Cognitive behavioral group therapy for abuse survivors with anger and depression

Group Therapy Proposal

Treatment Plan for Victims of Abuse

Overview of the Condition

Cognitive Behavioral Group Therapy

Proposed Meeting Schedule

Overall Goals and Objectives

Ten Week Program Outline

Thoughts and Moods

The ACT Model

Identifying Thinking Patterns

Understanding Thinking Mistakes

Positive Alternatives

Indivisible Self (IS) Model Awareness

Second Order Factors

Third Tier Factors

Lessons Learned and Next Steps

The following proposal outlines a treatment plan for group therapy for a group of individuals that have all suffered from abuse. Either as a result of abuse, or as a comorbid condition, the some of the group members are also dealing with anger and depression issues. This proposal will first conduct a literature review and then apply the best practices identified to the proposal. A outline the general population information about the group, the frequency and duration of the proposed meetings, the content, and the goals and objectives that will be set as the desired outcomes for the group\'s members. The proposal integrates the CBT models and the IS model to provide the patients information that can help them mitigate the emotional and psychological issues that have resulted from their abuse and take a more proactive approach in fostering a greater level of wellness in their own lives.

Overview of the Condition

There are many different forms of abuse that can cause negative impacts on an individual\'s lives and there are a range mental health issues that can result from these events. Abuse can often lead to significant emotional or psychological problems that can interfere with daily life because such events can be difficult to cope with and problematic behaviors can manifest in many aspects of life. There is a spectrum of abusive situations as well that can range from a onetime occurrence, to experiencing ongoing battering over a prolonged period. It is typically because of the hindrances that are imparted by these occurrences that people will typically seek some form of assistance and confronting the daily challenges they face.

Literature Review

Group therapy or group counseling, is often a highly effective form of treatment that can help people overcome various aspects of their emotional or psychological issues. One of the primary benefits of using the group counseling format is that the group\'s members get to interact with peers that can offer new perspectives as well as social support. One study looked the effects of a twelve-week group therapy session that was designed for a population that was diagnosed with the human immunodeficiency virus (HIV), a life changing diagnosis, and found that the results s indicated that the mood of the participants in the CBT group improved in terms of anger, tension-anxiety, depression, confusion, and overall mood (Labbe, O\'Cleirigh, Stein, & Safren, 2015). Although patients diagnosed with HIV and those who have suffered abuse are two totally different populations, there are also many parallels that can likely be drawn.

Another study focused a population that had substantially more in common with abuse victims. Nurses who work in mental healthcare are often exposed to high rates of aggression, violence, and being physically assaulted than the general population do to their professional roles and as a consequence, this population has been the subject of numerous research inquiries. Many studies have found that the aftermath effect of patient aggression and violence towards nurses inflict immense negative reactions such as shock, depression, demoralization, upset, loss and grief, ruminations, guilt, anxiety and many more (Chaun & Lim, 2011). This study conducted a meta-analysis and found that informal peer support in counseling was among the best practices in helping this population on a long-term basis.

Population

The population that is the subject of this proposal is a group of eight females that have all experienced some form of physical abuse. The age range in the group is between mid-twenties and late 50s. Although these members will share backgrounds that include some form of physical abuse, there is a range of types of abuse represented. For example, some members have experienced ongoing forms of domestic abuse, while others have experienced acute instances of sexual abuse. Some members in the group are also dealing with anger and depression as a result of their abusive relationships and have maladaptive coping mechanisms. Both internalizing and externalizing behaviors are present in all of the group\'s members and it is expected that the individual needs of each patient will be consistent with the group\'s collective objectives.

Proposed Meeting Schedule

This proposal suggests that the group meets for ten weeks, one evening per week, and for ninety minutes per session. The sessions will be held in the evening to assist members that cannot make day meetings due to their employment. There will also be the opportunity for the group\'s members to meet informally before the sessions begin so that they acquainted with each other beforehand.

Overall Goals and Objectives

The core objectives in the group counseling proposal will include focusing on developing increased levels of self-esteem in the group first and foremost. The literature review identified how important self-esteem can be for abuse victims and this is correlated to many related positive behaviors. Another objective that the proposal will focus on will be developing more effective coping mechanisms through education, dialogue, and targeting the negative and irrational thoughts that led to negative outcomes in many abuse victims\' personal lives. The counselor will use the ACT model to help teach the group how they can identify these processes and the group can exchange their experience in their application of these concepts in their personal lives.

