Benefits and Limitations of Group Therapy

 

Being part of a group can enable you to receive insights from people who are close to your situation and can enable you to express/share your thoughts and opinions.

 

Group therapy can be an effective treatment for people.

 

Group Therapy
Group Therapy Session

 

Group therapy is a type of therapy that involves therapist(s) working with several people at a time, often 6 to 12 people who experience similar problems. Unlike individual therapy group therapy offers people the opportunity to socialise with others within a supportive and safe environment.

 

Group therapy can often be used alongside individual therapy and medications. It can show people that they are not alone in their situations and can give them the opportunity to meet others and socialise, which in some cases may be something that is lacking within their lives.

Group therapy can be carried out within community centers, private practices or mental health clinics.

 

How do People often Perceive and React to Group Therapy

 

 

Group Counselling
Group Therapy Counselling

 

Many people can feel intimidated by the idea of group therapy and feel nervous about being around and sharing intimate thoughts and details with others. Many individuals may find it difficult to share their thoughts on a one-to-one basis with a Counsellor or therapist never mind an entire group of people that they may previously have never met. The fear and stress of contemplating this can be overwhelming for some.

However, many people who initially felt agitated about group therapy can often become more comfortable within a group after a couple of sessions. It is also up to the person how much they would like to reveal about themselves to the group. The more the person is willing to open up and share about themselves, the more valuable feedback and insights from other members they will receive.

 

Group Therapy
social anxiety in groups

 

Sometimes the cohesion between group members and the psychological security of the group can enable and encourage people to express themselves and make clear the support that they need from others.

 

So what are the Benefits and Limitations of Group Therapy

 

Group Counselling
Group Counselling

 

Benefits and Limitations of Group Therapy

 

Some of the benefits of group therapy are as follows:

 

Group therapy can promote social skills:

Group therapy can enable you to interact with others and build your communication skills through participation within the group. Individuals who have experienced increased loneliness can often find these social interactions beneficial, life-enhancing and rewarding.

Self reflection and awareness:

Groups can teach you things about yourself that you may not have previously been aware of. This self awareness can be learned from listening to the group’s feedback.

 

Group Therapy Session
Group Therapy

 

Support and encouragement from a wide range of people:

Group therapy facilitates individuals receiving support and encouragement from a wide range of people. Individuals within the group can also observe what others are going through by acknowledging their struggles or issues, this can help them feel less along.

Group members can serve as role models:

Seeing others cope successfully with their problems can help group members feel encouraged about their recovery and in some cases be inspired. As people begin to recover they can then become role models for others. This can form a culture of hope, support and motivation.

 

Group Counselling
Group Therapy Session

 

Observe behaviour:

The benefits to the counsellor or therapist of conducting group therapy is that they can see exactly how individual members react and behave to others within social interactions. Group therapy sessions can give the counsellor or therapist a clearer understanding of how each individual behaves, interacts and responds to others within social situations to a greater extent than if this was simply expressed individually by the client, within a one-to-one session.

Safe environment:

Some people can begin to feel safe and secure within the group and therefore be more confident to display natural behaviours and express themselves more readily.

 

Some of the limitations of group therapy are as follows:

 

Group Counselling
Group Therapy Session

 

It can make people uncomfortable:

Group therapy sessions can become very intense and as a result of this can be more uncomfortable for some members, which could result in individuals feeling too uncomfortable to continue with attending group sessions.

 

Loss of trust:

Trust within therapeutic environments is very important, often clients will have to feel some trust towards a practitioner before ever attempting to disclose sensitive or/and personal information about themselves.

It may be much harder to develop trust with all the individuals of the group at the same time as the individuals would have to develop trust with a number of individuals they may not have developed personal relationships with.

 

Group Therapy
Group Counselling

 

Clashes between personalities:

In groups there will often be a variety of people who have different personalities, with some individuals having markedly different personalities than others. One example, might be that some sensitive or/and introverted individuals may feel intimidated by other individuals who are very assertive or speak loudly and frequently, this can often be interpreted or misinterpreted by others as ignorance or aggression. Another example, might be that when the group is sharing their thoughts there is a difference of opinion and viewpoint, this can often result in disputes between group members who have a different moral or ethical stance on an issue that is raised. Some individuals opinions on a matter can contrast with the values of another group member.

