group therapy

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Mr. Jayesh Patidar (M.Sc. Nursing) www.drjayeshpatidar.blogspot.com

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Page 1: Group therapy

Mr. Jayesh Patidar (M.Sc. Nursing)

www.drjayeshpatidar.blogspot.com

Page 2: Group therapy

CONCEPT:

Group psychotherapy is a treatment in which carefully selected people who are emotionally ill meet in a group guided by a trained therapist, & help one another effect personality change.

In other word, Group psychotherapy is a treatment of psychological problems in which two or more patients interact with each other on both an emotional & cognitive levels in the presence of one or more psychotherapists who serve as catalysts (the person who can be related to or who can understand the other’s point of view), facilitators or interpreters.

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Three major kinds of groups are:

Group Therapy

Therapeutic Groups

Adjunctive Groups

Group Therapy:

Group Psychotherapy members gain a

personal insight, improve their interpersonal

relationship, change destructive behavior & make a

necessary alteration in their behavior. 4/24/2013

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Therapeutic Group:

It is a group of patients who meet under the

leadership of a therapist to work together to improve

mental & emotional health.

Example; Groups of expectant mothers, people who have

just lost their husband or wife. Group of people with a

chronic illness.

- Therapeutic groups are self-help like Ashiana, Saheli in

Delhi, who conduct these groups for drug addicts.

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Adjunctive Groups:

Adjunctive groups deal with selected

needs of a group.

For Example; for sensory stimulation allow them to

have music therapy, for self-expression art

therapy, for expression of feelings & emotions

through dance therapy. These are a few examples

which can be used for adjunctive groups

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CONTRAINDICATION

Antisocial patients

Actively suicidal or severely depressed

patients

Patients who are delusional & who may

incorporate the group into their delusional

system.

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GROUP SIZE…

Optimal size for group therapy is 8 to 10

members.

FREQUENCY AND LENGTH OF SESSIONS:

Most group psychotherapist conduct group

sessions once a week; each session may last for

45 minutes to 1 hour.

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Types Of Psychotherapy Groups

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1. Traditional Groups

2. Encounter Group or T. Group

3. Homogeneous or heterogeneous groups

4. Open or close groups

5. Groups for psychosis or neurosis

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1. Traditional Groups:

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Traditional groups includes mainly the patients with mental illness & are from the hospital inpatient department. In the didactic group therapy, lecture is given to the patient along with some filmshow, like in the case of excessive drinking or use of drugs

- Psychodrama is a technique of psychotherapy in which a patient acts out his feelings in front of a group of patients. The therapist guides & directs the patient & interprets the actions of the patient. This type of acting out provides an insight into the patient about his faulty patterns of learning which he can eliminate

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2. Encounter Group or T. Group:

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Encounter group is a form of small group in which

an individual learns how his feelings & behavior

affect him & others. This group is not necessarily a

group of people with mental illness. The individual

may have some coping difficulty which he would

like to resolve at the right time

For Example; a suspicious feeling gradually being

developed about his wife or any other illusions.

Theses groups are based on sensitivity training or

T-groups.

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3. Homogeneous or heterogeneous

groups:

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Homogeneous groups are composed of patients

of the same age, race, sex, socioeconomic level

& similar category of illness.

Heterogeneous groups vary on all these

aspects.

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4. Open Groups & Closed Groups:

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In open groups members may join & leave the

group at anytime. Closed groups have a

specific number of people, specific time to start

& close the group sessions; the duration is three

to four weeks. Inpatients & outpatients both

are included in this group.

Open & closed groups are used

extensively in the hospital.

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5. Group According to Mental Illness:

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Neurotic group or patient

suffering from psychotic illnesses come under

this category.

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APPROACHES TO GROUP THERAPY

The therapist’s role is primarily that of a facilitator; he

should provide a safe, comfortable atmosphere for self-

disclosure.

Focus on the “here and now”.

Use any transferences situations to develop insight into

their problems.

Protect members from verbal abuse or from

scapegoating.

Whenever appropriate, provide positive reinforcement,

this gives ego support & encourages future growth.4/24/2013

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Handle circumstantial patients, hallucinating &

delusional patients in a manner that protects the self-

esteem of the individual & also sets limits on the

behavior so as to protect other group members.

Develop ability to recognize when a group member is

“fragile”, he should be approached in a gentle,

supportive & non-threatening manner.

Use silence effectively to encourage introspection &

facilitate insight.

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Laughter & a moderate amount of joking can act as

a safety valve & at times can contribute to group

cohesiveness.

Role-playing may help a member develop insight

into the ways in which he related to others.

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THERAPEUTIC FACTORS INVOLVED IN

GROUP THERAPY:

1. Sharing experience

2. Support to & from group members

3. Socialization

4. Imitation

5. International learning

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1. Sharing Experience

This helps the patients to realize that they are

not isolated & that others also have similar

experience & problems

Hearing from other patients that they have

shared experiences is often more convincing &

helpful than reassurance from the therapist.

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2. Support to and from group members:

Receiving help from other group members can

be supportive to the person helped.

The sharing action of being mutually

supportive is an aspect of the group

cohesiveness that can provide a sense of

belonging for patients who feel isolated in

their everyday lives.

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3. socialization:

It is acquisition of social skills (for example,

maintaining eye contact) within a group

through comments that members provide about

one another’s deficiencies in social skills.

This process can be helped by trying out new

ways of interacting within the safety of the

group.

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4. Imitation:

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It is learning from observing & adopting the behaviors

of other group members.

If the group is run well, patients imitate the adaptive

behaviors of other group members.

5. Interpersonal learning:

It refers to learning about difficulties in relationships by

examining the interaction of individuals with the other

members of the group.

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STEPS OF GROUP THERAPY

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1. Selecting group Members

2. Developing contact

3. Selection of group leaders

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1. Selecting group Members:

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It is very important function of a group therapist.

She has to decide based on the condition of the

patient who all can be included in the group.

A very depressed patient may lead to

withdrawal of other members of the group,

whereas too many excited patients included in

the group may lead to unsuccessful group

therapy.

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2. Developing Contact:

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The purpose should be made clear to all the members in the group.

Time, length & place of the meeting should be announced.

Starting & ending time & how frequently the group sessions will be conducted.

Attendance of members.

Confidentiality to be maintained within the group.

Role of the members is; to report punctually, maintain confidentiality & interact freely.

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3. Selection of Group Leaders:

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Role of the therapist – the therapist acts as a facilitator & helper.

I. To provide information to the group.

II. Allow emotional catharsis.

III. Share members’ perception.

IV. Share feelings of fear, loneliness & frustration.

V. Improve communication skills

VI. Provide a role model.

VII. Help to know what is reality.

VIII. Set limits for some patients.

IX. Make observation of all the non-verbal techniques being used by

the patient.

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SOME TECHNIQUES USED IN GROUP

THERAPY:

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Reflecting or rewarding comments of group

members

Asking for group reaction to one member’s

statement

Asking for individual reaction to one member’s

statement

Pointing out any shared feelings within the group

Summarizing various points at the end of session.

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THANK YOU