Group therapy is a form of psychotherapy in which one or more certified therapists work with several clients simultaneously. Group therapy usually comprises four to ten clients and two experienced group therapists. Small group settings for counseling are held once to two a week. It entails sharing and listening to each other’s personal and social issues and the subsequent progress made with the clinician’s guidance. The format utilized in group therapy offers an interactive and supportive environment that allows the group members to discuss their concerns with people with similar concerns and get advice from professionals. Group therapy enables members to get varied perspectives on different issues, challenging them to look at issues from different perspectives. The group members can develop new social skills and connections with others. They are usually challenged to consider their current interaction methods and social skills (Kalhori et al., 2020). Many research studies have shown that group psychotherapy is effective and useful for meeting the psychological needs of individuals struggling with mental illnesses. Although this might be the case, many people express dissatisfaction with engaging in group therapy, and clinicians are also reluctant to facilitate group therapy. This derails the effectiveness of group therapy in helping clients deal with different social and personal problems.
Barriers to Group Therapy when Addressing GAD
Lack of Confidentiality
Clients must trust the clinician when seeking counseling services, whether in group or individual therapy. This can make them speak easily and openly about what is troubling them. Issues of confidentiality are the most profound barriers to group therapy. Trust and confidentiality in therapy create an environment where the client can discuss personal issues, believing that the clinician and group members will not disclose the information shared outside the therapy room. For a clinician, it is essential to maintain confidentiality because it is an ethical responsibility. This makes counseling different from other therapeutic relationships. Communication is key when building a trustworthy therapeutic relationship among clients engaged in group therapy. Groups have specific rules that govern numerous therapy areas, and it is essential to explain to each client how the therapeutic process is confidential (Dorsey et al., 2020). It is crucial to assure them that their issues, thoughts, and feelings will be safe with the clinician and group members. This will allow for deeper discussions on hidden and difficult-to-disclose matters.
The Desire for Individual Attention
People avoid engaging in group counseling for a variety of reasons. Individuals usually want undivided attention from a clinician, but in group counseling, the client has to share the clinician’s time and attention with other group members. For some, this type of sharing feels painful and depriving. Furthermore, in group therapy, a client has to ask for attention to be heard. This is usually hard for some clients who anticipate other members will not find them worthwhile. Some individuals experience a sense of “stranger danger” caused by fear of rejection or judgment. People with generalized anxiety disorder feel this danger is more immediate, leading to relational failure in the group context (Byaruhanga et al., 2020). It is essential to enhance interpersonal interactions to maximize the outcome of group therapy. The clinician should help the clients challenge their feelings of shame, fear, and self-doubt and replace them with rational thinking.
Fear of Therapy
Some individuals resist group therapy because they are afraid of hearing a diagnosis of mental illness or are afraid to unearth buried pain and face their feelings. Clients can also be reluctant to trust others and clinicians to hear about their issues. There is a profound social stigma on matters of mental illnesses, and this affects engagement with clients presenting with generalized anxiety disorder. Society encourages avoidant behavior, such as turning to drugs to block or avoid feelings. Social stigmatization worsens mental health problems and deters individuals from getting the help they need. Social stigma makes clients internalize a feeling of insufficiency and self-doubt, a major barrier to group therapy. When individuals believe that they cannot overcome their anxiety disorder, they are less likely to engage in therapy, affecting their treatment outcome (Ran et al., 2021). Numerous ways can be adopted to reduce the self and social stigma negatively impacting group therapy. It is essential to teach clients that they are not their problem, and they must get the help they need to overcome it.
Although numerous techniques are utilized in group therapy, they all follow a specific pattern. The first stage of standard therapy is the forming stage. In this stage, members get to know each other and try to build connections. This enhances their acceptability into the group. During forming, I will develop the group’s rationale, decide on a theoretical framework, adopt practical ideologies, publicize the group, and pre-train and select group members and leaders (Tuckman & Jensen, 2010). Developing a group rationale is important as it creates a clear-cut purpose for the group. The theoretical framework defines the purpose of the group and the necessary steps to be undertaken going forward. Practical considerations should then be taken care of. This includes the location of the meetings, time, and frequency of the group meetings. The location of the group greatly influences its success, and it is essential to organize and plan it well. The group will be a closed support group, and members can enroll within the first three weeks to enhance pre-training and selection of group leaders. Picking the right person to lead the support group is of utmost importance since they are the engine of the support group.
Therapeutic interventions frequently occur in the working or middle phase of the therapeutic relationship. During the middle phase, clinicians employ a variety of techniques in an attempt to understand the client’s problems and adequately address these issues. In this process, you use expressive and emphatic work skills to enhance the therapeutic process (Asri et al., 2020). Initially, we rehearsed the group’s action steps by preparing and encouraging the clients to carry out agreed-upon tasks. We identified and confronted the biopsychosocial and environmental obstacles to effective practice. We reviewed the action steps to provide better insight into the engagement and receptive nature of the clients. After reviewing the action steps, we evaluated the clients’ progress by observing changes in such indicators as goal attainment scales, rapid assessment instruments, and frequency counts. I engaged the clients in examining data per the plans for evaluating progress. I also educated the clients on life and social skills, which can be influential in attaining therapeutic goals. Often, I shared knowledge and hypotheses concerning their mental condition.
Continued exploration is an essential aspect of this phase as it allows me to get a better insight into the current state of mind of the clients. My focus was on the current clients’ experiences. These feelings and thoughts formed the subject for immediate exploration. Responding immediately to the client makes things real. Record keeping is crucial throughout the therapeutic process. This involved revisions to the primary assessment, contract, action steps, progress made in achieving the treatment goals, and results of the evaluation procedures. Going forward, I will ensure that the group therapy adopts a client-centered approach to enhance connectivity and togetherness among the group members. This will create a sense of belonging and collective responsibility, increasing the odds of treatment.
References
Kalhori, F., Masoumi, S. Z., Shamsaei, F., Mohammadi, Y., & Yavangi, M. (2020). Effect of mindfulness-based group counseling on depression in infertile women: randomized clinical trial study. International Journal of Fertility & Sterility, 14(1), 10.
Dorsey, E., Okun, M. S., & Bloem, B. R. (2020). Care, convenience, comfort, confidentiality, and contagion: the 5 C’s that will shape the future of telemedicine. Journal of Parkinson’s disease, 10(3), 893-897.
Tuckman, B. W., & Jensen, M. A. C. (2010). Stages of small-group development Revisited1. Group Facilitation, (10), 43.
Byaruhanga, J., Atorkey, P., McLaughlin, M., Brown, A., Byrnes, E., Paul, C., … & Tzelepis, F. (2020). Effectiveness of individual real-time video counseling on smoking, nutrition, alcohol, physical activity, and obesity health risks: systematic review. Journal of medical Internet research, 22(9), e18621.
Ran, M. S., Hall, B. J., Su, T. T., Prawira, B., Breth-Petersen, M., Li, X. H., & Zhang, T. M. (2021). Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review. BMC psychiatry, 21, 1-16.
Asri, A. S., Zainudin, Z. N., Wan Othman, W. N., Hassan, S. A., Ahmad, N. A., Abu Talib, M., & Mohamad Yusop, Y. (2020). E-counselling process and skills: A literature review. Journal of Critical Reviews, 7(13), 629-643.
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