Group intervention: methods and effectiveness

Introduction
The prevalence of depression in today’s society has necessitated the emergence of different measures by health practitioners and social workers. These measures help the affected individuals overcome the challenges of depression. One highly effective strategy usually employed by social workers is group support intervention program. This approach is believed to be exceedingly result-oriented as it has, with verifiable results, helped many affected patients recover from depressive experience. Attesting to the efficacy of peer support interventions for depressed people, Pfeiffer, Heisler, Piette, Rogers and Valenstein (2010, p. 1), in their comparison between peer support and care alone initiatives, evidentially reveal that "peer support interventions have the potential to be effective components of depression care.” However, a group intervention community has many challenges capable of altering the direction and effectiveness of a peer support community.
Common Challenges Experienced in Group Intervention Services
One key challenge an agency can face in group intervention is articulating the group's purpose. Interestingly, the thought of creating a group may be very motivating, having found a void to fill in society by assisting a set of people with depression. However, the challenges begin when as an agency, there is a need to accurately identify the specific aim of the community. A group’s structure must be formulated in a way that adequately meets the needs of the clients. Otherwise, it will be difficult to effect the positive change desired by all parties involved.
One of the lapses in group formulation usually faced by peer support agencies is the lack of commonality in a group. The commonality is needed to make members feel the need for one another to work together to achieve a specific goal and essential to the development of a mutual aid system (Gitterman, 2003, p. 6). Without this clarity, the agency may experience ambiguities which may lead to lack of result and loss of motivation to carry on. Another challenge faced by an agency in a group intervention for depressed people is coping with group members who have issues participating fully in group activities and general discussions. It is crucial that group members share their experience, fears and addiction to help one another overcome the challenges. However, some members, Gianino & Glick (2008, p. 281) observe, despite benefiting from the group social aids, feel detached due to self-disclosure issues. At times, some clients may feel isolated in group activities designed to help them get through the process. This may make them feel withdrawn or even experience a relapse. A situation like this is one of the challenges that can discourage an agency or a social worker, which may defeat or cause a setback to the set objectives for the group.
The challenges in group intervention programs are, however, not limited to agency alone, the community as a whole sometimes faces issues, which may be very perplexing to both the agency and the clients. Group intervention program, by its very nature, is a community-centered affair with the mandate to make individual members access remedy to their problem using a collective approach. To that end, a psychiatric intervention community is, on its own, an entity which may be impacted or impaired by any unhealthy circumstances facing it.
One of the obstacles usually experienced by a group of this nature is what Gitterman (2003, p. 5) describes as an organizational obstacle. The obstacle may include loopholes in the agency's structures. When there is the inadequate provision or absolute lack of essentials, for example, "lack of evening hours or the quality of services such as institutional food", the effect is mostly felt on the community as a whole. The group, due to occurrences of this nature is usually grappled with drawbacks that will affect the generality of the group. Another issue customarily faced by an intervention community is the size of the group. While it is understandable that a group constitutes many people and is not an individual affair; the number which makes up the group within the context of social intervention may shape or mar its overall success. Having too many people in a community might affect communication, openness and oneness which the group ought to enjoy. Gitterman (2003, p. 14) posits that the size of a community may be overstimulating and confusing to some depressed patients or the frail elderly, which may result in withdrawal or exhibition of unbecoming attitudes from this group. Another challenge that a group may face is timing. Not allocating enough time for community meetings or scheduling meeting hours at periods which might be not suitable for many group members due to their engagements may be challenging to the group as a whole.
A group intervention service is a three-prong concept which consists of the agency, the community and the clients who make up the group. Just as there are challenges within the agency and the community contexts, there also exist some challenges peculiar to the clients who are group members.
Prevalent among several hitches faced by clients on a personal level is the issue of confidentiality. Intervention groups are set up in a way that requires members to share confidential secrets with other group members. However, clients might feel uncomfortable sharing some secrets considered to be too personal by them. The possibility of having their private problems disclosed outside the community by other group members with whom they have shared these intimate secrets might cause them to be reserved. Difference in intervention needs is another challenge a client might face in a group. Some groups do not clearly classify the set of people who should constitute group members. Having a mix-up of individuals with uncommon problems can end in despair or conflict or both. For instance, a client who considered himself as “just being nuts” as shared by (Gitterman, 2003, p. 12), was inappropriately placed in a group of recently released hospital patients who were still psychotic. The experience, the client relates, was frightening and upsetting at the same time. It made the client think it was a waste of time being there. An experience like this usually makes the client feel alienated and loss of sense of belonging in the group.
