Week 7: Group Processes

Group therapy is an effective treatment option for a wide range of disorders and is much more cost-efficient than individual therapy. As a result, many insurance companies are showing preference for group therapy over individual therapy. This has led to more therapists including group therapy in their practices, making it very likely that you will facilitate group therapy in the future. To successfully develop groups and apply this therapeutic approach, it is essential for you to have an understanding of group processes and formation.

This week, as you examine group processes and stages of formation, you explore curative factors of groups and strategies for managing intragroup conflict.
Learning Resources
Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Standard 5G “Therapeutic Relationship and Counseling” (page 62)

Crane-Okada, R. (2012). The concept of presence in group psychotherapy: An operational definition. Perspectives in Psychiatric Care, 48(3), 156-164. doi:10.1111/j.1744-6163.2011.00320.x

Lerner, M. D., McLeod, B. D., & Mikami, A. Y. (2013). Preliminary Assessment of an observational measure of group cohesion for group psychotherapy. Journal of Clinical Psychology, 69(3), 191-208. doi:10.1002/jclp.21933

Nicholson, R. (2002). The dilemma of psychotherapy notes and HIPAA. Journal of AHIMA, 73(2), 38–39. Retrieved from http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4

U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved March 18, 2017, from http://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, Irvin D. ; Leszcz, Molyn. Copyright 2005 by Hachette Books Group. Reprinted by permission of Hachette Books Group via the Copyright Clearance Center.

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, Irvin D. ; Leszcz, Molyn. Copyright 2005 by Hachette Books Group. Reprinted by permission of Hachette Books Group via the Copyright Clearance Center.

Chapter 5, “The Therapist: Basic Tasks” (pp. 117–140)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, Irvin D. ; Leszcz, Molyn. Copyright 2005 by Hachette Books Group. Reprinted by permission of Hachette Books Group via the Copyright Clearance Center.

Chapter 8, “The Selection of Clients” (pp. 231–258)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, Irvin D. ; Leszcz, Molyn. Copyright 2005 by Hachette Books Group. Reprinted by permission of Hachette Books Group via the Copyright Clearance Center.

Chapter 9, “The Composition of Therapy Groups” (pp. 259–280)

Required Media

Psychotherapy.net (Producer). (2011a). Group therapy: A live demonstration. [Video file]. Mill Valley, CA: Author.

The approximate length of the video is 202 minutes. In preparation for this week’s Assignment, be sure to watch Parts 1 and 2 of this video.

Optional Resources

American Counseling Association (Producer). (2015). Leading counseling groups with adults: A demonstration of the art of engagement. [Video file]. Alexandria, VA: Author.

Assignment: Group Processes and Stages of Formation

In your role, you must understand group processes and stages of formation, as this will help you develop groups and determine an individual’s appropriateness for group therapy. Whether you are at the beginning stages of group formation or facilitating a session for a developed group, it is important to consider factors that may influence individual client progress. For this Assignment, as you examine the video Group Therapy: A Live Demonstration in this week’s Learning Resources, consider the group’s processes, stages of formation, and other factors that might impact the effectiveness of group therapy for clients.
Learning Objectives
Students will:

Analyze group processes and stages of formation
Analyze curative factors of groups
Analyze the impact of curative factors on client progress
Recommend strategies for managing intragroup conflict

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide on group processes.
View the media, Group Therapy: A Live Demonstration, and consider the group dynamics.

The Assignment

In a 2- to 3-page paper, address the following:

Explain the group’s processes and stage of formation.
Explain curative factors that occurred in the group. Include how these factors might impact client progress.
Explain intragroup conflict that occurred and recommend strategies for managing the conflict. Support your recommendations with evidence-based literature.