 

Some individuals can interpret rejection:

An individual can feel less of a bond with a therapist if they are in a group. Some individuals may have experienced rejection in their past or are currently experiencing perceived or actual rejection within their lives, they may experience social anxiety when being around others and in some occasions may have low self esteem, this may result in some individuals being highly sensitive to perceived or actual rejection from the group, which could make them feel uncomfortable, upset and anxious and in some cases could cause an angry reaction and outburst.

 

Group Therapy
Group Counselling

 

Limitations regrading privacy:

A person who is invited to take part in group therapy may feel a loss of privacy. Some people may not feel comfortable discussing past or present issues, feelings, thoughts and opinions that they feel are personal and that they are sensitive about. Some individuals may feel much more comfortable discussing such issues and feelings in the privacy of a quiet room with one individual, in which they have built trust and a bond with.

Large group discussions could also cause issues regarding confidentiality.

 

Social Phobia and speaking in front of a group:

For individuals with social phobia it might be difficult to speak in front of a group of people. For people who have experienced a significant amount of real or perceived rejection, the group may remind them of this and thus enhance these feelings of rejection.

For people who have experienced trauma and/or abuse then discussions about these issues that were traumatic to an individual within the group could trigger the feelings and thoughts of and related to this event for these individuals.

 

Group Therapy
Group Therapy

 

Individuals who are experiencing severe depression or who are currently in crisis or are suicidal would more than likely not be able to interact and function within this group to the extent that a group member would need too in order to gain benefit from the group. This is because they are not at that time in a strong enough psychological state to do so.

Summary

 

Group therapy can provide an excellent support system for some individuals and can give them a place to share their thoughts and opinions, they may also build important relationships within group therapy sessions that could provide them with a support network in which they can turn too in times of distress.

However, group therapy can be a bit overwhelming for some people who experience social anxiety or are experiencing significant distress related to psychological difficulties.

The effectiveness of group therapy and whether an individual would be best suited to group or individual therapy will depend on the previously stated factors. Some individuals may benefit greatly from group therapy and some people will not.

The Use of CBT within Schools

Cognitive Behavioural Therapy (CBT) in schools.
Cognitive Behavioural Therapy CBT in schools.

 

CBT Within Schools

 

It has been argued that the use of Cognitive Behavioural Therapy (CBT) in schools could reduce a variety of issues that pupils within schools might experience, some of which include, anxiety levels, self esteem, anger, depression, eating disorders, obsessive compulsive disorders (OCD) and post traumatic stress disorders (PTSD).

 

The need to improve the mental health of children and adolescents is increasingly being viewed as a priority in many countries around the world due to well documented health risks and the impact that mental health can have at a macro level upon economies and societies if interventions to address mental health issues are not applied early on.

 

cognitive behavioural therapy CBT in schools
cognitive behavioural therapy CBT in schools.

 

Teaching and training school staff and lecturers in CBT techniques may therefore, have an important impact upon the psychological health of children and adolescents and address issues early on, thus helping some children and adolescents with their mental health, emotions and behaviours in later life.

 

 

Research on Child and Adolescent Psychological Health

 

According to research for the BBC School Report half of teenagers cope alone with their mental health. Research for the Children’s Commissioner for England suggested that more than a quarter of children referred for mental health assistance received no support.

 

cognitive behavioural therapy in schools.
cognitive behavioural therapy in Schools

 

Research has also shown that the number of schools in England seeking help for students from CAMHS has risen by more than a third in the last three years. The NSPCC’s childline service has also reported a 26% increase in the number of counselling sessions with children regarding mental health related problems over the past four years with many pupils only getting help when others have perceived they have reached a crisis point.

Statistics from freedom of information requests from the NHS have also shown that the number of referrals to mental health services by schools rose by almost 10,000 from 25,140 in 2014/15 to 34,757 in 2017/18, more than half of these were found to be for primary school children.

 

Anxiety and children
Anxiety and children

 

Recently there has been much discussion on the impact and extent of poor mental health within schools. some articles have reported that four in five teachers (78%) have seen one of their pupils struggling with a mental health problem with one in seven cases involving the pupil suffering to the extent that they are having thoughts of suicide or displaying suicidal behaviours. Many reports have shown that less than half of those affected were able to access CAMHS care that could have helped them in their recovery.