Effective Remedies to the Challenges
Although these quagmires discussed above may look insurmountable judging by the way they can cause loss of motivation to both the client and the agency, and affect the general progress of the community. However, they are not without clear and proven remedies that can help bring their effects to the barest minimum if judiciously managed and operated. For instance, in articulating a group’s purpose and establish an atmosphere of commonality that will make each group member feel belong, loved and needed, Gitterman (2003, p.6) suggests that a group be formed around natural life stressors experienced by people. The clarity will eliminate divergence in needs of group members and establish the bond that will guarantee a sense of belonging to the generality of the community. The stressors as suggested by the author should be based on the “three interrelated areas: life transitions, environmental pressures, and interpersonal processes”. The concept of life stressors in group formation helps bond members with common interest or needs; proffers clarity of purpose to both the members and the agency; improves the overall engagements of the clients; and ultimately aid the positive output of the agency.
In dealing with members who appear distant, one of the best solutions, as proven by Gianino & Glick (2008, p. 281), is to identify such member, offer an individual session with him or her and get to understand the exact root cause of the noticed isolation, and works towards helping the client overcome the prejudice. For example, when a depressed client, a member of an open-ended, long-term psychotherapy group for gay men was observed to be exhibiting isolation from group activities, Gianno (2008, p.281) took him through an individual therapy sessions which was really helpful for him in overcoming the challenges and eliminating the prejudice which has been the cause of his fear and shame. Having entirely subdued his preconception, the client was reintegrated to the group and welcomed back in open arms of his old group members even as he became more active and open after that.
For the problems about group structure, size, and time usually faced by the community as a whole, a well-thought-out feasibility study will be required at the onset before the member admissions into the group. To build an effective community structure, there must be a perfect understanding of the constitution of the group membership based on the three interrelated areas which are life transitions, environmental pressures, and interpersonal processes as discussed above. Building a group within the confine of just one among these will remove the ambiguity and loss of focus and purpose of the community. Gitterman (2003, p.6) defines each of the threes emerging areas in a comprehensive approach. For instance, life transitional stressors revolve around helping people dealing with developmental changes over the life cycle, such as adolescents dealing with issues of sexuality, ethnic identity, and independence/ dependence. Environmental stressors group is formed to help deal with both life transitional issues and external organizational concerns. It may also be explicitly formed to attend to internal and/or external organizational issues. Interpersonal stressors group is formed to help people who have problems with interpersonal relationship with people within their social circle.
Similarly, other structural problems like meeting times and group size could be resolved by scheduling group meeting at the time most favorable to the generality of the community and allocating enough time for each session and as many times within a week or month, just as required by the need of the group stressors. For instance, an agency realized that the traditionally weekly hour was insufficient to help youngsters dealing with various school crises effectively. To ensure the effectiveness of the services offered, Gitterman (2003, p.14) recollects that the agency "restructured meetings for greater frequency", this time, twice to three times a week. An initiative like this will reflect positively reflect on all the parties in a group intervention service. The workers will work with better clarity of purpose; the clients will get the value for their resources and time expended on the program, and the community as a whole will experience a healthy atmosphere.
One significant advantage of having a well-articulated group structure is that it can be used for any age or social group. As revealed by Dennison (2008), any targeted demographic can benefit from a well-structured community of intervention group. Dennison in her work shows how different age group including children and adolescents found recourse in various group intervention programs. A group of elementary school children with emotional challenges and a high school group with the challenge of work and dealing with their bosses are some of the demographics (Dennison, 2008, p.315-317) showcased as a testament to the efficacy of social group intervention. Also, a middle school group was also recalled by the author to have leveraged on the power of a healthy group formation to find solutions to their emotional traumas.
Conclusion
From all indications, peer support intervention is one of the most effective ways of solving any traumatic and depressive experience. A community of people fighting a similar cause will not only be beneficial to the affected persons but will also reduce the societal stigma as members get to understand they are not alone in the fight. However, a premium must be paid on the clarity of purpose in a group setting in order to mitigate the potential challenges capable of submerging the overall goal of the community.
References
Dennison, S. (2008). Measuring the Treatment Outcome of ShortTerm School-Based Social Skills Groups, Social Work with Groups, 31:3-4, 307-328, DOI: 10.1080/01609510801981219
Gianinio M. & Glick, A. (2008). Wearing Two Hats: Clinical and Ethical Implications of Combining Individual and Group Treatment, Social Work with Groups, 31:3-4, 273-287, DOI: 10.1080/01609510801981078
Gitterman, A. (2003). Group Formation: Tasks, Methods, and Skills.
Pfeiffer, P.N. Heisler, M. Piette, J.D. Rogers, A. M. and Valenstein, M. (2010). Efficacy of Peer Support Interventions for Depression: A Meta-Analysis. 1, 29-36, DOI: 10.1016/j.genhosppsych.2010.10.002