Group therapy?

  1. 1
    I am currently working as a registered nurse in a psychiatric ward. I have been here for one and half year, and going to do a group counseling session.

    The session is for depression patient. They are mostly 30-50ish from our outpatient depression clinic, follow up for several years in our hospital.
    I never held this kind of session before, I just watched other people doing session for six months. Normaly 3-5 patients will came for each session.

    Seven session will be held, and I will be a main counselor for 5th session.
    First session will be done by the psychiatric doctor(He is the program manager). He is going to introduce consept of wrong reasoning for patient. 3rd session is for forgiveness. People will talk about it and write letters for people who hurt themselves before. 4rd session is about meditation. 6th session is some kind of art therapy, using clay and make things. 7th session will be lead by the doctor, and he will finish.
    Each session will be 90 minute and once a week, since it is for 7 weeks program.

    Can someone give me any kind of hint?
    I googled related books, documents about “therapeutic recreation” “group therapy”
    Can someone recommend psychiatric nurse’s 90 minute counseling example, or something similar?
    If any nurse, supported group therapy before? What kind of group program?


    I am the first nurse who joined this program. and I am very worried about result. (Unit manager also worried...) I have one month, so I ordered few books (for therapeutic recrean and group therapy...) but I feel like lost in nowhere. No focus in here.


    Thank you for reading

    *English is not my mother tongue, and I am trying to learn. If you feel hard to understand or found error from my post, please mention it. It will be very helpful for me. Thanks again!
    Davey Do likes this.
  2. 9 Comments so far...

  3. 0
    What are the patients being told? How about medications and side effects?
  4. 3
    Are you working in America? If so, group therapy is above and beyond the scope of practice for RNs in most states. It requires a Master's degree in psychology, social work or psychiatric nursing.

    The topics you're covering seem to be more along the line of group activities rather than therapy though.

    I can't think of any references for you. Is there another psychiatric facility nearby where you could find people who might have ideas?

    I think 90 minutes is wayyyyyy too long for someone who's depressed to maintain focus.
    hanasea, elkpark, and Davey Do like this.
  5. 2
    Quote from Whispera
    The topics you're covering seem to be more along the line of group activities rather than therapy

    I think 90 minutes is wayyyyyy too long for someone who's depressed to maintain focus.
    While working at a Community Mental Health Center, I was given an Assignment to do a two hour Lecture, the first thing in the morning, from 8 to 10, without a break, to Court Ordered Substance Abusers. The Lecture was to focus on the Effects of Alcohol and Other Drugs on the Body Systems.

    It was quite a challenge, but having had quite a bit of experience in giving Lectures, was generally a Success. I believe the Success was the result of being knowledgeable on the subject, loving the subject, and really wanting to motivate this Group of People.

    I encourage you to be Innovative, hanasea, but most of all, be yourself. Be Zen about this whole thing: Be the Group. You will find all sorts of information online and in books, but it will be you, and not the information, which will be leading this Group. Make it Personal. Immerse Yorself in this Subject. Find something to love about this subject.

    If I may, I'd like to relay to you a couple of examples that made my Lecture not only tolerable, but fun and interesting:

    During the part of the Lecture where I was explaining Peristalsis, I poised a question: Could you drink if you were upside down? The General Consensus was "No". I would do an Audience Participation Type of Demonstration to explain Peristalsis. I would ask for two Volunteers to assist me in Standing on my Head. Then, I would drink from a small container of juice from a straw. I would speak so the Group knew I was not holding the juice in my mouth. Afterwards, I would request that the Group give a Round of Applause to the Volunteers, and explain the process of Peristalsis. It was Peristalsis, the wave-like action of my Esophagus, that allowed me to drink juice up into my stomach. From there I could talk about Alcohol's effect on the Transitional Epithelium which lines the Alimentary Canal and so forth.

    As Whispera pointed out, Attention Spans cannot usually hold out for Expanded Lengths of Time. When my Supervisor informed me that No Breaks were to be given during the Two Hour Lecture, I Improvised a bit:

    In order to adequately explain the effect of the Brain's Naturally-Occurring Chemicals on the Body, the Group and I went for a walk. I would continue to Lecture, for example, about Endorphins. While walking, I talked about how Endorphins are sometimes secreted due to Aerobic Exercise. If Someone needed to use the Toilet on the way out of the building, we may talk about th Excretory Process of Waste Materials from The Body. Since we were ouside, and someone decided to fired up a cigarette, we'd have to talk about what smoke does to the Aveoli of the Lung, or how Nicotine affects the Heart.

