Group Process For Peer Case Discussion Paper

Group Process For Peer Case Discussion Paper

A group/team treatment comprises of at least one trained therapist and team/groups members. The team meet regularly at scheduled times, serving a two-fold purpose: a group process for peer case discussion that could include treatment recommendation, treatment planning, and diagnosis/assessment. It is an opportunity for the group members to share their cases and situations while learning from each other. The therapist mediates the interaction between the group members even as several cases are presented (Steen, Vannatta & Leva, 2022) Group Process For Peer Case Discussion Paper. This paper answers question about an alcoholics anonymous (AA) group meeting.

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What group did you attend (the type of group and city, state of the group)? If not obvious from the name, include the specific topic addressed.

I attended an AA meeting in Las Vegas, Nevada. The meeting occurred at Choices offices, the central office for AA meetings in Las Vegas. The meetings are open to the members of the public who wish to observe them. It is notable that the meeting opened up and closed with a prayer with the purpose clearly stated as helping the members to stay sober and helping other alcoholics to achieve sobriety. The attendees introduced themselves, where they were from, to include the visitors/observers. Sixteen people who included seven members, six sponsors, one therapists and two observers attended the meeting. In that meeting, the seven members shared their experiences with drinking alcohol, struggles they face in an effort to stop drinking alcohol, and advances they have made over the course of the therapy. In addition, the members talked about the progress made in following the twelve steps set forth for the AA program, exploring how following the twelve steps help them in developing a satisfying life without alcohol. Besides that, the therapist acted as a mediator, leading the meeting by choosing a topic and having the members take turns in sharing their experiences on the topic. The topic explored in the meeting focused on happiness, honesty, hope and humility with the members talking about how these words related to their recovery. A donation basket was passed around at the end of the meeting, with the attendees asked to contribute since the activities associated with AA are funded by public donations Group Process For Peer Case Discussion Paper.

What did you think about the group before you attended the meeting?

Before attending the meeting, I assumed that the meeting would function as an informal gathering where everyone would be supportive of each other. I expected that there would be some people that would be open and honest about their struggles with alcohol dependence and there would be some in attendance that would be guarded and not be eager to share their story. In addition, I expected the presence of a mediator who leads the meeting and ensures that it stays on topic while preventing it from generating into chaos.

What did you think about the group after you attended the meeting?

After attending the meeting, I felt it functioned just as I imagined it would. However, I made some new discoveries in the meeting. Although the AA charter indicated that it not allied with any sect, denomination, politics, organization or institution, and does not wish to engage in any controversy or endorse/oppose any causes, I was surprised that the meeting started and closed with a prayer. This meeting format is a clear indication that it is faith-based program. For a meeting that talks of being inclusive, it would appear that it is not accepting of atheists. The spiritual aspect of the AA program could be an obstacle for persons who wish to stop drinking.

What curative factors did you observe in this group?

Eleven curative factors were observed in the group. First, conversation/talking was identified as a curative factor. As the group members shared their stories, I felt that it was cathartic for those who spoke and for those who simply listen and observed. The talking allowed the group to have emotional release that relieved unconscious issues. This was seen as the members came into the meeting appearing burdened, but left the meeting appearing relieved and less burdened. Catharsis was also evident as the members learned to cope with and express their emotions to include the negative and painful emotions. The moments that the members were honest about their feelings were very important in the recovery process (Jebreel, Doonan & Cohen, 2018) Group Process For Peer Case Discussion Paper.

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Second, altruism as the group members helped and supported each other. This was especially seen in the sponsors who encouraged the new members to persevere and believe in themselves. Third, cohesion as the group members had a sense of belonging to the group even as they were understood and accepted. This was seen in the way the group members interacted with each other, joked and used nicknames, an indication that they are comfortable within the group. There were shared moments of despair, as well as playful and joyful moments among the members. In addition, the members expressed their gratitude to the group. Fourth, universality as the group members recognized each other in the sense of not being the only recovering alcoholic. Although this factor is not mentioned within the group, it is evident from the way the members interact, share successes, and reminisce over failures (Brouzos et al., 2021) Group Process For Peer Case Discussion Paper.

