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Examining Theories And Processes In Group Remedy Nursing Essay

Human beings live in organizations. Family is the first and most powerful group connection humans are born into. All customers of one's family are interwoven so that as each person's habit impacts others within it, a person commences to see himself or herself as straight influenced by the relationship he or she may have with the other members of the family. Human beings relate to others through conception and develop knowledge of others subjectively. This is in various manner than how a person perceives himself or herself. Families, although genetically connected aren't all alike, and far just like a group, tell you a composition and hierarchy. Like families, "a therapeutic group is not about conforming, being all as well. . . it is however, about symmetry, everyone being evenly important" (Foulkes, 1948, Chazan, 2001, p. 10). The purpose of this paper is to develop a deeper understanding and appreciation of group therapy and processes.

History of Group Therapy

Group processes in relation to group therapy identifies how members and leaders react to each other, as well as reactions to

An alternative to individual therapy, group therapy presents a practical option for folks to build up personal understanding or improve relationships and interactions with others. Depending of the concentration of the group it are able the members a chance to identify and change behaviors, learn new skills, and more effective way to deal with stress and personal struggle. A group comprises of not only the members but also the "therapist whose theory function is to make a positive and safe group culture in which therapeutic experiences may take place" (MacKenzie, 2002, p. 891). Communities also provide a supportive learning environment that can instruct members far better ways to interact with others. You can find as many different kinds of group remedy as there are issues that need to be resolved, as group constitute may differ by participant or by reason.

"Group psychotherapy is the treatment of psychological, behavioral, mental and interpersonal problems in a group context" (IEBS, 2008, p. 6426). Irvin Yalom (2005) identifies this process as interpersonal learning, and in Yalom's view this is the cornerstone of group remedy simply because an individual can see him or herself and exactly how they're identified by others through the group. This technique naturally supplies the client an chance to gain and build new skills, try them out within the safety of the group and in turn, internalize those skills to be used successfully in relationships with other connections beyond the group.

Group therapy started as a didactic technique and has been developed to include modern psychoanalytic, behavioral, cognitive-behavioral psychodrama, and system theories. Although these techniques will vary, the process goal is the same; to impact a sense of hope to the client, encourage cultural learning, and promote self applied disclosure, self manifestation and personal understanding.

Defining Group

Groups become an entity when group members connect. The general system theory and knowledge of groups is the fact as an entity, they are in totality the product of interactions between your associates. The dynamics within an organization can vary based on the individual group people and the target of the group. As part of the system, members match a function through contribution. This occurs in the form of observing others, developing a desire to understand conflict which may come up and solve it, as well as the reciprocity of giving to the group and receiving from it. As an organization member differentiates him self or herself while taking care of personal needs while integrating and doing things with other people of the group.

Groups can encompass any number of daily activities whether personal or business, and may also include inpatient treatment and drug abuse recovery. There are different therapeutic principles that psychotherapeutic groups can use: transactional analysis, reality remedy, Alderian, person focused, existential, Gestalt and psychodrama to name a few. Groups may also be used to address issues across the lifespan, with distinction by phases of development: Child, adolescent, adult, and aged adult to address issues that one encounters through life. Regardless of the focus or purpose an integration of theories and philosophies can be utilized to raise the therapeutic success of the group.

Socio-metric choice is a process that happens within the group (Hogg, 1992) and produces through the patterns of member patterns. Member's selections of personal preferences between individuals can effect how people within the group choose to conform to the group's framework (in-group) or break into subgroups (out-group).

Governed by the same legal and moral considerations as individual remedy, but by the type and complexness of the group, the group innovator must uphold the best ethical behaviors and goals. The group therapist is accountable for group variety and focusing on how the member's similarities and dissimilarities will have an effect on the group process. He or she is also sensible to make certain to get the credentialing and training as defined by the North american Group Psychotherapy Connection (APGA) that establishes expectations for professional and ethical practice suggestions fostering diversity and competence. (ASWG. org)

Group Development

Preparation is "the task of the group commences long before the first meeting" (Yalom 2005 p. 291) and a group's success will be based upon the therapists planning and development of the group. The prep process includes the introduction of focus, rules, goals, period, norms and process. Thought of insurance providers' expectations and rules for treatment and building a good working marriage provides the best value of services for the client and include:

Focus in treatment: By setting the leader is in charge of arranging effective goals and emphasizing that changes are part of treatment which the treatment is targeted to address the issues.

Engagement: The first choice is to facilitate interactions between group customers to establish determination to the group and allow participants to feel observed, comprehended and accepted.

Conflict: The first choice talks about to group people that understandingengagement and discord provide experiences required to develop determination to the group.

Interpersonal work occurs through users sensing safe and backed [and this] can lead to disclosure, personal catharsis and opinions from the group.

Termination: The final step provides opportunities for participants to expect responsibility for one-self.