Group Processes and Stages of Formation
Introduction
Groups transition across various stages of formation from formation to adjourning. According to Bruce Tuckman, the stages include forming, storming, norming, performing, and adjourning (Jones, 2019). The Group Therapy, A Live Demonstration video, shows two important curative factors, including universality, development of socializing techniques, and catharsis. During the healing process, groups can experience conflict. It is the therapists’ responsibility to resolve the conflicts by allowing the members to discuss the issues and recommend changes freely. The paper aims to examine the group processes and stages of formation, curative factors, and how to solve the intragroup conflict.
Group Processes and Formation
According to Bruce Tuckman, groups follow five stages in the formation process. The stages include forming, storming, norming, performing, and adjourning. Forming stages comprises formation as the group has just been introduced (Jones, 2019). Everyone is polite, calm, and excited to join a new group. In the storming stage, the members realize the reality of the tasks they need to complete. Members disagree since the initial excitement is wearing off. The Norming stage involves settling down and appreciating everyone’s strengths and weaknesses (Jones, 2019). Everyone starts to work as a cohesive unit. It symbolizes a time to resolve the differences they experienced in the storming stage.
The performing stage is another step in the group formation process. In this stage, the members are confident and energized to accomplish the task ahead. Everyone in the team is motivated to achieve the set goals (Jones, 2019). Performing is a critical stage since it is critical in the achievement of the goals. If the group does not make a successful transition from the norming stage to performing, it can delay the goals’ achievement. The next process is adjourning or mourning. Once the project ends, the members have to terminate the group (Jones, 2019). It is called the mourning stage since, after developing a close working relationship, the members have to part ways or start a new project.
Curative Factors of Groups and Impact
Curative factors are healing factors that are essential in the members’ interaction and the ability to overcome their challenges. The Group Therapy, A Live Demonstration video, shows two important curative factors, including universality and catharsis. Universality involves helping other people to realize that they are not alone (Gabel & Robb, 2017). Sitting in a group attracts a healing experience. For instance, Philip and Gill share their experiences, which shows that individuals are not alone in personal challenges (Gabel & Robb, 2017). Universality helps people to realize they are not alone and thus strive to overcome their challenges.
Catharsis is another curative factor that helps group members to express their deep emotional feelings. It provides an opportunity for healing when people express their frustrations or anger (Gabel & Robb, 2017). The curative factor is evident when Pam and Philip converse about an issue that occurred 15 years ago. Pam is angry about the sexual misconduct of Philip. She threatens to leave the group since it is not conducive to her. The healing factor provides Philip’s opportunity to apologize, an issue that resolves the difference between the two. The group provides an opportunity for developing socializing techniques (Gabel & Robb, 2017). It helps members to learn how to handle emotions and develop a cordial relationship. For instance, Philip learns to apologize for his sexual misconduct.

Intragroup Conflict
Intragroup conflict is an experience that is common among groups. In the Group Therapy, A Live Demonstration video, conflict occurs between Pam and Philip. The two had a sexual encounter that Pam believes was against her wish. She threatens to leave the group if the issue is not resolved. The experience is normal among groups since members quit when they realize the environment is not conducive.
The strategies for managing the conflict include allowing the members to discuss the issue and provide recommendations. A therapist should not take the issue personally but should allow the group members to provide amicable responses to the issue (Fleury et al., 2017). For instance, in the issue between Pam and Philip, members encourage Philip to apologize to Pam. When Philip apologizes, Pam is happy and determined to stay in the group. The strategy effectively resolves conflicts in group therapy (Fleury et al., 2017). Resolving group conflict is important since groups can accomplish their goals without deep-seated unresolved emotional problems.
Conclusion
Groups’ stages of formation include forming, storming, norming, performing, and adjourning. The Group Therapy, A Live Demonstration video demonstrates that the groups are transitioning across various stages to accomplish their goals. The video demonstrates curative factors essential in the members’ interaction and the ability to overcome their challenges. The healing factors evident in the group include universality, development of socializing techniques, and catharsis. The group process can present challenges due to conflict. It is the responsibility of a therapist and the group members to resolve the conflicts. Failure to resolve conflicts can present more problems in the future. The group processes and stages of formation are critical in accomplishing the set goals.
References
Fleury, M. J., Grenier, G., & Bamvita, J. M. (2017). A comparative study of job satisfaction among nurses, psychologists/psychotherapists and social workers working in Quebec mental health teams. BMC Nursing, 16(1), 62.
Gabel, A., & Robb, M. (2017). (Re) considering psychological constructs: A thematic synthesis defining five therapeutic factors in group art therapy. The Arts in Psychotherapy, 55, 126-135.
Jones, D. (2019). The Tuckman’s Model Implementation, Effect, and Analysis & the New Development of Jones LSI Model on a Small Group. Journal of Management, 6(4).

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