Fifth, interpersonal learning input as the members made presentations and received valuable feedback to help them improve. Sixth, guidance as the group members received helpful, accurate information and therapeutic interventions. Seventh, self-understanding as the group members discovered and accepted previously unknown or unaccepted parts of themselves. Eighth, instilling hope as the meeting reiterated that change and recovery is possible. The sponsors repeatedly encouraged the members not to give up their hope for change, with the ritual of their (sponsors) involvement having the goal of instilling hope. Ninth, existential factors as the members took responsibility for their lives while accepted the good and bad aspects. The members learned to accept negative emotions as part of their lives. Tenth, resilience as some members expressed the belief that they could cope with stressful life events, learning to adapt without falling back into alcohol consumption. Finally, epistemic trust as the members learned from others and trusted them even as they benefited from the social group environment (Hauber, Boon & Vermeiren, 2019) Group Process For Peer Case Discussion Paper.

What stage of group formation was the group in?

A review of the AA meeting based on Tuckman’s stages of group development reveals that this group is in the performing stage of development. At this point, true interdependence becomes evident with the group being flexible even as the members adapt to the needs of others. The observable behaviors at this stage are: better understanding of each other’s weaknesses and strengths, insights into the group processes, flexible functions, team well organized, independence, clear roles, and fully functional. The group members express feelings and thoughts of: continual discovery of how to sustain enthusiasm and momentum, general sense of satisfaction, personal development and creativity, excitement and fun, emerging tight bonds, understanding collaborative ethics, high commitment, and empathy for one another. Some of the evident team needs are: feedback and dialogue from guide/therapist, giving and receiving, provide information, measure knowledge performance, maintain team flexibility, and moving in collaborative direction. The group has leadership requirements to include: share new information, positive reinforcement and support, guide provides little direction, collaborative efforts, and shared leadership. With the evolution into stage four of group development, the group expands its depth, range and capacity of personal relations to true interdependence even as the members work independently with equal competencies (Steen, Vannatta & Leva, 2022) Group Process For Peer Case Discussion Paper.

Did you identify any problematic or challenging group members as described in your course learning materials? How did the group leader handle this? How did the way that they handled these group members differ from how you would have handled them?

A significant issue among the group members were that some of them found it difficult to talk about their personal shortcomings, failures and weaknesses. Opening up and being honest is important for strengthening the therapeutic alliance. Although the members felt connected to the group, they were unwilling to discuss some of the details about their experiences with alcoholism and recovery. This is understandable since opening up with personal details can make them feel vulnerable.  The therapist addressed this issue by asking leading questions and improving the sense of connection and security within the group while reiterating that the group environment offers a safe space. This allowed the members to open up about personal details (Steen, Vannatta & Leva, 2022) Group Process For Peer Case Discussion Paper.

The group leader did well in handling the challenging group members who were hesitant in opening up about personal details. However, four other strategies could be applied to better handle these challenging group members. First, expressing sympathy. The leader should not argue or make excuses, but should instead validate the members’ feelings. It involves using compassion that is accompanied by consequences, such as acknowledging the emotions driving the group member, then emphasizing the need to open up in the meeting. Second, reframing resistance, a useful strategy when dealing with group members who express willingness to change, but fight the change every step of the way to ensure that they do not change. For instance, expressing administration for a client who puts effort into resisting the change, and not castigating the client or reacting negatively. Third, cultivating patience that allows the member to slowly open up without being harried or harassed to do so. Fourth, seeking support from the other group members who would encourage the challenging client to open up. As the other group members share their personal details, the challenging group member would be encouraged to open up (Steen, Vannatta & Leva, 2022) Group Process For Peer Case Discussion Paper.

