist must identify factors that could impact group members contributions, affect group cohesiveness and attainment of group goals. Giving members the opportunity for a structured socialization helps to instill onto members the sense of positive fortification. Keeping group sessions short and brief will help group members stay focused as well as able to retain what is learned in the group.

References.

Bonhote, K., Romano-Egan, J., & Cornwell, C. (1999). Altruism and creative expressions in a long-term older adult psychotherapy group. Issues in Mental Health Nursing, 20(6), 603-617. Retrieved from 

https://doi-org10.1080/016128499248394

Sadock, J. B., Sadock, V.A., & Ruiz, P. (2015). Kaplan & Sadock’s Synopsis of Psychiatry Behavioral Sciences/Clinical Psychiatry. 

             (11th ed.). Phialdelphia, PA: Wolters Kluwer.

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse. A How-to Guide for Evidence-based Practice.

             (2nd ed.). New York, NY: Springer Publishing Company.

Yalom, I.D. (2005). The Theory and Practice of Group Psychotherapy.

              (5th ed.). New York, NY: Perseus Books Group.

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