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Question:
As a social worker in a non-government organization (NGO), I have chosen to plan and facilitate a therapy group for seniors experiencing depression. In the recent past, depression has become an increasingly common issue in older adults. Its symptoms also tend to affect every aspect of the person’s life, including their sleep, appetite, interests, relationships, hobbies, and energy (Duggal & Menkes, 2011). It is unfortunate that most seniors do not recognize the symptoms of depression until it is too late. Moreover, those who do, fail to take the necessary steps to get the assistance they need. Being a social worker, I have witnessed different reasons as to why seniors may experience depression, for instance, isolation, loss of loved ones, or health issues. What such seniors need to realize is that depression is not a sign of weakness and that it can happen to anyone regardless of age, background, or previous accomplishments in life (Brown, 2004). That is why the challenges of aging, physical illness or loss do not have to keep an elderly individual down.
Social workers need to be aware of the fact that depression in seniors is a common problem but it is not to be considered part of the normal aging process. Doctors have also, from time to time, failed to acknowledge that their elderly patient is experiencing depression. It is important to study the historical background of a senior in order to determine the root cause of the depression. While some seniors may have a family history of depression, others may have different brain chemistry compared to those without depression (Bieling, MacCabe & Antony, 2006). Older adults who experience depression for the very first time later in life may be as a result of transformations that take place in the brain and body as the individual ages. That is why it is important for a social worker to first and foremost identify the type of task or treatment group involved, and know how to plan and begin the therapy process.
There are generally two types of groups namely task and treatment groups. These can further be divided into formed groups and natural groups. Treatment groups are used to signify groups whose main aim is to cater to the members’ socio-emotional needs, while task groups tend to signify any group in which the prevailing aim is to attain objectives that are neither intrinsically nor immediately connected to the needs of the members of the group (Duggal & Menkes, 2011). In a treatment group, the roles are not official prior to the group first meeting, but are developed through the interaction of members. Communication is generally open with encouragement to interact. Here, members of the treatment group are expected to reveal their individual problems and concerns. Notably, these groups are strictly confidential. On the other hand, in a task group, members take on responsibilities through the interaction process and are often assigned roles by the group (Corey & Corey, 2006). The level of communication is directed by the agenda, and such a group is likely to have official rules such as committee or parliamentary procedures that oversee how members carry out group decisions, operations, and proceedings.
Formed groups constitutes members who come together to establish a group through outside influence such as therapy group members, board members, and committees. Natural groups generally form through inherent membership such as family systems (Toseland & Rivas, 2014). I believe that the group I have chosen is a treatment group which incorporates a formed group type.
Having established that the chosen group is a treatment groups for seniors experiencing depression, it is important to determine how I would plan and begin this particular group. Firstly, it is important to take time to work with my colleagues, peers, and other stakeholders, to think through various aspects of group design before beginning the group (Zastrow, 2001). I would, therefore, identify the main aim of the group, the context it will operate within, determine the criteria for membership, how I would recruit the group members, its size, how diverse it would be and if it would be time limited or open ended. Notably, the equipment and facilities available for use by the group would have significant impact on the group. Thanks to technological advancements of modern day, some treatment groups comprise of members who may not be physically present for the therapy, but still engage with the group by distance (Battegay, n.d.). Therefore, I would take into consideration the use of telephone or Skype, and presence of online groups where information can be accessed at any given time. I would also make this group an open-membership group where seniors experiencing depression are free to join and leave the group in the course of the life of the group. This would ensure presence of new group members within the treatment group. Once all the decisions regarding the group have been made and a clear aim, full design, and plan for the group is developed, recruitment can commence.
As a social worker, I am aware that the group type will impact or influence the tasks and activities involved in the planning and beginning phases of group work. Group work refers to any psychotherapeutic process in which a group of persons meets with a therapist or leader (Zastrow, 1999). The interactions taking place among members of the group are mostly therapeutic and are more effective compared to the conventional client, therapist dyad. Group therapy can assist with almost anything that individual therapy can, so long as a suitable group is available and the person will accept the group as the main approach to treatment. According to the first social scientists, participants in a two person group tend to develop a responsibility to each other, something that is not observed in larger groups (Lizzio & Wilson, 2001). Furthermore, smaller groups require more engagement compared to larger ones. The primary group which is the family has much influence on a member’s development, moral principles, values, and normative behavior.