 

Four in ten (40%) teachers believe the need for care has grown in the past year, 52% believed family difficulties were contributing and 41% identified bullying and exam stress as causes of emerging mental health problems. It is often teachers who witness the effects of bullying, family difficulties and exam stress on pupils. Many teachers have called for urgent support to tackle these issues.

A Department of Education spokesperson said that they want all pupils to grow up feeling healthy and have access to the right psychological support when they need it.

 

Children anxiety
Children anxiety

 

 

Introducing CBT Lessons Within Schools

 

Introducing CBT lessons within schools could enable children and adolescents to manage their emotions and replace their anxious or/and distressing thoughts with more helpful ways of interpreting and thinking about events.

 

Cognitive Behavioural Therapy within schools
Therapy within schools

 

Research has shown that anxiety prevention programmes given to children aged 9-10 within schools would be effective in reducing anxiety symptoms, according to research by The Lancet Psychiatry. It can also help pupils develop problem solving skills to cope with anxiety causing events and situations. Research has shown that anxiety is very prevalent in young people’s day-to-day lives as well as being a factor in increasing risks of poor mental health in later life.

 

 

Approaches to Introducing CBT Lessons Within Schools

 

CBT lessons could be introduced as part of the school curriculum. Another approach to introducing CBT lessons with schools could be training teachers and school staff to deliver CBT techniques and exercises.

One other approach might be to have professionals come into schools to talk to children and provide materials and online informational resources.

 

The benefits of CBT within the classroom.

 

CBT could help a child who may be suffering due to negative situations that have occurred in their lives and improve their ability to rationalise, cope with, focus and recall information. CBT would not just help children with issues they are already encountering but may also help them to preempt future difficulties.

 

CBT could help pupils to cope and respond differently to difficult issues that they face within their lives. If children can carry these techniques on to adulthood then this could help them to become well-rounded individuals.

 

Therapy within schools
Cognitive Behavioural Therapy within schools

 

Materials being widely accessible within schools would also give some children and adolescents an understanding on why they feel and behave in the way that they do, therefore helping them to deal with their emotions which may be upsetting and confusing to them. This may prevent thought patterns and emotions manifesting into future psychological difficulties.

 

Summary

 

Much research suggests that CBT could have a significant benefit to the psychological health of both children and adolescent pupils. The use of CBT techniques and exercises early on within a child or adolescents life could provide them with tools that could guide and help children and adolescents to cope better with events they perceive as stressful and confusing in both their current life and in their later life.

 

Due to the significant benefits of CBT upon young lives within society it could be argued that CBT should be an important contribution to the school curriculum within both primary and secondary schools.

 

I hope you enjoyed this article.

If you have any questions then please leave these in the comments section below.

 

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For Relief From Addiction, Tap Into Your Creative Side

Hello everyone,

Here is an article by a guest blogger.

I hope you enjoy.

It’ll make you feel better in so many ways, and that’s why therapists are adding a bit of creativity to their addiction recovery programs: to help patients achieve a greater sense of well-being that goes beyond abstinence. Whether it’s a strum of the strings or a brush to the canvas, the arts heal your damaged psyche and enrich your life physically, mentally and spiritually. Here’s how.

Health

This is the basis for good health. Difficult situations in life, such as being laid off, getting dumped or struggling with an addiction, can lead to stress, which has physical effects such as high blood pressure. That, in turn, causes even more stress. Creativity ends this vicious circle, as it brings peace of mind and helps you become energetically engaged with your body, according to A Lust for Life, a website devoted to well-being.

Tranquility

When you play an instrument, you focus your ears and eyes on what your hands are doing to produce a specific sound. This is a form of mindfulness, or being in the moment, in which nothing outside of you and your music matters, and that includes those worries and anxieties that you’ve been dragging around all day that are compounded by the pressures of readapting to a sober life. You can gain the same benefit from the visual arts.

Release

Artistic expression allows you to let go of the troubles that have been weighing on your mind. Painting is especially therapeutic for some people in addiction recovery. The Treehouse points out, “Whether it’s watercolor, acrylic, or oils, painting is a wonderful way for those suffering with addiction to cope. Not only is painting a quiet, soothing activity, it allows an artist to bring out whatever emotions they’re dealing with onto the paper or canvas and leave it there. Because drugs and alcohol can dull a person’s emotions, painting can bring you back to yourself, little by little.”

