Respond 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.
NOTE: Positive comment
Counselling older adults may be challenging because of a number of issues that may be associated with their age such as multiple chronic illnesses. The therapist needs to know how to accommodate these issues in a group in order to make sure that the elderly clients benefit from the group sessions. In one session with older adults, a group therapy was formed in order to address concerns that the elderly clients had about end of life. Most of them presented with symptoms of anxiety and others had depression. Some of them felt that they were not ready to die yet and others felt that they had regrets in life and had not achieve what they wanted. The purpose of the group therapy was to help them to cope with the fact that they are old and that they should try to focus on “here and now” instead of their past, which they cannot change. The therapy also created an opportunity to help the older patients to make plans about their medical care in the future such especially if they are not able to do so. Research shows that advance care planning for elderly patients is associated with low stress, depression, and anxiety in family members after the death of the elderly person (Kale et al., 2016).
The group is still in the forming stage and the members are still getting acquainted. There is very limited exchange between the elderly persons and most of the time, they only speak when they are prompted by the therapist. The therapist has been doing his best to create cohesiveness and set goals as well as expectations for the group. At this point and stage of the group, the main issues include feelings of anxiety, uncertainty, and distrust between members of the group (Malhotra & Baker, 2019). These are elderly persons that come from different areas and they have never met. They all have their fears and concerns about end of life, and they may not be ready to share them with the rest of the group before the become comfortable around each other. In order to improve on cohesion and reduce the level of distrust between the members, the therapist has been prompting each person to share something about themselves that do not necessarily pertain to their main concerns and reasons for accepting to start the group therapy. Once each member knows something about the other, the level of distrust will reduce, and they will be comfortable when it comes to sharing information about their fears, regrets and concerns about end of life. The therapist also planned to use group reminiscence therapy for this group after cohesion has been achieved and after potential conflicts have been addressed. Group reminiscence therapy is an approach that has been proved to be effective in improving the quality of live and self-acceptance in elderly persons (Gaggioli et al., 2014).
Working with elderly patients may be very challenging for any professional. First, as it was mentioned earlier, elderly patients may have multiple illnesses such cardiovascular diseases, diabetes, and hypertension. These chronic illnesses may prevent them from effectively performing their activities of daily living and this may affect their ability to attend and participate in every session. Failure to attend a session may limit the extent to which a person may benefit from the group. In addition, failure to attend several sessions by different members may negatively affect the progress of the entire group. The result may be that more sessions will have to be used before the group therapy is considered to be successful.
Gaggioli, A., Scaratti, C., Morganti, L., Stramba-Badiale, M., Agostoni, M., Spatola, C. A., … & Riva, G. (2014). Effectiveness of group reminiscence for improving wellbeing of institutionalized elderly adults: study protocol for a randomized controlled trial. Trials, 15(1), 408
Kale, M. S., Ornstein, K. A., Smith, C. B., & Kelley, A. S. (2016). End‐of‐life discussions with older adults. Journal of the American Geriatrics Society, 64(10), 1962-1967.
Utz, M. (2016). When a therapist leaves a client: Closing the therapeutic relationship effectively.Retrieved from https://sophia.stkate.edu/msw_papers/686/