Psychiatry: Group Therapy Paper

Group therapy is considered effective as groups support the individuals involved in the same situation and face the same problems. They facilitate social skills and enhance discussions among the same people who learn from their experiences (Orenstein, 2014). Also, group therapy costs lesser than individual counseling since a collection of members sits together to have the treatment by gaining a free learning experience of how others have been through the same medical condition and how they have been managing to cope.

This paper aims at providing a theoretical reflection on the group that I will be working with, its member selection criteria, group contract, boundaries and limitations, process and content of the group, stages of group therapy and how they are applied with this group, group concepts and other explanations. Furthermore, the group is formed to bring changes in attitudes (Ezhumalai et al., 2018), which is one of the major aims of this theory paper. The change is expected to be long-term so that their better health condition is achieved. It would be used as a means of helping and supporting the group members who would be selected for the specific purpose. Since the groups functions would be therapeutic, bring corrections to the disorder, educate the group members suffering from the health condition, and induce preventive measures in their daily routine for making adherence more convenient, it is also anticipated to bring positive change in a group rather than individually.

Also, the group is created by keeping certain group principles in mind such as planned group formation, determining specific objectives to be attained, forming and maintaining group relationships among the members, flexible group functioning, making progressions with letting the members voice out their past experiences and evaluation (Ezhumalai et al., 2018).

Details about the Group

The group that I aim to work with is the one that I formed for psychotherapy purposes. A psychotherapy-focused group was made by bringing similar patients together for the sessions, including those suffering from DSM 5 diagnosis for a health condition.

The criteria for member selection for this group are the basic symptoms of the DSM 5 eating disorder, specifically Anorexia Nervosa, and they need help with adherence to its treatment plan. The initial number of members planned for the group sessions is five since a small group would help produce better-targeted results for all the members equally (American Psychological Association, 2019).

The particulars about the group contract include the patients who are bound to follow therapy for the stated medical condition and need an adherence strategy to reduce the signs and symptoms of the stated disorder. The group members expected to mitigate the effects of the medical health condition affecting their other parts of the body, their thinking abilities, and emotions related to the physical conditions. The group sessions would help alleviate the problems related to their eating disorder and enhance social skills so that communication supports soothing their suffering of the condition. They presumed to listen to one another and observe what other people of the same kind are going through. For this purpose, keeping confidentiality and giving rise to trust between the group session conductor and the members is imperative for positive group outcomes.

The boundaries that were set for the group involve the limitations and needs for inclusiveness. The limitations encompass the exclusivity criteria such as people who are not suffering from Anorexia Nervosa that is to say; they might be able to maintain a healthy weight or even could be overweight, as these conditions do not come under the DSM 5 definition of Anorexia Nervosa (American Psychiatric Association, n.a.).

The process and content of the group is the group itself. The groups content would be based on the health conditions being affected by Anorexia Nervosa and its symptoms that first occurred among the included group members. The content would be signs conditions like less food or energy intake by the individuals that the actual body requirement, extremely low weight as compared to the healthy body weight needed to pursue a healthy life, great fear of gaining weight and for that they might be eating less persistently, disturbed body formation and not realizing the seriousness of the medical condition as they do not deem the current body weight as lower than the normal requirements (Body Matters, n.a.). Moreover, disturbed body formation includes occurrences like decreased calorie intake, low storage of fat within the body, diminished fat tissue, transpiring of low response to fat loss, self-starvation, mismanaged balanced diet intake causing malnutrition, brittle hair, and nails, wasting of heart muscles that could lead to heart failure or sudden death, vitamin and mineral insufficiencies, and dehydration, etc. (Harrington et al., 2015).

The content would also stress upon the treatment plan as most of the treatment for Anorexia Nervosa includes psychotherapy rather than medications. DSM 5 code for Anorexia Nervosa is 307.1 with the restricting type (Academy for Eating Disorders, n.a.). The role of monitoring of any possible betterment in eating disorders cannot be overstated since any nanoscopic progress in the condition would specify the effectiveness of group therapy and improvement in adherence to the treatment plan.

Stages of Group Therapy

There are four stages f group therapy: the initial stage, transition stage, working stage, and the final stage (Live Rehab, n.a.). In the first stage, the expectations were set for the group accomplishments and the members. The members are predicted to achieve betterment goals for their medical conditions, and confidentiality for the patient is mandatory. Another subject is the cultural concern for each individual and their diverse background that might affect the group therapy outcomes. Their personal beliefs and spiritual affiliations also influence their health condition results (Shahin, Kennedy & Stupans, 2019), which should be pre-determined in the first stage.

Next comes the transition stage, where the group members feel apprehensive of the group session consequences. In this group, too, they were fearful of sharing their thoughts with strangers and how others might feel about them. Some were shy at this stage and felt resistant in opening up about their thoughts. Although the group members include all those who suffer from the same DSM 5 diagnosis, the individuals should not feel uncomfortable in communicating with similar ones; however, there is a natural tendency of less participation that would be attempted to eradicate with the proceedings of...

…revealed as letting all the stress also go one of the main aims of the group therapy for improving adherence to the treatment plan. This activity brought them close, creating a mutual bond among the included members, being one of the prominent factors for group cohesiveness.

Seating Arrangements, Charts, Logs, and Interaction among the Group Members

The seating arrangement selected for this group therapy was circular, with five seats for all the group members. The sixth seat for the group session conductor included within the same circle. Face-to-face communication was accentuated with this arrangement as it is considered conducive to developing a positive therapeutic coalition when disclosing personal instances and experiences with others (Rickard, Hevey & Wilson, 2020). Moreover, side-by-side seating was also used at the end of each session because gaining feedback and completing questionnaires for this matter was deemed useful. The research has corroborated using two types of seating arrangement during group therapy to be effective since the actual materialization of several group goals is observed (Greenberg, 1976). The example of the seating arrangement used in this group is depicted in the image below:

Image 1: Circular seating arrangement

Source: Google Images

It was even noticed that the effect of seating arrangement on the group interaction enriched when group members could face each other. Verbal communication upgraded with the physical positioning of the individuals as they were able to interact openly by maintaining eye contact. Although they were shy in the initial stages of the group therapy, however, in the later stages, the seating arrangement helped in becoming more participative.

The group therapy was monitored in each session with the help of logs and charts that assisted in noting down each members development and progress in every coming session. As the objective was to improve the adherence to the treatment plan for an eating disorder, Anorexia Nervosa, so that the resulting physical adverse effects of the disorder could be treated, the sample group therapy case note was used to jot down the plan of each session. Ratings were assigned for marking the participation and willingness to adhere to the psychotherapy intervention by the group members with low, medium, and high. Even a section in the form presented the monthly evaluation for the entire group. The sample group session log and chart is given below:

Image 2: Sample group log and chart

Source: Google Images

Conclusion

The group formation for treating the DSM 5 diagnosis of an eating disorder, Anorexia Nervosa, is highlighted in this paper since the motive was to improve the adherence of the included group members for addressing their health needs. The deteriorating health signs were to be treated through this group intervention for which certain group therapy stages were perceived. Also, Yaloms group concepts were utilized intensely to achieve effective and positive outcomes in better adherence of the group members in changing their dietary habits, behaviors, and attitudes. Moreover, group cohesiveness was attempted to be sustained throughout the sessions. The seating arrangement, its impact on the group interactions and projected consequences, and the composition of logs and charts for constant monitoring and evaluation of the group and the individuals were presented. It was discerned that circular seating arrangement proved useful in helping…