Self-Esteem

Start with plucking a string while you tap your foot to the beat. Now, add another string to the mix. Then, place your fingers on the fingerboard, and add new notes to the composition. The next session, you’ll build even more complexity, and as your skills grow, you’ll learn to play songs in their entirety. Do you see how that works? Little by little, you become better and better. That’s how you accomplish things, and accomplishment is how you build your self-esteem.

Structure

Imagine yourself in front of the canvas for the first time, making your first tentative brush strokes. Seeking the same release of negative energy, you come back to the same place at the same time the next day to add to your budding work of art, but this time, with a steadier hand. You’re gaining skill, but also creating a routine, one that’s invigorating to your mind and spirit. This adds structure to your life, which you need to overcome the negative habits you developed in your previous life.

Positivity

“Express yourself in some way you enjoy on a regular basis, just once a day, and benefit from a more positive state of mind,” says a doctor writing in Psychology Today, citing research in which over 600 people were surveyed on their artistic endeavors and the positive and negative emotional responses they felt. The study also revealed that creativity increased happiness in their relationships as well as positivity in the workplace.

Playfulness

There was a time when you were full of hope, before the weight of the world came crashing down on your shoulders. That child is still there inside you, waiting to reconnect. Art offers a way to reach them. Children are masters at creativity, naturally diving into lumps of clay and pots of fingerpaint to bring their imaginations to reality, and here you are doing the same thing, adding a dash of playfulness to your life. “Nothing is more important than creative play through imagination. Never stop playing, and never stop imagining!” says writer Carmela Dutra.

Painting, sculpting, music – any of these creative arts can be added to your recovery efforts, whether in-patient or outpatient, 12-step or holistic. Talk your therapist for some suggestions, or begin your personal vision quest with a trip to the music or art supply store. Either way, it starts with you.

Image via Pixabay.

I hope you enjoyed this article.

You can post any questions or thoughts in the comments section below.

Thanks everyone.

Ian Morrison, Marketing Manager, Institute of Counselling.

https://www.instituteofcounselling.org.uk/ 

Write an article for our Journal

Hello everyone

Would you be interested in writing an article for the Institute of Counselling’s journal called The Living Document?

counselling therapy article writing
counselling therapy article writing

We are looking for people to contribute articles for publishing within our quarterly journal ‘The Living Document’.

We accept a wide variety of topics and subjects, with many of our previous contributions being focused within the areas of spirituality, personal reflection, personal development and counselling and therapy.

 

We do not require articles to be a certain length as we accept short articles for inclusion.

 

We adopt an open approach to publishing within our journal as we are more than happy to cover a wide range of topics and subject areas.

If you are interested in contributing an article for our journal you can contact us by email at ianinstituteofcounselling@gmail.com

 

or by telephone at 0141 204 2230. We are located in Glasgow, Scotland.

We would be happy to hear from you.

Thanks everyone

Regards.

Ian. Marketing Manager, Student Services

InstituteofCounselling

Alcohol Abuse And Domestic Violence (Part 2)

Hello Everyone,

Here is the second part of Alana Fraser’s article ‘Alcohol Abuse And Domestic Violence’. This article was originally published within the Institute of Counseling’s journal ‘The Living Document’.

Men, Women, Alcohol and Domestic Violence

It is a common stereotype that, in domestic violence, men are the abusers and women are the victims: but this is not always the case. Also, alcohol can play a
major role where women are abusing the men in their lives.

 For example, research indicates that in relationships where the male partner abuses alcohol, the woman may push, grab or slap the man out of frustration at the man’s continued substance use or relapse. Also, in couples where the female partner abuses alcohol, women report that, when intoxicated, they tend to argue and initiate physical aggression with their male partner(1). These crimes are typically reported less-most likely because of society’s views on sexual norms and stereotypes. It is a common view in our society that the man is the head of the household, and the dominant one in the relationship. Hence, it makes sense to think that a man might feel embarrassed to admit that his wife is abusing him:

“Incidents in which men abuse women are perceived more negatively than incidents in which women abuse men.”(2)

What the Research Shows

Dealing with domestic violence that is closely intertwined with alcohol consumption means dealing with two separate issues. This can make therapy a challenge.

In the past offenders have been asked to attend two different types of therapy groups: one for alcohol dependency and one for aggressive or violent behaviour. The relationship between the two has generally been missed, so the problem has not been dealt with properly.