How did this experience compare to your practicum experience where you could see a group run by a trained therapist? What was similar? What was different? If your current clinical site does not allow you to see group therapy or you are not in practicum, discuss groups you have seen previously.

There are significant differences between what was experienced and observed in the AA meeting when compared to a group managed by a trained therapist. Groups led by trained therapist were more organized and had a specific agenda whereas the AA group I attended has some structure but felt more like a group of men just got together to talk (Erickson, 2020). The main difference is that the AA meeting evoked listening and storytelling within a self-help group that complemented and resonated with the psychotherapeutic tradition of self-examination, acknowledging and coping with distress, and fostering personality change. AA effectively prescribes needed direction and control (Kelly et al., 2020) Group Process For Peer Case Discussion Paper.

In contrast, a group managed by a trained therapist is more interactive as it is more guided and focused. In this respect, the trained therapist has the opportunity to pursue the problems of character defects, distress and self-regulation revealed or stirred in the group meeting. A trained therapist explores and focuses in a sustained way on the suffering and compensatory defenses associated with vulnerability (Stone, Conteh & Francis, 2017). Still, it is important not that the two have some similarities. AA (as a self-help program) and a group run by a trained therapist interact to mutually enrich a better understanding of the needs and vulnerabilities of members in recovery. In addition, the two (AA and group run by a trained therapist) stimulate personality change and maturation (Wnuk, 2022) Group Process For Peer Case Discussion Paper.

Would you refer a client who was struggling with the issue addressed by the group to this mutual-help group? Why?   

I would recommend this group only if a client had gone to a formal detox/rehab program and they felt like they would benefit from being in a more relaxed environment. That is because AA provides a safe, controlled environment in which alcoholics can admit an inability to control alcohol use, get support from each other’s abstinence attempts, and spread the word that alcoholism is a disease while sharing with and committing to helping others. In addition, the AA meeting allows for public admission of vulnerability, spirituality, taking inventory of life, admitting to personal wrongs, and sharing with and commitment to helping others. These elements are effective in transforming the lives of alcoholics as they access and modify their (alcoholics) vulnerabilities. Besides that, these elements help in establishing and maintaining abstinence, while producing personality changes and modifying the suffering and distress associated with alcoholism as an addictive behavior. It is important to note that the defenses, deficits and vulnerabilities associated with alcoholism involve self-care, relationships, self-esteem and feelings. This allows for an appreciation of how and why alcoholics suffer, providing the needed comfort and support derived from the alcoholics being with others who have suffered and struggled as they do (Stone, Conteh & Francis, 2017) Group Process For Peer Case Discussion Paper.

Still, it is important to note that there is need for a trained therapist in the AA meeting. The therapist would maintain focus on the survival requirements and need for auxiliary sources of support and comfort. This helps the therapist to determine what combination of therapeutic interventions would be beneficial for the alcoholic. In addition, it helps in overcoming the alcoholic’s initial resistance to attending AA meetings and other support groups. Besides that, it allows the therapist to monitor how social panic and phobias might make the AA meeting unlikely to be beneficial (Wnuk, 2022). In essence, attending AA meetings increases hope for prospects of treatment and successful treatment for alcoholics as the meetings address vulnerabilities in the personality organization of alcoholics, and their need for human comfort and connection Group Process For Peer Case Discussion Paper.