    What I'm trying to do here hanasea, is give you examples of how I put myself into The Process. Of Course, I did these Lectures twice a week for several weeks, so I was allowed to Fine Tune them. But you know what They say: "Practise provides opportunity for possible improvement."

    Good Luck to you hanasea.

    Dave
    Last edit by Davey Do on Apr 2, '12
    sandanrnstudent and Fuzzy like this.
  6. 0
    What about relaxation techniques? Open discussion about meds, side effects? Stress relievers and coping skills?
  7. 0
    I am currently in South Korea. Actually I am a subtitute for one session! The other member all has Master's degree or Doctor's degree in psychology or medical science. I only have bachelor's degree in nursing.

    It is my first chance, and I may have another chance If I do well.

    I guess I shoud ask other member of this course.

    and 90 minutes is long. I didn't thought about that! I should find something to catch their attention.

    Your comment is really helpful! Thank you very much, Whispera.
  8. 1
    Quote from Davey Do
    I encourage you to be Innovative, hanasea, but most of all, be yourself. Be Zen about this whole thing: Be the Group. You will find all sorts of information online and in books, but it will be you, and not the information, which will be leading this Group. Make it Personal. Immerse Yorself in this Subject. Find something to love about this subject.
    It is exactly what the professor said! I was going to copy a session of other psychologist's, and the proffessor disagree.

    I got an idea from your comment, Dave. Nearby our hospital, small mountain road is available. Most of depression patient are less of activity. Therefor, I will make them walk!

    I will prepare story of my life, and will open my ear to hear their hard time story while uphill- easy time story while walking downhill. We will see new flowers of spring, and talk about season, nature, and other things.

    I guess we will walk for 30-40 minute and share experiance in room for 40-50 minute.

    You are most helpful. Thank you very much, Dave.
    Davey Do likes this.
  9. 0
    Quote from WillyNilly
    What about relaxation techniques? Open discussion about meds, side effects? Stress relievers and coping skills?
    Relaxation technique will be covered in other session!
    And half of patient are not with meds.

    But Stress reliever will be great topic for next session!! Thank you very much for your idea, WillyNilly. It is so nice to hear from other nurses
  10. 0
    Quote from Psychcns
    What are the patients being told? How about medications and side effects?
    Meds will be nice but half of patient are not with meds. ;o
    It is <Mind therapy program> and various professional personnel is going to show how to care 'mind', I guess. Pretty ambiguous.

    Whom I will with be is most important! It is very basic point but I didn't thought of it. Thank you for your comment, Psychcns
  11. 1
    hanasea,
    Here is a rough draft of what I do. hopefully it will help give you some ideas,

    I do nightly group sessions with mostly severely depressed pts w/SI-SA, stable schizophrenics, and bipolar pts.
    I try to stress the importance of:
    1. Taking their perscribed medication- correctly...time, dose etc being compliant
    2. Getting enough sleep- why that is important to mental health
    3. Talking to somebody regarding fears, questions regarding mental illness, coping skills, etc. That person can also help them keep track of how they are acting, remind them to take their meds, get their sleep, etc.

    Sometimes I do medication education, letting the pts ask about a specific med they are taking. (I am very careful in what I tell the pts, as we all know...if I say you may have this symptom, or this may happen with that medication, there are some that will surely begin to have that symptom)
    My groups usually last about 30-45 min. Smoke break and 9pm meds are right after my group, so the pts are usually eager to get to smoke and get their meds, any longer than this and I am afraid I would have some very unhappy and irritable pts.

    I remind them that mental illness is not something they can get over, like a cold, or broken arm...but it is something that they can control by the above points. 1-2 and 3. Mental illness can only get worse if they do not follow the above points.

    I also stress the importance of not doing street drugs as they will only intensify the symptoms of their mental illness.

    Sometimes I do roll playing for learning new coping skills. I always play the devils advocate...allowing the pt to come up with the appropriate coping skill to deal with a certain prob they are having at home.

    Hope something I said helps, good luck.
    lindaholder likes this.


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