Group Therapy

Definition

Group therapy is a form of psychotherapy which as small, carefully selected group of individuals meets regularly with a therapist. The client participates in sessions with a group of people. These individuals share a common purpose and are expected to contribute to the group to benefit from others in return.
In group therapy approximately 6-10 individuals meet face-to-face with a trained group therapist. During the group meeting time, members decide what they want to talk about. Members are encouraged to give feedback to others. Feedback includes expressing your own feelings about what someone says or does. Group rules are established that all members must observe. These set of rules vary according to the type of group.

Purpose of a Group Therapy

1. It helps an individual gain new information or learning
2. It helps an individual gain inspiration or hope.
3. The group also allows a person to develop new ways of relating to people.
4. During group therapy, people begin to see that they are not alone and that there is hope and help. It is comforting to hear that other people have a similar difficulty, or have already worked through a problem that deeply disturbs another group member.
5. In a group, a person feels accepted.
6. Group therapy sessions allow an individual to interact freely with other members that shares the same past or present difficulties and problems. The individual then, becomes aware that he is not alone and that others share the same problem.
7. A person gains insight into one’s problem and behaviors and how they affect to others.
8. Altruistic behavior is practiced. Altruism is the giving of oneself for the benefit of others.

As the group members begin to feel more comfortable, they will be able to speak freely. The psychological safety of the group will allow the expression of those feelings which are often difficult to express outside of group. The client will begin to ask for the support he or she needs.

Types of Group Therapy

1. Psychotherapy Groups
2. Family therapy
3. Education groups
4. Support groups
5. Self-help groups

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Gestalt Therapy

Definition

Gestalt therapy is a form of psychotherapy, based on the experiential ideal of “here and now,” and relationships with others and the world. It is an existential or experiential form of psychotherapy that emphasizes personal responsibility. Gestalt therapy is used often to increase a client’s self-awareness by putting the past to rest and focus on the present.

History

Gestalt therapy was originally developed by Frederick “Fritz” Perls, Laura Perls, and Paul Goodman in the 1940s. Perls believed that self-awareness leads to self-acceptance and responsibility for one’s thoughts and feelings. Gestalt therapy rose from its beginnings in the middle of the 20th century to rapid and widespread popularity during the decade of the 1960s and early 1970s. During the 70s and 80s Gestalt therapy training centers spread globally, but they were, for the most part, not aligned with formal academic settings.

Focus of the therapy

The therapy focuses upon the individual’s experience in the present moment, the therapist-client relationship, the environmental and social contexts of a person’s life, and the self-regulating adjustments people make as a result of their overall situation.

Goals that are encouraged to achieved by the patient during Gestalt Therapy

1. Identifying the person’s action or becoming aware of what they are doing.
2. Becoming aware of how they are doing a certain behavior.
3. Learning how to change the behaviors that keeps him or her from achieving life goals.
4. Accepting and valuing him or herself as a person.
5. Emphasizes of what is being done, thought and felt at the present time rather than what might have been, should have been, was or might be. It FOCUSES on what is happening instead of on the subject being discussed.

Gestalt Techniques

1. Increasing the awareness of body language and of negative internal messages.
2. Making a client speak continually in the present tense and in the first person to emphasize self-awareness.
3. Creation of episodes by the therapist and diversions that clearly demonstrate a point rather that explaining in words.
4. Asking the client to concentrate on a part of his or her personality or one emotion. The therapist would then ask the client to address it as if it were sitting by itself in the client’s chair.
5. To increase self-awareness the therapist often use this therapy by having then write and read letters, keep journals and perform other activities designed to put the past tp rest and focus on the present.

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General Nursing Interventions for the Mental Health Client

General Nursing Interventions for the Mental Health Client 

Forming a one-to-one relationship with the client

• It will help the client to enhance communication, problem solving, and social skills.
• Coping skills and trust in relationships may be learned or enhanced.
• The nurse who establishes this relationship needs to be clear about its purpose and provide positive interaction with the client.
• Establishment of a specific meeting time, expectations for interaction, and the duration of therapy are important boundaries to establish.

Constructive Feedback

• Given to the client so that the client’s self-esteem will not be compromised.
• When the confrontation technique is used, the nurse needs to discuss the discrepancies between the client’s verbalized intensions and non-verbal behavior carefully, without appearing to be attacking the client.

Trust

• Essential to establish a therapeutic relationship.
• Consistency is the key.
• If the nurse cannot meet with client at an appointed time, the client must be informed at the earliest possible time.
• A new meeting time is scheduled.
• Direct communication is essential for the building of a therapeutic relationship.
• Other factors that facilitate trust within the nurse/client relationship include:

1. Recognizing the client’s feelings.
2. Honesty
3. Respect for the client
4. Non-judgmental attitude

Emphasize Positive Results

• Do not argue with the client.
• Recognize that the client is experiencing pain but do not dwell on that pain.

Assessment

• Critical of their behavior at the time of admission or initial treatment. Reassessment is indicated at appropriate intervals.
• The client must also learn how to self-monitor his or her symptoms.
• This communicates to the client that he or she is respected and can control his or her symptoms.

Safety

• The primary concern.
• The client may require protection interventions; these must be provided in a safe manner with respect for the client.
• The milieu may need to be evaluated for safety

Environment

• Provide privacy and time with decreased stimuli.
• It should be a calm environment in which the client feels safe from psychological and physical threats.

Physical needs

• Intricately related to psychological function.
• Ensure that the client’s nutritional, fluid, sleep, hygiene, activities of daily leaving, and exercise needs are met.

Treatment planning

• The client should encourage to participate in every planning.

Medications

• Approach the confused or combative client in a calm, firm manner when administering client.
• Restrains or the assistance of another care provider may be necessary for injections.
• Ensure that the client takes medications and is not hoarding pills.
• Client will need to learn about his or her medications and hot to maintain this treatment without direct staff supervision.

Education

• Very important throughout treatment.

Discharge planning

• Begins with the client is admitted, whether it is in the hospital, home care, or any other treatment program.
• The family must be involved in the process to become successful.

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