Introduction
Medication helps ease a patient’s physical symptoms, such as pain and poor body functioning in nursing. But a patient may also have psychological problems that could affect their social, mental, or spiritual needs (Roesler, 2019). Nurses may find that some psychological issues cannot be eased through medication. For example, after a patient is treated for a sports injury, they may develop irrational fears about playing the same sport or develop social anxiety. In such cases, therapy comes in to attend to such needs.
Therefore, therapy can be defined as a psychological or mental treatment method without using medicines or medical operations (Roesler, 2019). This method employs skills founded on theoretical frameworks and approaches to ensure high-quality patient care. Among several theoretical approaches is process-oriented therapy, which comprehensively focuses on observing thoughts, emotions, and experiences that manifest through a group of people or a community (Roesler, 2019). This process was founded in the 1970s by Dr. Arnold Mindell and incorporates many psychology theories (Lefevor & Williams, 2021). As such, this paper discusses process-oriented therapy as observed in a given group therapy.
Group Dynamics that Occurred
Many people are brought together in process-oriented group therapy to understand human experience and influence change. In other words, this treatment approach is a collective approach. The group often consists of at least five people who meet face-to-face with at least 1 or 2 trained therapists as their leader (Lefevor & Williams, 2021). The given group therapy adheres to this dynamic by having one trained therapist, Dr. Ezra, and a group of 8 people. They all meet face-to-face, which is a significant dynamic power of group therapy. Such a group environment is excellent for psychological healing because it brings numerous perspectives that encourage an open-minded thought process.
Additionally, the power of a group dynamic lies in the ability to get immediate feedback on a face-to-face level. This further promotes a confident and safe environment. As the founder of group therapy, psychologist Pratt discovered that when a group of people meet, they find out that they can air out their emotional states subconsciously and feel comfortable because everyone is doing so (Lefevor & Williams, 2021). Hence, the members tend to feel a sense of belonging. Pratt held his first group therapy with eight patients in 1905 and found it highly effective. Therefore, group therapy is observed to have an appropriate number of members and a leader.
Another dynamic observed in the group is that the meetings happen regularly. This is seen through the conversation among the members, where they welcome a new member, Henry, who becomes the center of the better part of the conversation in the first episode. All the other members know each other except Henry (Lloyd, 2020). They then introduce themselves to him and get to know him more. This shows that the therapy approach is process-oriented, which is expected to take patients through an adaptive form of change or growth. In Jungian principles of psychology by Carl Jung, it is proposed that the natural tendency of personal development involves habitual learning, which is facilitated by regularity (Vahdani & Phillips, 2019). This means that when a person does something regularly, it becomes a habit, making it easier to instill change.
A habit is even more comfortable to form in a group setting because groups act as a support network for people. Jung conceptualizes the human ego, the personal, and the collective unconscious to establish the effectiveness of process-oriented group therapy (Vahdani & Phillips, 2019). The concept comes from the theory of personality, where Jung explains that the collective unconscious mind accommodates shared and inherited knowledge from the people around a person (Vahdani & Phillips, 2019).
This knowledge may unconsciously affect a person’s behavior and attitude towards something. Hence, as the group members continue to meet regularly, their interactions with each other register in their collective unconscious mind. Notably, the end goal of their regular interaction will be positive since there is a sense of belonging, accountability to each other, and openness. Hence, the most noteworthy group dynamics in the given therapy were the number of participants and the regularity of their meetings.
Group Leader and Group Member Interventions
Process-oriented group therapy usually involves certain developmental stages initiated by the group leader and group member interventions. Both the leader and the members naturally work together to share numerous experiences (Cotter, 2021). This means the leader is not necessarily an educator but a facilitator aiming to encourage the group members to participate. As seen in the first episode, a group member, Karina, is unhappy with how another member, Rebecca, acts towards Henry (Lloyd, 2020). Therefore, she expresses how she feels about it, bringing up a discussion topic on the other members’ experiences. The group leader, Dr. Ezra, encourages Rebecca to talk about how she feels about what Karina thinks of her (Lloyd, 2020). This continues and allows for more topics to emerge.
