Assignment: Discussion Board Week 2- Discussion of which model you prefer, due by 11:59pm (50 pts).

Discussions play an integral role in monitoring your course participation throughout the term. You should check back to the weekly discussions multiple times throughout the week to engage in the discussion with your professor and peers. Participation is only counted during the week in which this discussion is assigned. Be sure to appropriately cite any sources you use to support your responses with standard APA citations. Answer the prompt question(s) thoroughly using a minimum of 150-200 words and respond to as many of your peers as possible – note that responses of 75-100 words to 2 of your peers are required for full credit. Be sure to answer any additional questions asked by your professor in the discussion threads. Your initial post is due by Day 3 (Friday) of the current week, and follow up posts to your peers are due on Day 7 (Tuesday). 

Discussion Prompt: 

1. Please discuss/include the following in a minimum of 150-200 words for your initial post:

• Of the styles of leadership you learned about in the resources thus far in our course, choose one that you find most successful or appealing and share the following information with your peers:
  • Which style or approach did you choose and why do you think it is the most appealing to you?
  • To support your choice, share an example of a time when you or someone else used this style of leadership and it was helpful to others.

I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

ZERO PLAGIARISM

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.

 

• Within your community, there has been a large increase in teenage smoking, and community leaders are developing a plan to decrease the incidence of smoking. To help them, you will:

A) Develop a research question to address the problem.
B) Determine what kind of study should be undertaken.
C) Design a study to decrease the incidence of smoking in teenagers.

2 

 I NEED A RESPONSE FOR THIS ASSIGNMENT

2 REFERENCES

Group Therapy with Older Adults

Psychotherapy, according to Wheeler (2014), can be used to treat varying psychological disorders throughout the lifespan of an individual. In general, psychotherapy must be adapted to address and fit the specific needs of the age groups. Researches have indicated in older group therapy that one can socialize with peers who share similar symptoms. It also creates an opportunity to increase one’s altruism and empathy and feel useful by helping others (Tavares & Barbosa, 2018). However, the elderly often may have neurological deficits and comorbidities that may affect their ability to fully participate and benefit from psychotherapy (Wheeler, 2014). Studies indicated that some of these older adults live in isolation and have lost their relationships, occupation, and capacity. Group therapy allows them to connect to people and be useful while receiving help (Wheeler, 2014). The discussion will include a description of a group therapy session with older adults, the group’s stage, any issues or resistances present, therapeutic modalities utilized, and challenges resulting from working with the group.

Group Description

This group includes ten members whose ages range from 64 to 80, including females and males, each with different diagnoses such as depression, sleep disorders, anxiety disorders, personality disorders, alcohol, drug use disorders, and neurocognitive disorders. Some of the patients were hyperactive, while some were depressed. Currently, the group comprises patients in different stages, such as forming, storming, norming, performing, and adjourning. The orientation stage still ongoing as new members joins the group while some are in their terminal adjourning phase. This group did not follow the predictable pattern of the average group staging. However, the patients introduce their names, ages, professions, and family backgrounds. The group went back and forth, elaborating on more background aspects of individual lives. Individuals were encouraged to share as much as they feel comfortable sharing. The group ran for 60 minutes, from 1030 to 1130 in the morning. It is modified to bring the best out of the patients. The therapy session time was divided and organized to allow note-taking, summarization, memory aids, and mnemonics devices to help in their recovery (Tavares & Barbosa, 2018).

Resistance or Issues Present

The cohesiveness of the group met a few resistances. One group member, a 70-years-old male, did comment on the newness of therapy. His comment was: “back in the day; people did not meet with each other to talk about everyday life hurdles; we dealt with it, that is what is expected of us as men.” I had a 65-year-old female who said she is not crazy and should not be in the group; this was her second day. She laughs, smiles, and shakes her head when others are speaking. She moved her chair further away from how the chairs were spaced-out due to the coronavirus pandemic. 

The compilation of both hyperactive and depressed patients made it often difficult for every patient to participate and achieve their expected goal at the same time. Some patients were hyperactive, intrusive, and monopolizing. They tried to control everything and respond to every question asked, which sometimes increased anxiety and tension to other group patients. While depressed and quiet, patients feel irritated, intimidating, and sad. 

Therapeutic Techniques

Cognitive-behavioral therapy (CBT) is a practical approach for a wide range of problems affecting older adults (Secker et al., 2020). As a therapeutic approach in group therapy sessions, CBT has proven to be beneficial to the elderly. It helps them build an interpersonal relationship with others, improve socializing skills, improve the symptoms of depression, and help manage stressful life events (Tavares & Barbosa, 2018). CBT aims to have the patients and the counselor in agreement on markers of progress in therapy. Domhardt and Baumeister (2018) stated that the CBT coping strategy helps the patient identify negative thoughts and replace more functional views. CBT equips the patients with internal resources and enhances their coping skills (Wheeler, 2014). In this manner, the individual’s symptoms reduce, and behaviors change as they learn to control their feelings.

Challenges

I encountered different challenges in conducting therapy with the age group. There was an issue with the seat arrangement; because of COVID-19, the patients were spaced six fits apart to maintain social distance. With some of the patients being intrusive and exhibiting poor boundary behavior, it became difficult to keep the space. Some patients had physical declines that affected therapy, some with cognitive impairment, hearing impairment, and decreased eyesight. Thus, requiring the facilitator to speak more slowly, louder and to explain more clearly. To accommodate those with low vision, I had to provide large print worksheets for the patients. Some patients remained in the forming and storming stages for a prolonged period due to their cognitive state. The group dynamic also affected this group outcome due to new admissions and discharges, which hinder the group’s progress.

No matter what population of people being counseled, it is necessary to recognize the challenges they face and change practices accordingly. CBT is feasible and highly effective in geriatric patients. Early diagnosis, good access to psychotherapy, and early intervention could improve care for older patients.

References

Domhardt, M., & Baumeister, H. (2018). Psychotherapy of adjustment disorders: current state and future directions. The World Journal of Biological Psychiatry, 19(sup1), S21-S35.

Hummel, J., Weisbrod, C., Boesch, L., Himpler, K., Hauer, K., Hautzinger, M., … & Dutzi, I. (2017). AIDE–acute illness and depression in elderly patients. Cognitive-behavioral group psychotherapy in geriatric patients with comorbid depression: A randomized, controlled trial. Journal of the American Medical Directors Association, 18(4), 341-349.

Secker, D. L., Kazantzis, N., & Pachana, N. A. (2020). Cognitive behavior therapy for older adults: Practical guidelines for adapting therapy structure. Journal of rational-emotive and cognitive-behavior therapy, 22(2), 93-109.

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