One study(3), which addressed both issues together, took the form of a twelve step CBT group for alcohol dependent men with interpersonal violence issues. The men were divided between a Twelve Step Facilitation (TSF) group and a Cognitive Behavioural Substance Abuse Domestic Violence (SADV) group. The participants had been approved by the DSM as having alcohol dependency; they had also been arrested in the past year for domestic violence.

The SADV group concentrated on problem solving skills related to violence, awareness of anger, managing emotions, coping with alcohol cravings, dealing with feelings of loss of control, and emergency planning. The TSF group focused on better understanding both alcoholism and the recovery process, learning how to manage their negative feelings, developing an effective support system, and maintaining recovery.

Results showed that the SADV group experienced a reduction in both violent episodes and levels of substance abuse. Group therapy, here, was more effective as it focused on the relationship between alcohol consumption and domestic violence.

Another effective treatment approach is Behavioural Couples Therapy for Alcoholism and Drug Abuse. The purpose of this therapy is to improve relationship functioning and to create support for abstinence from alcohol and drug consumption.

In this form of treatment, the abuser participates in counselling and an Alcoholics Anonymous group. At the same time, their spouse participates in counselling and an Al-Anon group. This gives both individuals a chance to deal with the situation separately. The abuser is aided in learning how to effectively control their emotions and cravings. The spouse learns more about the nature of addictions. He/she also learns how to influence their partner in a way that is loving- but does not permit the use of alcohol or other substances. This approach is effective because each spouse learns what their roles and responsibilities are.

The Impact on the Family

 Domestic violence and an alcohol addiction are serious issues that can greatly affect, not only the couple, but the wider family, too. Also, domestic abuse is viewed as including a range of different levels of involvement. This varies from witnessing aggression and violence …to being caught up in a violent situation (for example, intervening to protect another family member) … through to being a direct victim of abuse(4).

Children often bear the negative effects of alcohol abuse and domestic violence by observing the abuse, being neglected, and by being abused themselves. Being under the influence of alcohol affects one’s ability to decipher responsibilities and what is, or is not, appropriate behaviour.

 

Thus, the intoxicated parent may leave their child unattended or neglected.

They may also emotionally, physically or sexually abuse the child. This is clear from the following statement:

“The parenting skills and behaviours of adults with alcohol problems are significantly impaired: they are frequently neglectful, abusive, unreliable, inconsistent and violent.”(5)

Furthermore, any kind of neglect or abuse can be detrimental to a child’s development. That is:

“The interplay between witnessing family violence, suffering child abuse, observing chemical dependency in a parent, and experiencing parental separation increases the likelihood that developmental problems will occur.”(6)

Children who experience abuse can develop low self-esteem, a lack of trust, feelings of helplessness, self-hatred, depression, anxiety, boundary issues, violent behaviour, and so on. They usually find it hard to manage these emotions – and the effects may continue into adulthood.

Indeed, abused children often become abusing parents. They then perpetuate the negative cycle of abuse. They may respond to their own children out of anger and rage as that was how their parents responded to them.

“In alcoholic and abusive homes behaviour may be very unpredictable or it may be rigid and very painfully predictable. The child may be perceived as intentionally frustrating his parent or as being bad and uncontrollable.”(7)

So, when a child resists control or starts to misbehave, a parent who was previously abused themselves may believe that their child is ‘doing it on purpose’. They then relate this purposeful, unpleasant behaviour to how their parents treated them in the past (intentionally causing them pain.)

This gives rise to angry feelings towards their child and, in response, the parent may become abusive.

Abuse is an emotionally devastating occurrence. It is provoked and intensified when alcohol is present. Both of these abuses can be extremely painful and devastating to a family.

Conclusion

Domestic violence is a serious issue that is significantly influenced by alcohol abuse. Alcohol consumption facilitates violence as it negatively impacts decision- making and cognitive functioning. This can have dire consequences for the person, their spouse and any children in the home.

When intoxicated, it is more difficult to think through the consequences of our actions. People act in ways that may be out of character as they lack control over their thoughts and behaviours. Specifically, while under the influence of alcohol, they may react emotionally instead of rationally.

Most therapy deals with the two issues (domestic violence and alcohol dependency) separately. This is usually ineffective as it ignores the connection between
alcohol and domestic violence. Research shows that a combined approach is more effective as offenders are taught to control their cravings, as well as their negative, destructive emotions.

 

References

(1)   O’Farrell, T. J. & Fals-Stewart, W. (2006). Behavioural couples therapy for alcoholism and drug abuse. New York: Guilford Press.