It is of great significance that each group member knows who the other individuals in the group are, and therefore introductions are necessary. However, there are some seniors who might be suffering from extreme depression and prefer not to be open or communicate; they keep their feelings inside. Such members may negatively influence the tasks and activities at the initial stages of group work because they may not be willing to collaborate with their fellow therapy group members (Donigian & Hulse-Killacky, 1999). Others might take longer to feel like they are comfortable enough to know where they fit in the group. Groups can be unique mechanisms for social transformation and good governance where much community work is focused around the work of different groups of individuals.
Identification and critical analysis of the external (organizational and broader community level) and internal (roles, dynamics, leadership) factors/aspects that could influence the early stages of the group
There are a number of external and internal aspects or factors that could influence the early stages of the chosen group. The organizational culture that a group develops tend s to have an authoritative influence on its ability to attain its goals while meeting the members’ socio-emotional needs (Corey & Corey, 2006). The size of the group, location, infrastructure and seating arrangements of the group setting all influence the nature and feel of the group, especially within initial impressions. It is therefore important for the environment to be welcoming so as to allow the seniors to feel comfortable and safe to participate in the group therapy. One of the most crucial tasks of the social worker is to assist groups to develop dynamics that will promote the satisfaction of members’ socio-emotional needs while at the same time facilitate the attainment of group tasks. In order to develop good group dynamics during the early stages of the group, a group worker should not only recognize and introduce group members to each other, but also begin to establish a supportive safe group culture (Toseland & Rivas, 2014). The worker should also clarify agency stake in the group service together with potential problems and concerns the senior members may have.
It is crucial that the group worker becomes aware of the communication process and consider patterns of interactions that develop in the chosen group. Some of these patterns may incorporate the hot seat where there is an extended back and forth exchange between a leader and a specific member, as the other members observe, round robin where the senior members take turns in talking, and the maypole where the leader is the key figure (Sundel, n.d.). In this case, communication usually takes place from the leader or therapist to member or from member to therapist. Notably, roles are an important influence on group members as they allow for division of labor and fair use of authority. With regards to leadership within a therapy group of seniors suffering from depression, various approaches can be used such as the Trait approach and Leadership-Style approach. With the former approach, a leader or therapist seems to have natural personal features which differentiate them from ‘followers’ (Zastrow, 2001). On the other hand, Leadership-Style approach can either be democratic, authoritarian, charismatic, or transformational. It is therefore important for the social worker to identify and determine the most appropriate leadership style approach to use in a therapy group of seniors suffering from depression.
Battegay, R. (n.d.). Trends in group psychotherapy with borderline patients. Group Analysis, 25. Pp. 66 – 73.
Bieling, P.J., MacCabe, R.E. & Antony, M.M. (2006). Cognitive-Behavioral therapy in groups. New York, NY: Guilford Publishers.
Brown, N.W. (2004). Psychoeducational groups: Process and practice. New York, NY: Brunner -Routledge.
Corey, M.S., & Corey, G. (2006). Groups: Process and practice. 7th Edition. Belmont, CA: Brooks/Cole/Thomson.
Donigian, J., & Hulse-Killacky, D. (1999). Critical incidents in group therapy. 2nd Edition. Belmont, CA: Brooks/Cole-Wadsworth.
Duggal, R., & Menkes, D. (2011). “Evidence-based medicine in practice.” International Journal of Clinical Practice, 65(6). Pp. 639 – 644.
Lizzio, A., & Wilson, K. (2001). “Facilitating group beginnings part 1: A practice model.” Groupwork, v.13, no. 1. Pp. 6 – 30.
Sundel, M. (n.d.). Individual change through small groups. 2nd Edition. New York: Free Press.
Toseland & Rivas. (2014). An introduction to group work practice. 7th Edition.
Zastrow, C. (1999). Social work with groups: Types of groups and guidelines for leading them. Pacific Grove, CA: Brooks/Cole Publishing.
Zastrow, C. (2001). Social work with groups: Using the class as a group leadership laboratory. 5th Edition. Pacific Grove, CA: Brooks/Cole.
Zastrow, C.H. (1999). The practice of social work. 6th Edition. Pacific Grove, C.A.: Brooks/Cole Publishing.
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