MacKenzie, 2002, p. 895-900

Theoretical Orientations

Group psychotherapy happens to be used to treat a range of problems including unhappiness, eating disorders and addiction to name just a few. Group procedures may also be used for a work group, or include a psycho-educational part like instructing parenting skills or a behavioral adjustment. There are as many different types of teams as there are issues to be resolved. "Whatever patients experience as curative varies by theoretical orientation of the treatment and if the treatment is an organization. . . who is being cured and the environment of the procedure" (Johansson, Andrzej, 2009, p. 122).

Psychoanalytic group-therapy is based in the task of Sigmund Freud. The analyst uses the traditional analytic ways of free connection, interpretation and transference functions to find out about the client's irresolute issues and conflicts. Psychoanalytic group remedy can help your client offer with issues of specialist through the relationship made with the group head. Concerns about personal romantic relationship and passion can be did the trick through the client's romantic relationships with the other categories' people. By employed in such a way that your client gains information, transference to a cathartic release can take place so the client can let go of his / her unresolved anxieties.

Phenomenological remedy includes the practice of Gestalt, psychodrama and person- focused remedies. Where some therapeutic milieus seek to repair your client, phenomenological theories make an effort to see the consumer as someone who has his or her own knowledge of the planet and through the work finds the potential they're with the capacity of (Yalom, 2005).

Cognitive-Behavioral therapeutic teams are not worried about the reason for the client's problems or issues, but look at them through the lens of learning theory. Once diagnosed, the therapist will continue to work with the client "through cognitive restructuring, self-instructional training, and problem dealing with teaching" (IEBS, 2008, 6427). Customers can be given homewoirk assignments that offer both the experience of a supported learning opportunity in the group and a second opportunity for learning when the results of the home work as reported back again to the group.

Psycho-educational categories can give attention to any number of activities. Formerly developed for use in educational settings and for educating academics skills the group can have needs that vary based on the group users, but all individuals usually need to focus on the same concerns or share the same examination. A psycho-educational group can help clients understand the diagnosis that he / she may have and work within the group to find ways to handle it. The purpose of a psychoeducational group is to concentrate on learning as aimed by the group leader. Groups of this kind can also focus on topics like parenting, drug abuse or learning how to be part of the community. The goal of the group is to "prevent future development of [the] debilitating dysfunctions while building up coping skills and self esteem" (Coyne, 1999, p. 157, Gladding, 2008, p, 28).

Interpersonal psychotherapeutic groups give attention to member interaction. A member will relate to others within the group as he or she will relate to other folks in his or her life. The group can provide information to the member through reviews. Interpersonal learning occurs as the therapist models the actions that he or she wants the client to learn. Feedback from the therapist and in such, the group users provide reassurance and reinforcement. This is the basis of cultural learning as define by Irvin Yalom (1995). This technique known as a curative electricity takes place as the users share and go through the process of writing information.

Trauma Work

Groups can be made to target specifically on trauma. These types of groups can are present to deal with individual injury (like rape or maltreatment) or groupings of people diagnosed with activities related to natural disasters or conflict. The therapist is incurred iwth the responsibility to amke the group a place of basic safety to provide a client an chance to rebuild his / her self-confidence and learning that he / she still has the capacity to garner faith in others.

As an organization process can include reenactment of the occurrence, a leader should become aware of the countless ways the group can transform and how associates may respond as some participants may provide an optimistic experience and identify with the survivor, while some may criticize him or her laying blame for insufficient awareness or planning. At exactly the same time, other associates can just continue to be quiet and unaggressive.

Trauma survivors develop the ability to read a person's cosmetic cues, unspoken communication as well as body gestures. Members can respond to these unspoken forms of communication to the first choice or other associates. This transference reaction can disrupt the group as the original injury is the travelling power behind it, as the member is responding to perceived threats colored by the knowledge in his / her former. "Hypervigilance [can] business lead to distortion, because [the member] responds to the uncon scious motives as though they were really acted out" (Weinberg, Nuttman & Gilmore, 2005, p. 196).

The clinician also needs to consider the value of self care as working with stress survivors may result in vicarious stress for the therapist because they're exposed to recounts of mistreatment or assault as an organization member recounts his / her experience. Since group users need to see interactions with the leader as supportive, empathetic and taking, the therapist must practice good do it yourself care strategies whenever using clients who've experienced most varieties of trauma.

A phenomenon called vicarious traumatization can effect when a theapist is influenced by the encounters of the client (s) and should address these problems with therapist support groups, stress management techniques and guidance. Vicarious trauma is different from counter-top transferrence "for the reason that it represents the impact on the therapist of vicariously experiencing many instances of trauma rather than specific countertransference reaction to a particular [customer] (Weinberg, Nuttman & Gilmore, 2005, p. 199).


