Social Work and Human Services

As a reference, here are some key aspects of the structure (these are not all of the instructions) for the Proposal:

Here are your assigned stages, each has to be explored in detail:

Proposal
The formation of the group
The initial stage
Τhe transition stage
The working stage
The final stage or termination of the group.

For the Proposal Paper, select a therapy from the list below to apply to a specific client population. The options are as follows:

Person Centered
Adlerian
Gestalt
Rational Emotive Behavior Therapy

The options for client populations are as follows:

A Multi-Cultural group
Children
Adolescents
Αdults
Elderly
Suggestions & Pointers:

a.) I would strongly recommend that your section headings directly align with each of the assigned stages (e.g. Proposal, Formation, etc.)

b.) I would also recommend that you be specific in your group’s chosen goal/purpose. In other words, past students have found it much more difficult to research a broad group goal (e.g. adolescents who are sad) versus one that is more specific (e.g. adolescents with depression).

c.) Then, you need to complete rigorous and in-depth research into
i.) one of the four assigned theories,
ii.) group stage development,
and iii.) the specific needs of your selected group population.

d.) After completing your research, you need to clearly address each assigned stage, while simultaneously tying your chosen theory into each stage (i.e. how will the theory inform the majority of your decisions per the structure of the group, your conceptualization of the client’s needs, and your specific interactions/interventions with the group as a whole).

e.) In addition, the specific needs/challenges of your selected population needs to be addressed within each stage as well. So, say you choose REBT with a group addressing depression in elderly clients. For the Proposal stage you need to identify why the theory is a good fit for the population and what your group will achieve. For the Formation stage you need to discuss how your theory will inform your design and structuring of the group, as well as member selection. For the Initial stage you need to explore what types of challenges are typically experienced in this stage, and how REBT will inform your work with the group. This same integration needs to occur within the remaining stages.

ANSWER

Group Therapy for Geriatric Depression

Proposal

Geriatric depression is a common occurrence, especially among older adults living in nursing homes and older adult facilities. Geriatric group therapy is an excellent way to help older adults feel a sense of support and also help them come together in dealing with their issues. Depression among older adults in long-term care is common due to various factors such as the feeling of being unproductive, being separated from their families, sometimes the loss of a spouse and the feeling that their families have abandoned them. Gestalt therapy is an excellent way of helping older adults in dealing with depression and feelings of sadness that come with living in a long-term care facility (Momeni et al., 2017). Gestalt therapy improves self-differentiation and decreases depression through its self-awareness approach and focusing on the present rather than the past.

Formation of the Group

The group therapy will take place in a nursing home of choice. This location will be the best location because it is likely to have the highest number of older adults suffering from depression. It is also accessible to older adults, and thus the therapy sessions will take place in the nursing home. The first step in the formation of the group will be to identify the depressed older adults in the nursing home. The writer will use the geriatric depression scale to identify the older adults who will be involved in the group therapy sessions. A geriatric depression scale is a 15-question short answer scale used as a self-report measure to identify depression in older adults (Tasca et al., 2021). The various staff in the nursing home will administer the tests to the various residents they believe are struggling with depression. The group will involve eight members. Eight members are a manageable group of ode adults, and thus the proposal will take eight members who are severely depressed in the nursing omen ad involve them in the group therapy.

Ageing is a natural process. However, this natural process might make some people unaware and thus the issue of geriatric depression. One of the challenges that one might face while forming a group for group therapy is that some older adults might be reluctant to get help. There is also the challenge of some having conditions such as Alzheimer’s and other health conditions that might prevent them from receiving the full benefits from the therapy. In this case, the group will focus on depressed adults, especially those with full functions and who are only experiencing a few health issues that do not stop them from achieving other functions such as listening and participating in the group therapy. The major challenge expected in this stage is deciding on the older adults who need the therapy more.

The Initial Stage

At the initial stage of group therapy, issues arise around topics such as the role of the leader, beginners’ anxiety, and orientation. At this stage, the leader welcomes the group therapy members to the therapy session. Gestalt therapy aims to ensure that people are aware of the significant sensations within themselves and the environment. In this case, older adults in the group could be depressed for various reasons. They could be depressed because they do not like the nursing home environment, it could be that they are lonely in the nursing home, or it could be that they feel like their bodies are betrayed at this age. At this stage of the group therapy, the first step will be to let the group member identify the issues that are leading to their depression.