Through education and practice the aim is for the group members to become more mindful of their internal thoughts and how these thoughts can hamper their emotional wellbeing. Finally, we will also expand on the concepts related to wellbeing using the Indivisible Self Model of Awareness to build a framework in which the participants can have more control over their personal choices and experience greater levels of self-efficacy in their decision making. Through collaboration and dialogue about the individual experiences with the application of using a wellness model, the group should be able to gain many insights from one another and build some momentum that can also positively influence self-esteem and efficacy.

Ten Week Program Outline

Week 1 -- Introductions

The first week will be largely marked by the group introducing themselves to each other, discussing objectives, and going over the schedule and content for the rest of the sessions. The group will be asked to discuss items such as what brought them to the group and what they hope to achieve.

Week 2 -- Thoughts and Moods

The second week will serve as introduction to CBT and the associations between thoughts, moods, and behaviors. The group will begin to learn about the interplay between these factors and be more mindful of how they arise in their lives. The group will be asked to bring in examples of thought processes from the week to the next session.

Week 3 -- The ACT Model

The third session will be extension of the previous session and dive deeper into the details of the formal ACT model. Examples will be provided of the model and the group will be asked to participate in the discussion of any personal examples that they can identify. The group will be asked to bring in samples of different lines of thinking that they have become cognizant of in their thought processes to the next class.

Week 4 -- Identifying Thinking Patterns

This week will cover different thinking patterns and processes that people typically go through. The group will discuss the different facets of constructive and destructive thinking, positive and negative thoughts, and necessary versus unnecessary thoughts among others.

Week 5 -- Understanding Thinking Mistakes

This week\'s session will cover some of the common thinking mistakes that many people make unconsciously. Examples of these errors include exaggerations, expectations, and reactions and how our internal filters and lens can naturally distort the way that we perceive different circumstances and situations.

Week 6 -- Positive Alternatives

After the group has become familiar with the types of thoughts that manifest unconsciously in their minds, the next step will focus on healthier and more beneficial alternatives to distorted and/or problematic thought processes. Once an individual is capable of recognizing different patterns of thinking, then it is prudent to introduce more suitable alternatives that are more closely associated with the individual\'s own personal objectives.

Week 7 - Indivisible Self (IS) Model Awareness

Once the concept of being able to have more influence over our internal thought processes has been introduced, the next step will be to introduce how a more detailed and holistic sense of balance could be achieved and the Indivisible Self Model of Awareness will be given as one framework that could be used to plan activities that support different areas of wellness. The connection between the body and the mind, particularly when it comes to the treatment of trauma, the field of psychotherapy has developed rapidly (Duros & Crowley, 2014). These connections and the interplay between them will also be discussed.

Week 8 -- Second Order Factors

In this session, the second level factors in the IS model will be introduced to the group and their five components, Coping Self, Social Self, Physical Self, Essential Self, and Creative Self, will be discussed as well as the relationships between these factors.

Week 9 -- Third Tier Factors

Within the second order factors are 17 third order factors: realistic beliefs, stress management, self-worth, leisure, friendship, love, exercise, nutrition, spirituality, self-care, gender identity, cultural identity, thinking, emotions, control, work, positive humor. Each of these factors will be briefly introduced as well as the contextual factors that also influence the model. The group will only develop an awareness of these factors, but also be provided routes in which they can further explore these topics on their own.

Week 10 -- Lessons Learned and Next Steps

The final meeting will review all of the information that was covered and provide an opportunity for the group members to discuss their insights, discoveries, concerns, progress towards their objectives, and other relevant information. There will also be the opportunity for the group to provide feedback to all the members, including the counselor. The proposal concludes with some information related to potential next steps and further introspection as well as provide the opportunities for further growth and development. Various channels of support will also be discussed that might be relevant to any future challenges.

Conclusion

This proposal for a group counseling session for victims of abuse was developed with the CBT and IS models as a foundation for its development. Each of these models is backed by a significant amount of evidence-based research and were selected for their abilities to help abuse victims identify and correct negative thinking patterns. Once an individual learns to identify patterns in their own cognition, then the IS model can provide a foundation for them to take a more proactive role in promoting their own wellness.