Ethical concepts on confidentiality dictate that any information that your client shares with the therapist is not shared with others. The sole instance when that will not apple is when there is an issue around the responsibility regarding duty to warn or protect or misuse, homicidal or suicidal strategies or action. Group work reveals a whole series of challenges predicated on the actual fact information once shared is disclosed to the whole group. "In groups. . . maintenance of trust is more complicated because many folks have to be relied after for keeping confidences" (Brandler, Roman, 1999, p. 278). Once confidentiality is affected, it may be impossible for the group to move past it returning to a point of safety and trust. The group innovator must be clear on expectations his or her expectations of group users so it is known from the very first meeting the importance of keeping identities and information distributed private and the consequences that may need to be applied in case of a breech.

Issues that may surface regarding a breech of confidentiality and resolutions may include a meeting between the offending member and the group leader as well as the opportunity to meet the group. "Violations should be prepared within the group to rebuild trust and deter further violations" (Brabender, Fallon, Smolar (2004, p. 184). Participants should be given the opportunity to share feelings, and become area of the development of an action plan to solve the understanding and importance of confidentiality.

Self disclosure

At one time or another, group leaders will be met with the possibility to disclose private information. There appears to be as much reasons to disclose as there are reasons not to.

Disclosure, if done effectively may bring the group deeper together, generating acceptance and understanding. There is as much information available that expresses that clients need to find out that a leader is empathatic and knows what he or she has gone through, as well as for those participants, disclosure is helpful. Others within the group may feel that personal disclosure by the group leader bring with them issues around intimacy, plus some clients might not be comfortable with it. Other reasons include showing the group leader as falliable, and therefore judgment regarding the group can be questioned. The North american Group Psychotherapy Association (AGPA) has this statement regarding personal disclosure: "The judicious use of self disclosure can have significant therapeutic impact" ( 2007 apga. org). It's important that any personal disclosure by the group leader is done in a manner that benefits the users, which is not done due to the therapists transference or for any other reason.

Core Competencies in Group Work

The Relationship for Specialists in Group Work ASGW) has a couple of core competencies criteria of bare minimum competencies for group market leaders, as well as a tool for self applied evaluation and specifications of practice. Competencies and key training include:

Nature and Opportunity of Practice: Knowledge and skill development

Assessment of group people: Social systems in which clients live and work

Planning Group Interventions: Impact of group diversity, planning consultation

Implementation of group interventions: Key points of group development, leadership

functions and group dynamics

Leadership and Co-Leadership: Command styles, group methods, co-leadership

Evaluation: Methods for analyzing group process, self-evaluation

(ASGW. org)

As with any control role, group market leaders are anticipated to have the ability to effectively lead the group so it stays on activity, allow all associates time expressing concerns open up and close the group, and become empathetic and caring of all members.

There are concerns regarding Ethical Practice, Best Practice, and Variety Practice recommendations and ethical things to consider that are unique to group work. Inability to obtain the proper training and creditialing can position the clinician at risk for any quantity of ethics violations. A head must be familiar with the procedure and materials of the organizations that he / she is leading. Jacobs, Masson & Harvill (2009) posit the following as attributes of effective command. Leaders should have the following competencies:

Experience with individuals

Experience with groups

Planning and orgizational skills

Knowledge of this issue [that is the focus of the group]

A good knowledge of basic human conflicts and dilemmas

A good knowledge of counseling theory

(p. 25-27)

A clinician who chooses to develop or lead an organization needs to make certain that he / she has been trained in leading groups. Failure to obtain the proper creditentialing can put the clinician at rsik for honest violations. A innovator must be familiar with the procedure and materials of the groupings that he or she is leading.

Dual relationships and considerations

Dual relationships especially in rural communities at times cannot be prevented and must be checked to make certain that the partnership beyond the group will not adversely impact the restorative impact within the group.

The creators define similarities and distinctions in how humans develop morals, principles and virtue. Although interconnecting when looking at honest judgment, each discussion is damaged by how the people engaged view the world. Within the context of treatment, and use of theory, the therapist should consider a client's culture and experience and plan appropriately.

Counseling is a sophisticated profession. Being aware of the living for potential moral issues and finding well-timed and appropriate resolution if you need to surface is the duty of the counselor. As every counselor is different, personal value judgments cannot provide answers. Ethics rules are not only a guideline to react in a certain way, but an instrument on which to base in charge interactions offering a consistent construction and process where to address issues.

In Chapter one of The theory and practice of group psychotherapy Yalom & Leszcs (2005) ask the question does indeed group therapy help clients? His answer to the question lies in therapeutic activities realted to eleven principal factors that can result in healing change. Dscribed as a complex process they are simply:

Instillation of hope


Imparting information


The corrective recapituation of the promary family group

Development of socializing techniques

Imitative behavior


Existential factors


Interpersonal learning input

Interpersonal learning output

Self-understanding (p. 1-2)

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