w11 PRAC group psychotherapy open discussion

Group Therapy Session

       Group work among older adults has shown to enhance their spontaneity, creativity, and empathy, decreasing depressive symptoms, and enhance psychosocial functioning life (Jalili Nikoo et al., 2017). According to Wheeler (2014), humans grow older, modifications in priorities, relationships, and accountabilities occur and may produce positive and negative feelings and experiences. Efficient psychotherapy with older adults necessitates an understanding of individual, family, collective, and systemic issues to ensure an effective psychotherapeutic process (Wheeler, 2014). Utilizing and encouraging psychotherapy interventions can address these developmental modifications and improve older adults' quality of life and wellbeing.

Group Description and Stage:

The group I observed consist of 5 older adult members. The group accepted additional member to make the formative stage. The group member met each other and introduced themselves; goals and perceptions of each member have been discussed and explained, and they have expressed commitment to the group's goals and the number and nature of the weekly therapy. Stangor (2017) highlighted that in the forming stage, group members come together and sharing information. The group will meet twice weekly for five weekly sessions. The group is racially diverse, with adults in different age brackets and gender. The group participants appear comfortable with each other and are open in disclosing their challenges. Some group members require frequent redirection to focus on discussion, thereby ensuring that every group member can process and share. The group is mostly older adults, have a common difficulty with depression at different levels. The therapeutic approach utilized for this group was cognitive behavioral therapy. Krishna et al. (2013) emphasized that group CBT is efficient in treating geriatric depression and reducing depressive symptoms. In the later years, death becomes universal than life, and assisting individuals through this process can significantly improve their quality of life (Tavares, & Barbosa, 2018).

Therapeutic Approach

The therapeutic approach the therapist used was Cognitive behavioral therapy. CBT for depression includes behavioral strategies and cognitive restructuring to help change negative automatic distorted thoughts and address maladaptive behaviors (Halverston, 2019). Clients started by filling out questionnaires and cognitive measures, including the Beck Depression Inventory (BDI). The Group participants engaged in an expressive style in disclosing their challenges for about 15 minutes of the therapy session. The group participants verbalized their deepest thoughts and feelings about a crucial emotional issue that affected them and their lives. Some group members maintain journals to freely write about the same event on each day or about different other events. People diagnosed with a major depressive disorder who display feelings in expressive writing shows significant decreases in depression scores of the Beck Depression Inventory and Patient Health Questionnaire-9 scores.

Challenges: 

               Group therapy works best where there is open and honest communication between members. Confidentiality is an integral part of the ground rules for group therapy. However, there is no guarantee of privacy when sharing with others, so members need to use common sense when divulging personal information (APA.org, 2020). There is a possibility of disagreement arising when working with a group of diverse adults. The therapist has a role in diffusing conflicts, disagreements, and concerns as they arise among members to decrease festering's animosity, reducing cohesion. 

 According to Wheeler (2014), possible peculiar challenges working with older adults in group settings include the presence of chronic illness, cognitive decline that impacts functional capacity and decreased mobility, and the ability to perform ADLs. If not tackled, these challenges can impede older adults from efficiently utilizing all the psychotherapeutic resources available to them and hinder progress. Encouraging exercise, personal independence, and self-mastery are all measures that combat these challenges (Wheeler, 2014).

Conclusion

       Older adults have experienced numerous life challenges that necessitate sharing, which focused on using the psychotherapy approach to settle. Group psychotherapy benefits older adults because they are set up in small groups to focus on interpersonal and cognitive behavioral therapy.

References:

American Psychological Association (2020). Psychotherapy: Understanding group therapy/

Retrieved from https://www.apa.org/topics/group-therapy

Halverson J.L MD (2019). What are the DSM-5 criteria for diagnosis of major depressive

disorder (clinical depression)? Retrieved from

https://www.medscape.com/answers/286759-14692/what-are-the-dsm-5-criteria-for-

diagnosis-of-major-depressive-disorder-clinical-depression.

Jalili, N. S., Karimi, Z., Nejatinejad, N., Bahmani, B., Naghiaee, M., & Ghasemi, J. R. (2017). Effectiveness of cognitive existential group therapy on quality of life of elderly people.

Krishna, M., Honagodu, A., Rajendra, R., Sundarachar, R., Lane, S., & Lepping, P. (2013). A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults. International Journal of Geriatric Psychiatry. Vol. 28(9). Pp. 881–888. DOI:10.1002/gps.3905.

Stangor, C. (2017). Group Processes. Oxford Research Encyclopedias: Psychology. DOI: 10.1093/acrefore/9780190236557.013.255. 

Tavares, L. R., & Barbosa, M. R. (2018). Efficacy of group psychotherapy for geriatric depression: A systematic review. Archives of gerontology and geriatrics, 78, 71-80.

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