At the initial stage of the therapy, some of the group members might not be willing to participate in the group activities fully. They might not even want to talk about their feelings and how they feel. The role of Gestalt therapy is to ensure that the patients are self-aware and regain confidence in themselves. This means that they first have to acknowledge that their confidence and self-awareness have suffered for them to start the healing process. At this stage, to ensure that all the members participate, the gestalt approach that will be taken is taking rounds. Each member of the group will be asked to talk about the challenges they are facing and their feelings (Austin & Austin, 2022). This will help them get in touch with their issues before moving to the next stage. The therapist will guide them during the rounds by asking questions about their feelings.

The Transition Stage

In Gestalt therapy, this is also known as the dialogical stage. At this stage, the therapist should be fully involved in the discussions happening in the group. In the initial stage, the group therapy members talked about their present emotions, as gestalt therapy focuses on the present. In this stage, the members of the group and therapist now start discussing their present emotions. At this stage, open communication is an important factor. This stage requires dialogue, inclusion and engagement (Austin & Austin, 2022). This means that every member of the group is involved in the dialogue on their feelings. For example, one group member might say that they feel like they are being punished by their children, which is why they are in the nursing home. This will become the basis of the dialogue with the therapist, trying to understand these feelings and whether the group members also feel the same way.

The working stage.

At this stage, the group members are already aware of their emotions. They have also accepted they are depressed and they need help to get better. This is the stage where the work is done to ensure that the members are improving and even getting better. The gestalt theory method does not have specific guidelines. Therapists are encouraged to be creative in different ways of approaching clients. This is group therapy, and the aim of the therapy is to help the members connect with their current environment. The best action is to create different individual and group activities depending on the group members’ interests to help them connect with their current environment (Dianti, 2021). Some of the individual techniques that would be used in this group would include the empty chair technique. The members of the group would be asked to imagine that the chair is somebody they want to have a conversation with but have not. They would then be asked to talk about anything they need to, assuming the person is available.

The other technique that would be applied to the group is exaggeration. This would involve the exaggeration of anything. Being that this is an elderly group, they would be asked to exaggerate things such as frowning, wincing, and bouncing a leg. This activity is helpful in increasing awareness of the emotions attached to the behaviour (Macaluso, 2020). This will help the group become more in touch with their present emotions ad let go of their past emotions without necessarily invalidating their past experiences. Other activities that will be involved in the group therapy include creative arts and any other activities that the members of the group enjoy. These activities will be included to ensure that they enjoy their nursing home stay. It will also help get them in touch with the present emotions they feel while involving themselves in activities such as painting. This evokes happy feelings and helps them focus on the now rather than the past or the future. Also, through these activities, group therapy members will interact, and they could find friends within the nursing home who share similar likes. These activities also help them become self-aware and also start their healing process.

Final Stage

This is the last stage of group therapy. At this point, most of the group members are feeling much better. They have started their healing process, and each day looks better than the last. At this stage, the group members are allowed to reminisce about their journey. They are allowed to talk about the things they are doing to stay in the present, and now that they are more self-aware of what they are doing to ensure they do not go back to the depression. Each group member will be allowed to share their experience from the group therapy and what they are going to continue practising. Some group members will carry a lot out of the therapy, and there are others who might need more work before they can heal. At this point, it is up to the members to decide what they will do with the experience they have received, and as the therapist, one would tell the group members that it is the last session of their group therapy and that they hope that they will continue doing the work, staying in the present and keeping a positive outlook.

References

Austin, J., & Austin, J. A. (2022). Gestalt Applications to Group Work. Revista de Psicoterapia, 33(121), 123-138.

Dianti, T. M. (2021). ANALYSIS OF THE GESTALT APPROACH IN GROUP COUNSELING. Literasi Nusantara, 2(1), 94-108.

Macaluso, M. A. (2020). Deliberateness and spontaneity in Gestalt therapy practice. GESTAL, 29.

Momeni, S., Foroughan, M., Yonesi, S. J., & Doladtshahe, B. (2017). The Efficacy of group counseling by using gestalt techniques on morale and loneliness of older adults living in nursing homes. Iranian Journal of Psychiatric Nursing, 5(1), 30-38.

Tasca, G. A., Mikail, S. F., & Hewitt, P. L. (2021). Group therapy theory and group psychodynamic-interpersonal psychotherapy stages of development. American Psychological Association.