Group Therapy Progress Documentation and Analysis

Group Therapy Progress Documentation and Analysis

Students will:

• Develop effective documentation skills for group therapy sessions *
• Develop diagnoses for clients receiving group psychotherapy *
• Evaluate the efficacy of cognitive behavioral therapy for groups *
• Analyze legal and ethical implications of counseling clients with psychiatric disorders *

Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session (group therapy session about drug addiction)

Then, in your Practicum Journal, address the following:

• Using the Group Therapy Progress Note (see file downloaded) document the group session.
• Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

SAMPLE ANSWER

Group Therapy Progress Note American Psychological Association

Client: Mr. JJ and Mr. Q                                                   Date: 21/10/19

Group name:  Achievers                                         Minutes: 45

Group session: 1                                                Meeting attended for this client: 1

Number present in group 2 of 2      scheduled Start time: 10:00 AM           End time: 10:45

Assessment of client

1. Participation level: ❑ Active/eager ❑ Variable ❑ only responsive ❑ Minimal ❑ Withdrawn
2. Participation quality: ❑ Expected ❑ Supportive ❑ sharing ❑ Attentive ❑ Intrusive ❑ monopolizing ❑ Resistant ❑ other: _____________________________________
3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________
4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other: _______________
5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ disoriented ❑ confused ❑ disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other: __________________
6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt
7. Change in stressors: ❑ less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic
8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able
9. Change in symptoms: ❑ same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse
10. Other observations/evaluations: patients are willing to make a change in their lives.

Group Psychotherapy is concerned with various strategies that are used in helping individuals have a safe and trustworthy forum where they would interact with each other and help each other. The group session as made up of people who were battling addiction with a majority of them having an alcohol addiction.

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Description of the Clients

One of the group members was known as Mr. JJ, a 34-year-old man who experiences insomnia. History reveals that he is very worried that he may end up losing his job and he is also unable to control the worry. The worry makes him experience challenges sleeping and therefore he would take alcohol so that he can sleep. He, therefore, began by consuming alcohol as a self-cure for insomnia but he became dependent.

The second client is Mr. Q and he is a 36-year old man who has been experiencing challenges in his marriage for a long time. He describes his wife as nagging and always complaining about the things that he cannot do for her. This makes him prefer to drown his sorrows in alcohol so that he can forget about the treatment at home. He does not want to divorce his wife because his parents had a divorce and it negatively affected him.

Diagnosis

Mr. JJ needs a dual diagnosis because he presents mental issues, i.e. depression and anxiety, in addition to alcohol use and therefore has a co-occurring disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), (2013), the diagnostic criterion for insomnia is where there are complains that the patient is not satisfied with the quantity of sleep that they get or the quality. At the same time, Khurshid (2018) establishes that depression can present as insomnia and hence Mr. JJ was screened for depression. People with mental issues tend to take alcohol because of its stimulating effect so that it can help them sleep (Jacobson and Newman, 2014). Mr. Q is diagnosed with post-traumatic stress disorder because of the stress that he receives at home which makes him want to be away. According to the diagnostic and statistical manual of mental disorders, (2013), post-traumatic stress disorder is said to be present when the patient has experienced an actual exposure to a stressful event. In his case, the trauma is from the divorce that the parents had.

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In-session procedures:

For this people Cognitive-behavioral therapy (CBT) will be employed and it involves activities that will aim at exploring the negative thoughts that an individual has and replaces them with thoughts that are positive and that will play a role in creating favorable behaviors and emotions ( Patterson, 2014). Cognitive-behavioral therapy would be effective for the treatment of addiction because it is instrumental in helping them to find the relationship between their actions, thoughts and feelings and how they impact recovery. This is because CBT is based on the idea that the feelings, as well as the behaviors of an individual, are caused by their thoughts. Therefore, while they may not be able to change their circumstances they should be able to change their thoughts about them. The expected outcome is that there will be skills learned on how to cope with the issues that they go through. They will, therefore, not need to use alcohol as a coping mechanism.

Homework:

1. To talk with the spouses about the issues that they think they can change
2. Be more open and spend time at home
3. Appreciate the spouses more and try to make time to do the things they all used to love

Group Therapy Progress Documentation and Analysis

Other comments:

Legal and ethical issues have been considered.

An ethical requirement for both clients is to ensure that they sign an informed consent form. This means that they will have made an informed decision to be part of the psychotherapy group. It also confirms that their participation is voluntary and rational. This is also important because it helps them to have an increased sense of ownership over the process.

The ethical issue will involve giving both of them a safe and confidential opportunity to express his concerns, fears, and issues. Privacy and confidentiality will be ensured as this is an ethical requirement for psychotherapists. As a result, everything that is discussed will be kept secret and will not be disseminated to any other person

Signatures     …………………………                              Date………/………../……….

Group Therapy Progress Documentation and Analysis

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental

Disorders, DSM-5. (5th edition). Washington, DC American Psychiatric Association.    ISBN-13: 978-8123923796

Jacobson, N. C., & Newman, M. G. (2014). Avoidance mediates the relationship between

Anxiety and depression over a decade later. Journal of anxiety disorders, 28(5), 437-445. doi: 10.1016/j.janxdis.2014.03.007

Khurshid K. A. (2018). Comorbid Insomnia and Psychiatric Disorders: An Update. Innovations

in clinical neuroscience, 15(3-4), 28–32.

Levi, O., Bar‐Haim, Y., Kreiss, Y., & Fruchter, E. (2016). Cognitive–behavioural therapy and

psychodynamic psychotherapy in the treatment of combat‐related post‐traumatic stress disorder: A comparative effectiveness study. Clinical psychology & psychotherapy, 23(4), 298-307. doi.org/10.1002/cpp.1969

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