In the second episode, Frank opens up about leaving something he did, journalism, and going to public relations in a technology company to serve his relationship with his wife, Edith. He also confesses that he hates Edith. As more confessions occur from the second episode, a group leader and group member intervention is observable. When a member confesses something, another intervenes by asking questions, and the leader adds more. Hence, the conversations continue growing as people become more open about their experiences.
In essence, the interaction among the members and their leader creates a natural progressive cycle of communication, feedback, and awareness. This is a remarkable aspect of process group therapies, where similar ways in which different people deal with various problems are brought out. It mainly allows members to talk as much as possible and as openly as possible about how they feel, think, and act (Cotter, 2021).
Additionally, members remind each other about important people in their lives and how they make them feel, think, and act. For example, the talk about conditional love reminds Karina about the death of her mother and how it makes her feel like she lost unconditional love (Lloyd, 2020). As such, when Frank talks about changing careers, he is reminded of his wife and immediately expresses how he hates her.
Nonetheless, most importantly, when members share their feelings, the leader and other group members help them process them and offer a positive insight. For instance, Dr. Ezra tells Karina that she only lost her mother but did not lose the love and that her mother’s love is still intact (Lloyd, 2020). As for Frank, another member tells him that he probably hates his wife because she is making him change what he loves doing to make more money to support his relationship with her (Lloyd, 2020). This means that the group interventions help people reflect on their feelings and come to a conscious realization.
Therapeutic Factors
Psychologists include the use of several therapeutic factors that contribute to treatment success. Arnold Mindell’s process-based group therapy offers four significant therapeutic factors observed in the given group. These include universality, altruism, catharsis, and imitative behavior. Starting with universality, mainly characterized by sharing, Group members share a familiar feeling, which helps them understand that they are not alone. (Lefevor & Williams, 2021). For example, Dr. Ezra’s group members seem to feel understood by the others.
When every member shares their experiences, others air out their opinions, and even though they may initially disagree, they realize they have a standard way of thinking, feeling, or acting. For instance, when Henry offers an opinion about the situation surrounding Frank and his wife, Frank says he does not trust Henry (Lloyd, 2020). But towards the end, Frank discovers that Henry is compassionate and likes him, bringing out a sense of acceptance between the two. The second factor, altruism, focuses on the aspect of helping others.
Usually, some psychological problems stem from feelings of inadequacy. This means some patients may feel like they do not have much to offer. However, coming into a group setting and being able to help others changes this perception about themselves. For instance, when Tilda tells Karina to stop seeing his father as a sadist because of the dangers of labeling people, Tilda gets to help Karina (Lloyd, 2020). This shows that Karina’s adequacy is a proper way to boost her self-esteem.
The third factor, catharsis, is also seen in group therapy. Catharsis is defined as the process of letting out strong, suppressed emotions. According to Dr. Mindell, catharsis happens when a person is in an emotionally comfortable environment (Cotter, 2021). This is because a great relief usually comes after a catharsis. Thus, a process of group therapy offers ample opportunity for catharsis. This is evident from the entire season of group therapy, where all the members bring out their profound emotional experiences, such as hate, anger, and love for each other and the people close to them.
Lastly, imitative behavior is when group members imitate each other or their leader. Numerous researches indicate that therapists strongly influence how group members communicate and behave toward each other (Lefevor & Williams, 2021). They tend to imitate the therapist’s listening skills, not being judgmental and providing support. For example, Dr. Ezra notices that Rebecca seems to understand Manny more than he understands himself (Lloyd, 2020). He later recognizes that Rebecca has been listening to Manny as he talks about his relationship with his father for years. This shows that Rebecca has imitated the therapist’s listening skills. Hence, the four therapeutic factors are pretty helpful in patient outcomes.
Other principles of process-oriented group work are also notable. The members have connected within their interaction framework (Cotter, 2021). This means they have put their life values aside and focused on their unique values. People may be ashamed to talk about their feelings in real life, but they can become open in this group. Also, members seem to transform from their old-learned behaviors and adapt to new, healthier ones (Cotter, 2021). This is due to the need to accommodate each other’s safe expressions. Hence, these two principles create meaningful interactions that can last a lifetime.