References

Brouzos, A., Vassilopoulos, S.P., Stavrou, V., Baourda, V. C., Tassi, C., & Brouzou, K. O. (2021). Therapeutic Factors and Member Satisfaction in an Online Group Intervention During the COVID-19 Pandemic. Journal of Technology in Behavioral Science, 6, 609–619 (2021). https://doi.org/10.1007/s41347-021-00216-4

Erickson, M. (2020, March 11). Alcohol Anonymous most effective path to alcohol abstinence. https://med.stanford.edu/news/all-news/2020/03/alcoholics-anonymous-most-effective-path-to-alcohol-abstinence.html

Hauber, K., Boon, A. E., & Vermeiren, R. (2019). Therapeutic factors that promote recovery in high-risk adolescents intensive group psychotherapeutic MBT programme. Child and Adolescent Psychiatric and Mental Health, 13, 2. Group Process For Peer Case Discussion Paper https://doi.org/10.1186/s13034-019-0263-6

Jebreel, D. A., Doonan, R. L., & Cohen, V. (2018). Integrating Spirituality Within Yalom’s Group Therapeutic Factors: A Theoretical Framework for Use With Adolescents. Group, 42(3), 225-244. https://doi.org/10.13186/group.42.3.0225

Kelly, J. F., Abry, A., Ferri, M., & Humphreys, K. (2020). Alcoholics Anonymous and 12-Step Facilitation Treatments for Alcohol Use Disorder: A Distillation of a 2020 Cochrane Review for Clinicians and Policy Makers. Alcohol and Alcoholism, 55(6), 641–651. https://doi.org/10.1093/alcalc/agaa050

Steen, S., Vannatta, R., & Leva, K. (2022). Introduction to Group Counseling: A Culturally Sustaining and Inclusive Framework. Springer Publishing Company, LLC.

Stone, D. A., Conteh, J. A., & Francis, J. D. (2017). Therapeutic Factors and Psychological Concepts in Alcoholics Anonymous. Journal of Counselor Practice, 8(2), 120-135. https://doi.org/10.22229/nav074629

Wnuk, M. (2022). The Beneficial Role of Involvement in Alcoholics Anonymous for Existential and Subjective Well-Being of Alcohol-Dependent Individuals? The Model Verification. International Journal of Environmental Research and Public Health, 19(9), 5173. https://doi.org/10.3390/ijerph19095173 

After you have attended the meeting, write a 6- to 8-page paper in APA (7th edition) format in which you address the following questions: What group did you attend (the type of group and city, state of the group)? If not obvious from the name, include the specific topic addressed. What did you think about the group before you attended the meeting? What did you think about the group after you attended the meeting? What curative factors did you observe in this group? What stage of group formation was the group in? Did you identify any problematic or challenging group members as described in your course learning materials? How did the group leader handle this? How did the way that they handled these group members differ from how you would have handled them? Group Process For Peer Case Discussion Paper

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How did this experience compare to your practicum experience where you could see a group run by a trained therapist? What was similar? What was different? If your current clinical site does not allow you to see group therapy or you are not in practicum, discuss groups you have seen previously. Would you refer a client who was struggling with the issue addressed by the group to this mutual-help group? Why? You should clearly articulate why you would or would not make the referral if you were working with a client who had a problem like the one that the self-help group purports to help. Reference Requirements While you may reference the textbook, you must also use a minimum of five peer-reviewed scholarly articles related to peer-support, mutual-support, and/or self-help groups. The literature may refer to these types of groups in a variety of ways. Include an APA-formatted reference list (not included in the page count). Submission Submit your 6- to 8-page paper in Microsoft Word.

Choices in Las Vegas Nevada offers open AA meetings to those who wish to observe.

Before attending the meeting, I assumed that the meeting would function as an informal meeting where everyone would be supportive of each other and that there would be some people that would be open and honest about their struggles with alcohol dependence and there would be some in attendance that would be guarded and not be eager to share their story Group Process For Peer Case Discussion Paper.

After attending the meeting, I felt it function just as I imagined it would.

As group members shared their stories, I felt that it was cathartic for those who spoke and for those who simply listen and observed.

Groups led by trained therapist were more organized and had a specific agenda where as the AA group I attended has some structure but felt more like a group of men just got together to talk.

I would recommend this group only if a client had gone to a formal detox/rehab program and they felt like they would benefit from being in a more relaxed environment Group Process For Peer Case Discussion Paper