Group Therapy With Older Adults

NURS 6650N-04: Group Therapy with Older Adults

Group Therapy and the Stage of the Counseling Session

I have the privilege of joining our Mental Health Social Worker (MHSW) in his weekly Post Traumatic Stress Disorder (PTSD) group counseling session which predominantly consists of our proud baby boomers, the Vietnam veterans, ages  60 to 75 years old (Wright, 2017).  The Veterans Affairs (VA) follows an inclusively male with the military-related traumatic experiences as the main criteria. Despite the marked progress in the treatment and the growth of the skills from the evidence-based practice (EBP) interventions, each member becomes comfortable to stay in the storming and norming stages as they enjoy each other’s camaraderie and brotherhood (Sloan, Unger, & Gayle Beck, 2015).

Therapeutic Techniques, Resistance, and Challenges

            For the last eight months, the group cognitive-behavioral treatment (GCBT), group supportive counseling approach, and the group motivational interviewing are utilized with each group session (Wheeler, 2014); while, the prolonged exposure (PE), cognitive processing therapy (CPT), and trauma-focused CBT (TF-CBT)  administered for individual therapy as the recommended treatment guidelines by the American Psychological Association (APA) and the VA and Department of Defense (DoD) (Watkins, Sprang, & Rothbaum, 2018).

The majority of the resistance fundamentally comes from the developmental task of “ego integrity versus despair” which can be viewed in a positive and in a negative way (Wheeler, 2014). The three members who earned successful careers and stable family are seeking higher respect and entitlement; while the four others who are battling substance -abuse disorder (SUD) with poor family support, suffers not only from the PTSD symptoms but also from the low esteem and projected blamed to the VA for not looking after their interest (Reisman M. 2016).  

The challenges are not only limited for further research towards the treatments but also in the ability to apply a holistic approach to our clients. In my personal opinion, the therapist has failed to incorporate a more comprehensive manner in his treatment plan. With his background as an SW, he overlooked some major factors essential for successful treatment, for instance, chronic comorbid conditions, neurocognitive decline, also the growing dependency to family and social support, and finally the financial capability versus the cost of treatment (Wheeler, 2014).

As future MH clinicians, we must learn to perform a comprehensive assessment and compliment the need by the multimember approach to involve the patient,  family, and the institution. As nurses, we are positioned with a better opportunity to assist our clients in a more holistic way as conceptualizing a practical treatment becomes our mandatory commitment.

Reference

Reisman M. (2016). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s

Next. P & T : a peer-reviewed journal for formulary management, 41(10), 623-634.

Sloan, D. M., Unger, W., & Gayle Beck, J. (2015). Cognitive-behavioral group treatment for

veterans diagnosed with PTSD: Design of a hybrid efficacy-effectiveness clinical trial. ‘

Contemporary clinical trials, 47, 123-30.

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A Review of

Evidence-Based Psychotherapy Interventions. Frontiers in behavioral neuroscience, 12,

258. doi:10.3389/fnbeh.2018.00258

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

guide for evidence-based practice. New York, NY: Springer.

Wright, J. (2017).  The baby boomer war. The New York Times. Retrieved from

            https://www.nytimes.com/2017/04/11/opinion/the-baby-boomer-war.html