Stages of Group Development
Since process-oriented therapy is considered a holistic approach, it follows the well-being of a person’s whole personality rather than a part of it. In doing so, Psychologist Bruce Tuckman describes certain stages of group development seen in group therapy that contribute to a person’s whole well-being. These stages include forming, storming, Norming, performing, and adjourning (Hamilton, 2022). The forming stage involves members looking up to the therapist for guidance. The group has little confidence as they try to familiarize themselves. According to Tuckman, the first stage of group development has members striving to achieve safety and comfort (Hamilton, 2022). As such, it is seen that all the members get to know each other on a surface level.
The storming stage is where conflict arises. This is because there is a dire need for approval and acceptance among the members. The members are comfortable confessing their experiences; since different people have different beliefs, they air their ideas and attitudes. In this process, tensions arise, and the therapist aims to promote group cohesiveness (Hamilton, 2022). Karina is seen to have a conflict with Rebecca in the first episode, as well as Henry and Frank. This brings about a competitive atmosphere.
The third stage, norming, involves a common understanding of the group dynamics since the therapist has achieved cohesion. This is seen by how Dr. Ezra’s members tackle each other’s issues rather than confronting individuals. It is also observed that members such as Rebecca and Tilda actively listen to each other instead of competing to air their views. In the fourth stage, performing, members integrate their roles in improving each other’s emotional needs (Hamilton, 2022). It is established that their common goal is supporting each other psychologically; hence, group productivity is increased.
Lastly, the adjourning stage has group members feeling like they have achieved something. This is because they often reach a state of self-actualization, where they realize how their whole personal image is reflected in others and themselves (Hamilton, 2022). The therapist may evaluate the members’ feelings to understand their progress since the beginning of the sessions. Also, the last stage may make members sad because they have to say goodbye to other members, essentially their support network. As such, the therapist may need to follow up on patients after the adjournment stage.
Benefits Gained by Members of Dr. Ezra’s Group
Dr. Ezra’s therapy group has significant benefits for the members. The members realize that whatever they are going through can be shared with others (Maaß et al., 2021). This means that they are not alone in their struggles. Furthermore, a beneficial skill of emotional control is gained. This skill is quite essential in the functioning of day-to-day life. Through it, members learn to objectively respond to conflict by considering the primary goal of the therapy. In addition, the members find their voice through group therapy. This is a beneficial factor because one needs to be aware of their feelings and be able to express them (Maaß et al., 2021). This equates to having a connection with oneself, and this promotes healthy living.
Conclusion
In conclusion, process-oriented group therapy is a beneficial therapeutic approach that helps improve individual’s consciousness of themselves. It involves a group of people coming together and sharing their experiences, thoughts, and feelings with the help of a therapist. The approach uses psychotherapy theoretical frameworks from psychologists such as Carl Jung, Arnold Mindell, and Joseph Pratt to help people gain an inner understanding of themselves and others. Therefore, group therapy provides a safe environment where people support each other emotionally and allows individuals to change their attitude after being aware of their thought processes.
References
Cotter, P. (2021). A comparison of process-oriented psychotherapy with person-centred psychotherapy, cognitive behaviour therapy, analytical psychotherapy, brief psychodynamic therapy, gestalt therapy and Milan systemic family therapy. International Journal of Psychotherapy, 25(3), 9-25. Web.
Hamilton, W. (2022). The group-based dissertation in practice: A journey worth taking. Impacting Education: Journal on Transforming Professional Practice, 7(1), 42–46. Web.
Lefevor, G. T., & Williams, J. S. (2021). An interpersonally based, process-oriented framework for group therapy with LGBTQ clients. In E. M. Lund, C. Burgess, & A. J. Johnson (Eds.), Violence against LGBTQ+ persons: Research, practice, and advocacy (pp. 347–359). Springer Nature.
Lloyd, A. (2020). Group the film fundraiser [Video]. YouTube. Web.
Maaß, U., Kühne, F., Hahn, D., & Weck, F. (2021). Group cohesion in group-based personal practice. Behavioural and Cognitive Psychotherapy, 50(1), 28–39. Web.
Roesler, C. (2019). Theoretical foundations of analytical psychology: Recent developments and controversies. Journal of Analytical Psychology, 64(5), 658–681. Web.
Vahdani, R., & Phillips, M. (2019). Existential–Jungian analysis: Reconciling the personal and archetypal realms in the consulting room. Journal of Humanistic Psychology, 61(5), 806–827. Web.
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