THE JOB IS TO REPLY WITH A COMMENT TO EACH POST, POST 1 AND POST 2. WITH 2 COMPLETED (EDUCATIONAL  REFERENCE) includidig retrival or doi, IN APA WITH CITATION ABOVE 2013 PER COMMENT.   

POST 1

Group therapy with older adults

Studies show that group psychotherapy can be used to treat elderly persons with multiple symptoms as it has shown improvement in physical function, behavioral, and symptoms associated with depression (Wang, 2014). This post will discuss an experience in practicum while attending a group therapy session. The name of the group is engagement to recovery and included clients that were struggling with addiction. It was formed prior to practicum and was in the sixth week of progress. The group meets once a week for 60 minutes with the ages ranging from 24 to 67. They were through the forming stage and into the storming phase.

According to Yalom & Leszca (2005) during the storming phase, the group begins to push against the boundaries established in the forming stage. This was evident when one of the young group members made a statement of, “it was just marijuana.” The therapist immediately corrected him and reminded him that it is illegal, it is a drug, and this is the engagement to recovery group. If substance use was continued, they would not be able to continue in this group. Many of the older members nodded in agreeance and their frustrations with this individual were evident.

Resistance was met by this group member as he didn’t feel that marijuana was an issue. This went against the goals of the group which was to remain abstinent from their addictions and gain support from each other to do so. The oldest gentleman of the group shared his gambling addiction which had recently caused their home to go into foreclosure. He was tearful and other members near his age shared feedback, but the younger members didn’t engage.

It was felt that the biggest challenge faced was the age differences. It seemed that since the member’s ages ranged so much that they were in different stages of their lives making it difficult to engage with each other. There was almost a type of group separation, the older members on one side of the room, and the younger on the other side. The therapist was aware of this and is working to decrease the separation by encouraging a full group activity.  A great benefit of group therapy is that as clients interact, they can learn from one another (Roback, 2010).

The therapist primarily used cognitive behavioral therapy in combination with a humanistic approach. Cognitive therapists focus more on their client’s present situation and distorted thinking than on their past (Wheeler, 2014). With addiction, relapse is one of the main struggles. The humanistic approach believes in the goodness of all people and emphasizes self-growth and self-actualization (Wheeler, 2014). For interpersonal interaction to be beneficial, it should be guided by empathy. The group leader should model empathic interaction for group members, especially with people with substance use disorders because a lot of the time they cannot identify and communicate their feelings (Roback, 2010).

Recommendations to improve group cohesiveness would include encouraging clients to communicate openly and honestly, think and reflect on experiences, and share them with others (Wheeler, 2014). If incorporating a whole group activity is unsuccessful, the makeup of the members may need to be adjusted to be a more homogenous group.

References

Roback H. B. (2010). Adverse outcomes in group psychotherapy: risk factors, prevention, and research directions. The Journal of psychotherapy practice and research, 9(3), 113-22. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330596/

Wang, C., Tzeng, D., & Chung, W. (2014). The effect of early group psychotherapy on depressive symptoms and quality of life among residents of an apartment building for seniors. Psychogeriatrics: The Official Journal of the Japanese Psychogeriatric Society, 14(1), 38-46. doi:10.1111/psyg.12037

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

POST 2

Group Therapy Session with Older Adults

Group Therapy Session

To begin, I am going to explain a group session I completed with a group of older adults with a diagnosis of depression. This group took place at an ALF located in Tampa, FL. The clients that participated in the group were 65-80 years old, there were 10 members present on this day. This group session lasted approximately 40 minutes.

 The type of group that I lead is a reminiscence group. Group reminiscence therapy is a brief and structured intervention in which participants share personal past events with peers. This psychotherapeutic approach has been shown to improve an older person’s wellbeing and has the potential to reduce symptoms of depression (Gaggioli et al, 2014). This approach involves the recollection and review of past personal events. It is believed that reminiscence therapy can help elderly individuals by increasing self-acceptance, providing perspective, and enabling the resolution of past conflicts (Gaggioli et al, 2014). This is a very fun and interesting group to lead because it gives the group leader and the other members the opportunity to hear remarkable stories from the other clients. At it gives that particular member a moment to shine and share with others certain meaningful events they accomplished during their life instilling a since of pride.

Stage of Group & Techniques Used

There are five stages group formation known as forming, storming, norming, performing, and adjourning (Caffaro, 2007). This group of clients meet twice per week and will complete different group activities together. The stage that this group is currently in is known as performing. This group is already well known to each other, they have been working together for several months now. These members operate without friction, there is respect and empathy present between members, diversity is welcomed, and members welcome new ideas without conflict (Kumar, Deshmukh, & Adhish, 2014). Since this group is in this phase when I conducted the reminiscence group with these members my approach was to allow the members to be less active and allow them to take a role in welcoming me to their group. I was welcomed with open arms and joined right in, at this time I was able to comment on how functional the group is.

Challenges

There can be many challenges when providing psychotherapy to older adults. Chronic health problems can impact psychotherapy with the elderly. Eighty percent of those 65 years or older have at least one chronic illness (Wheeler, 2014). If an older client has a cognitive impairment then they will require simultaneous treatment for both the cognitive impairment and the mental health condition to be effective. Also another challenge when working with older adults is their views on mental illness. Older adults may not be as accepting and open regarding mental illness due to the time period in which they were raised and how mental health was viewed during that time.

References:

Gaggioli, A., Scaratti, C., Morganti, L., Stramba-Badiale, M., Agostoni, M., Spatola, C. A., Molinari, E., Cipresso, P., Riva, G. (2014). Effectiveness of group reminiscence for improving wellbeing of institutionalized elderly adults: study protocol for a randomized controlled trial. Trials, 15, 408. doi:10.1186/1745-6215-15-408

Caffaro, J. (2007). Review of The theory & practice of group psychotherapy, 5th edition. International Journal of Group Psychotherapy, 57(4), 543–549. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-14773-008&site=eds-live&scope=site

Kumar, S., Deshmukh, V., & Adhish, V. S. (2014). Building and leading teams. Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine, 39(4), 208-13.

Mackenzie, C. S., Scott, T., Mather, A., & Sareen, J. (2008). Older adults’ help-seeking attitudes and treatment beliefs concerning mental health problems. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 16(12), 1010-9.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.