“Group therapy is an effective opportunity through which group members are involved in “companion struggles” to cope with the feelings related to mistrust and alienation trauma (Gyle, 2006, p. 267).” In adults, cognitive, psychodynamic, and supportive behavioral models have been used in group therapy. However, this paper specifically describes the cognitive behavioral approach together with features of unique group therapy. It is apparent that as a result of exposure to trauma, group therapy is an appropriate approach although it lacks the evidence of enhancing prevention to the trauma related to psychopathology.
In this article, a rationale is detailed for group therapy to distress related trauma. In addition, an overview is generated for various group intervention models for persons that have been prone to life-threatening violence.
Cognitive behavioral group therapy approach
Van der Ploeg, Schwab, Walker, Fraser, Siqford, Date, Scott. Curtis, Salazar & Warden (2008) explains that cognitive behavioral therapy is one of the approaches used in counseling. This approach has successfully been employed in treating the post-traumatic stress disorder (PTSD) patients. In the veterans’ affair (VA), cognitive behavioral therapy approach has been used for the PTSD treatment. In this approach, the current symptoms related to trauma are reduced thereby providing the members with skills for successfully coping with the chronic symptoms exacerbations (USDVA, 2007). In the cognitive behavioral approach to group therapy, cognitive techniques of restructuring are used in each individual’s experience. In each individual, there is an opportunity of revealing their story to the others. Moreover in the cognitive behavioral group models, the personal narrative strength is encouraged together with the power of providing support to the group as is it possible to hear the other peoples experience without judgment (Gyle, 2006)
With the psychoeducational material regarding the coping skills and relapse prevention, the group members’ resources are bolstered to enhance responding to the existing and future symptoms of PTSD. For instance, in a study examining cognitive behavior efficacy, there was a clear demonstration of improvement in the group members’ agony at the end of the cure. These groups were inclusive of not only the combat veterans but also other populations (survivors of abuse and sexual assault). Various techniques of cognitive behavior in these groups were inclusive of: confidence training, and inoculation of stress. Various groups meeting were held on weekly basis for a period of one and half to four months. In all this period, the PTSD symptoms were directly verified.
In the year 2007, the Veterans Affairs admitted 365 military members that were on active-duty. These veterans registered various traumatic injuries that had resulted for the land mines, bomb grenades, bullets, grenade bleats, and vehicle accidents while in combat. Various Afghanistan and Iraq veterans had a likelihood of suffering from traumatic brain injuries (TBI) together with PTSD among other physical injuries (USDVA, 2007). A common diagnosis that results in behavioral and cognitive changes is TBI. This diagnosis has a likelihood of reducing self-awareness of the patient. As a result of deficits in impairments self-consciousness and inappropriate interactions among the veterans, there were problems in impulsiveness control. Consequently, the veterans encounter various problems that hinder restoration to previous social lives (Keltner & Cooke, 2007). In addition, there is a likelihood of these individuals reducing the chances of resuming their duties; a trend that is followed by a reduced quality of life (Goverover, Johnston, Mark, Togla, & DeLuca, 2007).
In both programs, occupational, physical, prevocational, neuro-physiology, and speech therapies were incorporated. According to the result, there was improved participation in the community and ability to manage the emotional and cognitive symptoms for the cognitive rehabilitation group. Moreover, the follow-ups established stability in these improvements as opposed to the perception that time would welcome behavioral changes. In contrast, the neuro rehabilitation group participants needed repeated all-inclusive rehabilitation for a period of 24 weeks after being discharged from the survey. This study concluded that with the program of intensive cognitive rehabilitation, there was a continuity and stability in the progress of psychological wellness in caparison to a program of standard neuro rehabilitation.
The relevance of trauma treatment through group therapy
Basically, interpersonal violence is commonly involved in several traumatic experiences (for instance domestic violence, rape, physical assault, or combat veterans). In addition, there is a vivid illustration of the capability of the human beings when it comes to causing dreadful harms to other individuals (Trudel, Nidiffer, & Barth, 2007). In other traumas; especially as a result of accidents or disasters, interpersonal violence may hardly be involved as such, individual violence of horror, helplessness, or fear is actually invoked. Through these emotions, the survivors may be forced to question if really there is support from others in extreme needs and in trust disruption.
“Group intervention appeal for the survivors of trauma to a larger extent rests on the importance of joining with others in therapeutic work when handling victimization consequences such as alienation, diminished feelings, and isolation (Gentry, 2008, p. 21).” The suitability of group intervention is even more enhanced when it comes to such populations as Vietnam and Afghanistan veterans (Salazar, Deborah, Warden, Karen Jack, Steven, Joan, Reginald, Mary, Rosner, Elisabeth, Martin, Ecklund & Ellenbogen, 2000). These individuals are dominated by a feeling of isolation from the larger society and to some extent, their predicament result to blames. An important step of regaining trust can be enhanced by building ties with the environment that may be perceived to be supportive. Beyond the obviously underlined advantage, group therapy may be perceived as important to the veterans failing to meet the common expectations that are perceived to be needed for individual psychotherapy (Klein & Schemer, 2000)
A study conducted by Schnurr, Friedman, Lavori, & Hsieh (2001) established three approaches through which group therapy may be enhanced. Among these approaches, cognitive behavioral approach is highly illustrated. This approach is among the various approaches sharing common features of building a safe, therapeutic and respectful environment. These features are inclusive of: regulation of the group therapy by shared trauma (for instance the adult victim of child abuse combat veterans), disclosing and validating the traumatic experiences, and validating the behavior that is needed for survival during the traumatic moment.
Group therapy for the trauma related to distress hardly incorporates the process-oriented treatment approach (Gentry, 2008). The key ingredient hardly involves processing and recreation of the family dynamics of origin within group relationships. In contrast, this approach incorporates various directions of addressing the traumatic experiences of the members. Gentry (2008) add that the experience is uncovered by cognitive behavioral therapy through intentionally focusing on event discussion and the experience of the members’ memories.
Basically, occupational therapy is perceived to be an appropriate intervention for the TBI veterans when it comes to adapting to the behavioral and cognitive changes. Through this approach, these veterans are successfully transitioned back to their previous responsibilities while ensuring that they are reintegrated to the community. Although the cognitive therapy treatment seems to be on the early stages, it holds promise as an effective approach for treating the veterans PTSD. In order to gain a clearer insight to the effective veterans’ rehabilitation intervention, there is need for further studies on therapy approach whereby the main focus should be on the TBI veteran populations, their challenges, distinctive needs and the best approach through which these individuals can be assisted to regain independence.
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