Discussion gr | NURS 6650 – Psychotherapy With Groups and Families | Walden University

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Week 11 Discussion Post

There are special considerations when working with older adults, as the psychosocial developmental process can be both positive and negative. The positive is that later years allow time for personal growth and development that were difficult when work and family responsibilities were priorities (Wheeler, 2014). The negative is that family relationships begin to change, friendships change and losses occur. Retirement often means finding new meaning in life (Wheeler, 2014). 

During group therapy sessions with older adults, many of the members are diagnosed with depression. Depression is common among the elderly but is not a natural aspect of aging (Wheeler, 2014). Symptoms often include physical manifestations such as aches, pains, and gastrointestinal problems and cognitive symptoms such as changes in sleep, appetite, and use of pain medication (Wheeler, 2014). One of the main issues that have presented itself during our group sessions is participation resistance. Some of the elderly members are reluctant to share and are withdrawn. 

Techniques by the facilitator include a variety of ways to encourage participation. While this may seem silly, one of these techniques is to play Jenga. Each member of the group takes turns grabbing a wood piece from the stack without causing the stack to fall. Once they successfully grab a piece, the facilitator asks a question such as, “what is one of your greatest accomplishments” or “what is one stressor or situation you have overcome in your life”. This encourages participation without putting group members on the spot. This also promotes cohesiveness among group members as they’re working together toward a common goal. Other techniques by the facilitator include art therapy, worksheets, and vision boards. One challenge that may arise is members who blatantly refuse to participate. When this occurs, the facilitator should encourage participation without being forceful. For example, “Joe, we’d love to have you join us in this activity but we understand if you’re not feeling up to it today.” While strategies may vary, several studies have concluded that cognitive behavioral therapy is effective in older adults with depression (Krishna et al., 2012) (Krishna et al., 2010). 

References

Krishna, M., Honagodu, A., Rajendra, R., Sundarachar, R., Lane, S., & Lepping, P. (2012). A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults. International Journal of Geriatric Psychiatry, 28(9), 881–888. https://doi.org/10.1002/gps.3905

Krishna, M., Jauhari, A., Lepping, P., Turner, J., Crossley, D., & Krishnamoorthy, A. (2010). Is group psychotherapy effective in older adults with depression? a systematic review. International Journal of Geriatric Psychiatry, 26(4), 331–340. https://doi.org/10.1002/gps.2546

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse (2nd ed.). Springer Publishing Company, LLC.

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