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 Respond  by recommending strategies for improving the effectiveness of  their group therapy sessions. Support your recommendations with  evidence-based literature and your own experiences with clients.  

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 Counselling  older adults may be challenging because of a number of issues that may  be associated with their age such as multiple chronic illnesses. The  therapist needs to know how to accommodate these issues in a group in  order to make sure that the elderly clients benefit from the group  sessions. In one session with older adults, a group therapy was formed  in order to address concerns that the elderly clients had about end of  life. Most of them presented with symptoms of anxiety and others had  depression. Some of them felt that they were not ready to die yet and  others felt that they had regrets in life and had not achieve what they  wanted. The purpose of the group therapy was to help them to cope with  the fact that they are old and that they should try to focus on “here  and now” instead of their past, which they cannot change. The therapy  also created an opportunity to help the older patients to make plans  about their medical care in the future such especially if they are not  able to do so. Research shows that advance care planning for elderly  patients is associated with low stress, depression, and anxiety in  family members after the death of the elderly person (Kale et al.,  2016).

   The group is still in the forming stage and the members are still  getting acquainted. There is very limited exchange between the elderly  persons and most of the time, they only speak when they are prompted by  the therapist. The therapist has been doing his best to create  cohesiveness and set goals as well as expectations for the group. At  this point and stage of the group, the main issues include feelings of  anxiety, uncertainty, and distrust between members of the group  (Malhotra & Baker, 2019). These are elderly persons that come from  different areas and they have never met. They all have their fears and  concerns about end of life, and they may not be ready to share them with  the rest of the group before the become comfortable around each other.  In order to improve on cohesion and reduce the level of distrust between  the members, the therapist has been prompting each person to share  something about themselves that do not necessarily pertain to their main  concerns and reasons for accepting to start the group therapy. Once  each member knows something about the other, the level of distrust will  reduce, and they will be comfortable when it comes to sharing  information about their fears, regrets and concerns about end of life.  The therapist also planned to use group reminiscence therapy for this  group after cohesion has been achieved and after potential conflicts  have been addressed. Group reminiscence therapy is an approach that has  been proved to be effective in improving the quality of live and  self-acceptance in elderly persons (Gaggioli et al., 2014).

   Working with elderly patients may be very challenging for any  professional. First, as it was mentioned earlier, elderly patients may  have multiple illnesses such cardiovascular diseases, diabetes, and  hypertension. These chronic illnesses may prevent them from effectively  performing their activities of daily living and this may affect their  ability to attend and participate in every session. Failure to attend a  session may limit the extent to which a person may benefit from the  group. In addition, failure to attend several sessions by different  members may negatively affect the progress of the entire group. The  result may be that more sessions will have to be used before the group  therapy is considered to be successful. 

References

Gaggioli,  A., Scaratti, C., Morganti, L., Stramba-Badiale, M., Agostoni, M.,  Spatola, C. A., … & Riva, G. (2014). Effectiveness of group  reminiscence for improving wellbeing of institutionalized elderly  adults: study protocol for a randomized controlled trial. Trials, 15(1),  408

Kale,  M. S., Ornstein, K. A., Smith, C. B., & Kelley, A. S. (2016).  End‐of‐life discussions with older adults. Journal of the American  Geriatrics Society, 64(10), 1962-1967. 

Utz, M. (2016). When a therapist leaves a client: Closing the therapeutic relationship effectively.Retrieved from https://sophia.stkate.edu/msw_papers/686/

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