(2)   Seelau, S. & Seelau, E. (2005). Gender-role stereotypes and perceptions of heterosexual, gay and lesbian domestic violence. Journal of Family Violence, 20(6), 363-371.

(3)   Easton, C. J., Mandel, D. L., Hunkele, K. A., Nich, C., Rounsaville, B. J. & Carroll, K. M. (2007). A Cognitive Behavioral Therapy for alcohol-dependent domestic violence offenders: An integrated substance abuse- domestic violence treatment approach. American Journal on Addictions, 16(1), 24- 31.

(4)   Velleman, R., Templeton, L., Reuber, D., Klein, M. & Moesgen, D. (2008). Domestic abuse experienced by young people living in families with alcohol problems: results from a cross-European study. Child Abuse Review, 17(6), 387-409.

(5)   Velleman, R., Templeton, L., Reuber, D., Klein, M. & Moesgen, D. (2008). Domestic abuse experienced by young people living in families with alcohol problems: results from a cross-European study. Child Abuse Review, 17(6), 387-409.

(6)   Potter-Efron R. T. & Potter-Efron P. S. (1990). Aggression, family violence and chemical dependency. London: The Haworth Press.

(7)   Potter-Efron R. T. & Potter-Efron P. S. (1990). Aggression, family violence and chemical dependency. London: The Haworth Press.

 

Barnwell, S., Borders, A. & Earleywine, M. (2006). Alcohol-aggression expectancies and dispositional aggression moderate the relationship between alcohol consumption and alcohol-related violence. Aggressive Behavior, 32(6), 517-527.

Hittner, J. B. (2004). Alcohol use among American college students in relation to need for cognition and expectations of alcohol’s effects on cognition. Current Psychology, 23(2), 173-187.

McMurran, M. & Gilchrist, E. (2008). Anger control and alcohol use: Appropriate interventions for perpetrators of domestic violence? Psychology, Crime & Law, 14(2), 107-116.

 

I hope you enjoyed this article.

Please Like this article and leave any comments in the comments section below

Many thanks.

Best Wishes

Ian Morrison.

www.instituteofcounselling.org.uk   

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Grief & Bereavement Counselling Models Part 2

Hello Everyone,

This is the second part of the article about Grief and Bereavement Counselling Models from Neil Morrison. This article was published in the Institute of Counselling’s journal ‘The Living Document’ Spring 2010 edition. Please enjoy.

Murray Parkes moved from stages to phases and cycles, which were fluid in their construction. He worked with Bowlby (l6), the father of attachment theory, and so began to understand the dynamics of attachment and separation and the pain that this dynamic caused. Dr. Parkes presented a lecture to Cruse Bereavement Care (17) which included the following powerpoint slide:

ATTACHMENT THEORY

(John Bowlby)

 

All social animals become attached to each other.

  • The main function of attachment is to provide security.
  • The function of crying and searching following separation is to provide reunion.
  • The nuclear source of security is the family.

The above illustration of social attachment shows how security, reunion and the family are all impacted by death and bereavement. That is, “the ideas that Colin Murray Parkes shared together go beyond description to propose an explanation, rooted in attachment theory, for the nature of complicated responses to bereavement. The thinking expounded here is destined to become part of the accepted fabric of those working in this field and will undoubtedly prompt continuing debate and further research.” The key word here is complicated – no matter whether it is ‘stages’, ‘cycles’ or ‘tasks’ of grieving and mourning.

Stages of Grief –

 

A Cyclical Model (ColinMurray Parkes)

 By describing different stages, Murray Parkes (18) implied that grief was a journey. It has various landmarks and the route will meander and change direction along the way. The final destination or end point of the journey is the healthy resolution of the loss.

Four stages are identified. These include:

1.     Shock versus Reality –

–         Characterised by numbness, denial and a sense of unreality.

2.  Protest versus Experience

–         Characterised by yearning and longing for what is lost.

3.  Disorganization versus Adjustment

–          Slowly realizing the full impact of the loss and finding a way of coming to terms with the changes death precipitates.

4.  Attachment versus Reorganization

–          Accepting that life has changed forever. Reattaching and forming new relationships. Establishing a new and fulfilling life separate from the deceased.

Colin Murray Parkes emphasized that these stages manifested in cycles which could reoccur during the grief journey.

