Psychotherapy: Analyzing Group Techniques

Analyzing Group Techniques

Treatment of psychiatric conditions may necessitate the use of psychopharmacologic or psychosocial interventions. Psychosocial interventions include a variety of psychological and educational components designed to provide individuals with mental illnesses and their families with support, education, and guidance (Locher et al., 2019). Psychotherapy is a well-known and widely used psychosocial intervention in the treatment of psychiatric patients. This occurs in various ways, one of which is through group psychotherapy/therapy. Healthcare professionals use group therapies to care for a large number of patients.

Group therapy interventions are premised on the principles of universality, in which an individual realizes that the symptoms they are experiencing are not unique to them but are also shared by many other people (Malhotra & Baker, 2022). Furthermore, patients learn from one another about their illnesses and coping strategies. While group therapies can be used in any setting, they are especially effective in rural and low-income areas where access to care is limited due to understaffed facilities and a high volume of patients. In such cases, group therapies help to reduce waiting times and improve access to care. The purpose of this paper is to discuss group therapy techniques in great detail using data from a video scenario.

The Group Therapy Techniques Demonstrated

The video depicts a group therapy session for teens diagnosed with anxiety. Molly, the therapist, is working with three adolescents, Jill, Kala, and Blair. The adolescents are in an enclosed room, with their counselor in front of them, prompting them to have an interactive session. In the beginning, the group therapy technique demonstrated is psychoeducation. Psychoeducation is a type of group therapy in which a counselor transfers knowledge of the illness (etiology, presentation, coping strategies, etc.) and its treatment to the patients (Malhotra & Baker, 2022). The group discusses anxiety coping strategies in the video. The counselor asks two questions: (1) What comes to mind when you hear the word yoga? And (2) why do you believe yoga could help you deal with your anxiety? The counselor gives them time to express themselves, actively listens to them, and then offers her opinion. The video concludes with a series of yoga exercises performed to provide the teens with anxiety-coping strategies. This is part of a mindfulness-based stress reduction (MBSR) program, which is a flexible and customizable group program that assists patients in reducing stress. MBSR has two main components: mindfulness meditation and yoga (Santamara-Peláez et al., 2021), with the latter being used in the video. Six yoga exercises are performed on the adolescents, including child’s pose, mountain pose, warrior pose, butterfly pose, corpse pose/savasana, and forward fold. The counselor then concludes with a debriefing session in which the patients discuss their experiences with the sessions.

Evidence from Literature Supporting the Use of the Group Therapy Techniques

Psychoeducation and MBSR techniques have been used in treating patients with various psychiatric conditions in various settings. Abazarnejad et al. (2019) carried out a randomized intervention-controlled study to assess the efficacy of psychoeducational counseling on anxiety in preeclampsia. The study included 44 patients from two governmental hospitals in Sirjan, Kerman, divided into two groups: control (n=22) and intervention (n=22). Psychoeducational counseling was provided to the intervention group twice. The Spielberger State-Trait Anxiety Inventory (STAI) was used to assess anxiety before the first session and again after the second session during the hospitalization period. The results showed that the intervention group’s anxiety level decreased significantly after the counseling sessions (p=0.005), while the control group’s anxiety level increased slightly after the study.

In a different study by Janjhua et al. (2020) on the effect of yoga on emotional regulation, self-esteem, and feelings of adolescents, 110 students aged 13 to 18 studying in senior secondary schools in the Mandi district participated. The sample included 52 yoga-practicing adolescents and 58 non-yoga-practicing adolescents. Individuals who practiced yoga had higher mean values for emotional regulation, self-esteem, and positive statements (feelings), proving that yoga intervention was effective in the three areas mentioned.

In a separate study by Adhikari (2021) on the effect of yoga exercises on stress and aggression among adolescents, 50 male students of U.G college participated in various yogic exercises such as Surya Namaskar, Asanas, Pranayam, and Meditation regularly for eight weeks. Stress was measured by a stress questionnaire designed by the International Stress Management Association. The Buss Perry Aggression Questionnaire was used to assess aggression. The pre-test and post-test mean stress scores were 9.42 and 3.96, respectively, while the pre-test and post-test mean aggression scores were 83.04 and 64.18, respectively. The results show that yogic exercises reduced stress and aggression, making yoga an MBSR component effective intervention in stress/anxiety relief.

What the Therapist did well, what I would have done differently

The therapist exhibits excellent skills at prompting an interactive session. The therapist asks the teens questions and gives them enough time to respond. Also, while they answer, the therapist listens intently and does not interject until they have finished. At the end of their responses, the therapist expresses her thoughts on the question and does not chastise them for incorrect answers, thus encouraging participation, whether correct or incorrect. As she guides them through the yogic exercises, she plays the role of an effective team leader. In the end, she leads them through a debriefing session in which the teens reflect on what went well and had the opportunity to share their thoughts on what could have been done better. If I were the therapist, I would create a curriculum with different topics scheduled on different days. Furthermore, Malhotra and Baker (2022) recommend that an effective psychoeducation session lasts between 15 and 90 minutes; I, therefore, believe the one in the video was shorter. As a result, I would design the lessons to be 15 minutes long, short yet even suitable for patients with short attention spans. Moreover, I would have used videos to demonstrate various yogic exercises to the teens before they began doing them; this would have shortened the yoga sessions because the teens would have already known what to do.

