Respond to the post below by recommending strategies for improving the effectiveness of their group therapy sessions. Support your recommendations with evidence-based literature and your own experiences with clients.
wk 11 main post
Group Therapy with Older Adults
One of the primary issues challenging the mental health of older adults is the tendency to self-isolate and reduce the amount of socialization in which they engage (Teverovsky, O’Toole, Solai, Swartz, & Wallace, 2018). As peer groups shrink in one’s later years due to divorce, death, and other factors, older adults tend to experience greater levels of loneliness and depression leading to the need for supports and services outside of the regular course of their daily lives. For many of these individuals, group therapy can be an effective way to address their concerns and feelings and allow them to return to active, productive lifestyles that more closely resemble what they experienced earlier in life (Jayasekara, et al., 2015). In this discussion, we will dive into group therapy for older adults in the context of one session that I had the opportunity to facilitate, we will also look into the stage of development of the group, resistance to therapy noted by some of the group members, and challenges that may arise in the course of treating older adults.
Description of Therapy Session
The group therapy session was conducted at the community psychiatric center. The therapy session included seven individuals over the age of sixty, with three males and four females. The entire group participants were either still working, retired whether because they had reached the end of their careers or because medical conditions required cessation of their professional lives. Additionally, every member of this group was single, with two of the group members widowed and the remainders were either divorced or still married. While many of the group participants had adult children, most reported a significant distance and disconnect between their lives and the lives of their extended families due to either substance abuse addictions or ongoing conflicts within their families.
The group session was focused on helping the group members recognize the signs of self-isolation and the need to actively engage in social experiences that helped to create bonds between peers of similar age and experiences (Elias, Neville, & Scott, 2015). I opened the group by asking the participants to share their recent experience that moved into a discussion of how to recognize when negative thoughts and perceptions resulted in the participants declining invitations to socialize or to participate in activities that would bring them into contact with groups of people. Many of the participants struggled to move past negative thoughts and I tried to focus on having them recognize the benefits of socialization on their mindsets.
Stage of the Group
This group was having its second meeting and the members were just beginning to know one another and myself. Because the group was relatively new, it was still in the formation stage wherein some members have not yet bought into the therapeutic approach and others remain skeptical about the need for therapy entirely (Anderson, Wickramariyaratne, & Blair, 2018). I definitely wanted each group member to feel welcome, so I encouraged as much participation as possible, eventually getting everyone to provide input at least once during the hour-long session. This group is likely to become more effective as it grows and the participants develop trust with one another.
Because the group is relatively new, there were several issues with resistance experienced. Many of the group members, particularly the males, are reticent to accept the need for therapeutic intervention and continue to be in denial about the effects of isolation and depression on both their physical and mental states. Some of the group members appeared to feel as though sharing their thoughts and perceptions placed them in a position of weakness that they weren’t willing to assume. However, as the session progressed many of those participants began to open up and share their experiences, seemingly coming to understand the benefits of therapy and socialization.
Therapeutic Techniques Used By Facilitator
The group worked through the application of Cognitive Behavioral Therapy, or CBT (Anderson, Wickramariyaratne, & Blair, 2018). They first focused on helping participants understand their own negative thoughts, perceptions, and attitudes not only toward socialization and interactions but also to hear others’ perceptions and contrast those to their own. By becoming cognizant of their thought processes and emotional reactions, participants in this group will move toward being able to re-shape those processes or halt them altogether, reaching a place where they are able to consciously re-frame their negativity into positive perspectives that support healthier lifestyle choices such as socialization and participation in group events (Jayasekara, et al., 2015).
Challenges Working with Older Adults
Several challenges may occur when working with older adults in this group. Firstly, older males tend to be less expressive than females and often cling to stereotypes of prior eras, resulting in a reticence to share feelings, thoughts, and emotions. This could impede progress for such patients (Anderson, Wickramariyaratne, & Blair, 2018). Also, there is often a power-distance struggle between facilitators who are younger than their clients and the clients themselves, resulting in a failure to establish trusting relationships (Teverovsky, O’Toole, Solai, Swartz, & Wallace, 2018). These challenges are definitely in place in the current group and could impact outcomes if not appropriately navigated.
Working in group therapy situations such as this one with older adults presents specific challenges to both treatment and the establishment of trusting relationships (Elias, Neville, & Scott, 2015). When facilitating group therapy for older adults, it is important to remember the influences on their life experiences that have created a willingness or distance from therapy and how those may best be overcome. In the case of this current group, it is important to both honor their experiences and help guide them toward new perspectives on life, treatment, and socialization to ensure appropriate outcomes for all involved.
Anderson, K., Wickramariyaratne, T., & Blair, A. (2018). A feasibility study of group‐based cognitive behaviour therapy for older adults in residential care. Clinical Psychologist, 22(2), 192-202.
Elias, S. M., Neville, C., & Scott, T. (2015). The effectiveness of group reminiscence therapy for loneliness, anxiety and depression in older adults in long-term care: a systematic review. Geriatric Nursing, 36(5), 372-380.
Jayasekara, R., Procter, N., Harrison, J., Skelton, K., Hampel, S., Draper, R., & Deuter, K. (2015). Cognitive behavioural therapy for older adults with depression: a review. Journal of Mental Health, 24(3), 168-171.
Teverovsky, E., O’Toole, K., Solai, L. K., Swartz, H. A., & Wallace, M. (2018). The Implementation and Effectiveness of a Higher Level Outpatient Mental Health Care Program for Older Adults. The American Journal of Geriatric Psychiatry, 26(3), S154-S155.
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