William Worden – The Tasks of Mourning

William Worden (19) introduced the ‘Tasks of Mourning’. This not only observed what happened to grieving clients but was also proactive in that it suggested ‘tasks’ that clients could work through in order to facilitate the grieving experience. These are summarised below:

Task 1: To Accept the Reality of the Loss.

Task 2: To Work Through the Pain of Grief.

Task 3: To Adjust to the Environment in Which the Deceased is Missing.

Task 4: To Emotionally Relocate the Deceased and Move on With Life.

When a grieving client cannot work through each task successfully, they may experience complicated mourning.

This can be described as follows:

Task 1 not tackled: This is where the person does not acknowledge the reality of the loss.

Task 2 not tackled: This is where the person has not allowed himself or herself to experience the pain of grief.

Task 3 not tackled: This is where the bereaved person is unable to adjust to living without the person who has died.

Task 4 not tackled: This is where the person is unable to move on and does not, therefore, have the energy to adjust to the environment without the deceased(20),(21)Worden’s Task 4 has received some criticism, as is highlighted by the following quote from a University paper on ‘Holding on and letting go: The resolution of grief in relation to two Xhosarituals in South Africa’:

“While the dominant emphasis in contemporary bereavement literature is on the need for the bereaved to sever their ties with the deceased, this is not a straightforward issue … (It is possible that) some ties are not easily severed. Maintaining the polarity between the ‘holding on’ versus ‘letting go’ distinction is thus not always helpful, as this ignores the references within contemporary literature to holding on and disregards a multiplicity of meanings of what holding on and letting go entails”.

Worden himself has moved on from ‘letting go’ to ‘relocating’ the deceased in the mind of the bereaved. This is viewed as being a more humane way of counselling the person.

 

(16) Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

(17) w w w.crusebereavementcare .org ,uk

(18) Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

(19)        Worden, J.W (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

(20)        http://www.heron.nhs,uk

(21)        www.uel.ac.uk

 

References

Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

http ://bjp .rcpsvch .org

http://www.businessballs.com/elisabeth kubler ross five stagesof grief.htm

w w w.crusebereavementcare .org ,uk

www.grief.net/Articles

http://www.heron.nhs.uk

www.uel.ac.uk

 

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Ian

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Grief & Bereavement Counselling Models Part 1.

Hello Everyone,

 

This is an article about Grief and Bereavement Counselling Models from Neil Morrison. This article was originally published in The Living Document Spring 2010. I hope you enjoy.

 GRIEF AND BEREAVEMENT COUNSELLING MODELS

By Neil Morrison

Introduction

Historically, counsellors will look to the work of Dr Elisabeth Kubler-Ross (13) the pioneer of support to personal trauma, grief and grieving, associated with death and dying. Her work dramatically improved the understanding and practices in relation to bereavement and hospice care.

 

Kubler-Ross’ ideas, notably the Five Stages of Grief Model (denial, anger, bargaining, depression, acceptance), are also transferable to personal change and emotional upset resulting from factors other than death and dying.

 

Dr. Kubler-Ross was at pains to stop practitioners thinking of her Five Stages of Grief Model as linear. However, it seems that this has been the thinking of many practitioners. (Worden (14), Parkes (15)). A common criticism was that not all clients come to the acceptance stage and may seem to be ‘stuck’ in the grieving experience at anger or depression. That was certainly my experience whilst in clinical training as a hospital chaplain. Many patients were stuck in their grieving experience and acceptance was by no means universal.

 

The concept that people in bereavement go through a grieving process is now also being challenged.

Is there a universal grieving process?

What seems to be developing is the view that people go through a grieving experience which is different for different people. This would, then, suggest that the Stages of Grief model is somewhat out of date.

Other theorists, while accepting the value of Dr. Kubler-Ross’ work, have moved on to phases and cycles, rather than stages, of the grieving experience (for example, Worden, Parkes and Ainsworth-Smith).

Russell Friedman and John W. James of The Grief Recovery Institute state: “We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to the ideas presented to them. After all, a griever is often in a very suggestible condition: dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred.

http://www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm

 

 Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rded). Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

 

I hope you enjoyed the first part of this article. 

You can post your comments in the comments sections below.

Please Like and Share it.

Thanks.

Best Wishes

Ian Morrison

www.instituteofcounselling.org.uk                       

http://www.onlinegraduatecentre.com/

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