Insight from watching the Video

After watching the video, I realized that altruism, information dissemination, and the development of socialization techniques are all important components of psychoeducation. Members help others improve by being altruistic. For example, Blair expresses concern when Kala remains silent for the majority of the video, prompting the counselor to trigger her to speak. This shows that Blair wanted them to succeed as a group rather than as individuals. Also, the group thrives when members share knowledge on specific topics related to the illness of interest, such as yoga as a coping strategy for anxiety. Finally, the development of a socialization strategy, in this case, yogic exercises, aids in the group’s bonding.

Handling a Difficult Situation with a Disruptive Group Member

Individuals who cause disruption in the group by engaging in chronically disruptive behavior or whose communication style is chronically inappropriate present a challenge. When dealing with a disruptive person, there are several basic steps to take. One step I would take is to turn the disruption into a constructive contribution. For example, I might respond, “perhaps you could provide a better solution,” in an attempt to redirect the disrupter’s attention away from the abusive remarks and toward constructive contributions to the group. As an alternative, I would confront the difficult person directly and inform them of the impact their actions are having on our group. Finally, I would separate the disruptive person from the group if all else fails. According to Mahvar et al. (2018), communication may not be a panacea for every problem that arises in groups, and some individuals leave no other option but ostracism. However, if the person is powerful, this may not be an option. I do not anticipate a smooth interaction throughout the phases of group therapy; there may be a conflict. However, such environments increase the likelihood of constructive conflict resolution in groups.

Benefits and Challenges of a Group Therapy

While group therapy has many benefits, it also has drawbacks. The advantages are summarized in three main themes: universality, imparting information, and a platform for alleviating social phobia. The concept of universality is based on the fact that a person meets several other people with similar problems; on the other hand, imparting information refers to patients gaining knowledge and information from both the group members and the provider (Malhotra & Baker, 2022). Individuals with social phobia are also exposed to social interactions in group therapy, which may be a step and therapy in and of itself in helping them overcome their anxiety. Aside from the advantages, there is a concern about patient confidentiality, as the counselor may have less control over the information shared. Furthermore, the possibility of conflict is not uncommon, necessitating competence in conflict resolution should one arise.

Conclusion

Group therapies may be recommended to treat patients suffering from various psychiatric conditions. A provider delivers interventions to multiple patients during group therapies, which solves the problem of a low provider-patient ratio. Furthermore, because many patients will be seen together with one or more care providers, group therapies are effective in reducing wait times. While it has demonstrated benefits in meeting a patient’s needs, potential challenges such as breaches of confidentiality, conflicts, and dealing with disruptive individuals must also be considered. Furthermore, while patient cooperation is necessary, the effectiveness of group therapy is also dependent on the therapist’s competence in delivering a well-orchestrated session that encourages the participation of all members.

 

References

Abazarnejad, T., Ahmadi, A., Nouhi, E., Mirzaee, M., & Atghai, M. (2019). Effectiveness of psycho-educational counseling on anxiety in preeclampsia. Trends in Psychiatry and Psychotherapy41(3), 276–282. https://doi.org/10.1590/2237-6089-2017-0134

Adhikari, D. A. (2021). Effect of yogic exercises on stress and aggression among the adolescents. International Journal of Yogic, Human Movement and Sports Sciences6(2), 124–126. https://doi.org/10.22271/yogic.2021.v6.i2c.1232

Janjhua, Y., Chaudhary, R., Sharma, N., & Kumar, K. (2020). A study on effect of yoga on emotional regulation, self-esteem, and feelings of adolescents. Journal of Family Medicine and Primary Care9(7), 3381–3386. https://doi.org/10.4103/jfmpc.jfmpc_153_20

Locher, C., Meier, S., & Gaab, J. (2019). Psychotherapy: A world of meanings. Frontiers in Psychology10, 460. https://doi.org/10.3389/fpsyg.2019.00460

Mahvar, T., Ashghali Farahani, M., & Aryankhesal, A. (2018). Conflict management strategies in coping with students’ disruptive behaviors in the classroom: Systematized review. Journal of Advances in Medical Education & Professionalism6(3), 102–114. https://www.ncbi.nlm.nih.gov/pubmed/30013994

Malhotra, A., & Baker, J. (2022). Group Therapy. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549812/

Santamaría-Peláez, M., González-Bernal, J. J., Verdes-Montenegro-Atalaya, J. C., Pérula-de Torres, L. Á., Roldán-Villalobos, A., Romero-Rodríguez, E., Hachem Salas, N., Magallón Botaya, R., González-Navarro, T. de J., Arias-Vega, R., Valverde, F. J., Jiménez-Barrios, M., Mínguez, L. A., León-Del-Barco, B., Soto-Cámara, R., & González-Santos, J. (2021). Mindfulness-based program for anxiety and depression treatment in healthcare professionals: A pilot randomized controlled trial. Journal of Clinical Medicine10(24), 5941. https://doi.org/10.3390/jcm10245941

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