An alienated client with schizoid personality disorder, announced in the eighth meeting that he felt he was getting nowhere in the group and was contemplating termination. In an individual session, he told the therapist something he had never been able to say in the group- namely, that he had many positive feelings towards a couple of the group members. Nevertheless, he insisted that the therapy was ineffective and that he desired a more accelerated and defined form of therapy. The therapist noted Joseph’s criticism of the group therapy and he was, in fact, fleeing from the closeness he had felt in the group. The therapist again explained the social phenomenon and clarified for Joseph that in the group he was repeating his lifelong style of relating to others. He had always avoided or fled intimacy and no doubt would always do so in the future unless he stopped running and allowed himself the opportunity to explore his interpersonal problems. The client continued in the group and eventually made considerable gains in therapy Group Psychotherapy Assignment Essay.
How can the therapist address his feelings of wanting to drop out of therapy?
Explain the relationship between the client’s schizoid personality disorder and how he feels about the group. What type of defense mechanism is he using when he criticizes the group therapy format?
Describe the potential issues that can manifest within the group when a group member drops out or discusses dropping out during group therapy.
Which phase of group development does this group appear to be in? Explain your answer. (Wheeler, Table 11.3, pg. 419)
Identify a specific group you would like to lead in your practice and discuss the purpose, your target population, how you would screen and recruit participants, establish a fee schedule, time frame (open or closed), number of participants, theoretical orientation for the group, selection of a co-therapist or why you do not want a co-therapist, marketing and advertising, and length of each session Group Psychotherapy Assignment Essay.
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Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.)
The therapist can address the client’s feelings of wanting to drop out of therapy by first collecting feedback using a pre-structured form at the end of each session. The feedback would then be explored to clarify the areas in which the client is satisfied or unsatisfied. Finally, the feedback would be incorporated into immediate future sessions to ensure that the client’s issues are addressed with satisfaction (Wheeler, 2014). In this respect, the client would be relied upon to explore the reasons for wanting to drop out with strategies developed to address the reasons.
The client’s schizoid personality disorder has the client appear to have restricted emotions, flat effect, detached and a loner. In fact, he is indifferent to interpersonal relationships thereby making him resistant to forming interpersonal relationships within the group. The client applies an ego-syntonic defense mechanism when criticizing the group therapy format. This entails blaming others in the group for the problems that occur, such as criticizing the format for his inability to improve during the therapy and yet he is simply resistant to the closeness that has started to develop within the group (Wheeler, 2014).
A group member dropping out or discussing dropping out from the group therapy will cause other members to feel abandoned since they could have formed close interpersonal relationships that would be interrupted by the exit. In addition, the group cohesion is likely to be damaged since each member would feel that the interpersonal relationships formed within the group are only transient and could easily be broken without much warning. Other than the group members, the therapist is also likely to feel rejected and demoralized since the client is existing the group before being cleared by the therapist as an indication that the therapy is ineffective. Once these feelings have manifested in the group members and therapists, the remaining sessions are likely to be ineffective thereby interfering with subsequent treatment (Wheeler, 2014) Group Psychotherapy Assignment Essay.
The group appears to be in the norming phase where the group member are more aligned as a unit and work in concert to achieve a common goals. In this phase, the members have developed a greater sense of trust so that they now form interpersonal relationships. In the present case, the group has just had its eight therapy session (Wheeler, 2014). At this point, Joseph (the client) who has a schizoid personality disorder has started having positive feelings towards other group members. In fact, he confesses that he feeling close to some group members and even began forming interpersonal relationships. Given his schizoid personality disorder, it is clear that he would flee from intimacy thereby it is expected that he would instinctively seek to leave the group the moment he starts forming interpersonal relationships. Given that the group is only attending its eighth therapy session and, interpersonal relationships and feelings of closeness between group members are first developed at the norming phase, there it would be logical to assume that the group is at the norming phase of its development.
I would like to lead a group comprising of adult patients suffering from interpersonal difficulties and anxiety. That is because these are persons in need of immediate psychotherapy owing to suppressed feelings of pain result from past or ongoing traumatic experiences that could include sexual abuse. The choice of adults as the target population is because they are knowledgeable about their condition and receptive to the therapy since they want to find a solution to the interpersonal difficulties and anxiety. In contrast, children are not typically receptive in group therapy owing to personal fears in expressing themselves in a group setting. In forming the group, the number of members would be restricted to eight to ensure that each member has an opportunity to contribute. The sessions would be conducted once weekly for one hour at each session. Payments would be made prior to attending each session. No co-therapist would be recruited since the group is small enough to be managed by a single therapist. Marketing and advertisement would be conducted using local dailies and print media.
Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company Group Psychotherapy Assignment Essay.
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