Introduction
Many people face bereavement or grief and loss in their lives. These events can leave a significant imprint on the psychological well-being of an individual; however, it is a normal reaction to a traumatic loss. An essential aspect of this process is the provision of assistance that will help to cope with the circumstances.
Grief can have far-reaching consequences, including emotional suffering, physical symptoms, and altered behavior patterns. The problem is that, despite the prevalence, feelings of sadness and loss are rarely discussed. This is the result of the fact that many individuals internalize their experiences and remain alone in this problem. Group counseling for older grieving individuals is more effective than individual therapy because it allows them to share their experiences with others who can relate and receive guidance on moving forward.
The main topic of this research work is the study of how group counseling can help cope with loss and grief in the adult population. Within this context, the paper will be divided into several parts. A literature study will be conducted on the importance of various such groups and leadership styles and approaches for group therapy. The next step will be establishing the theoretical foundation to work with the group and determine the most effective leadership approach. The final part of this academic paper will provide information on cultural, legal, ethical, and therapeutic factors and a plan for group activities and interventions.
Comparing Supporting Literature
A study of the scientific literature has provided significant insight regarding issues and types of groups with which counseling can be conducted. Bereavement is complicated for anyone at any age, but it can be challenging for seniors because it typically coincides with other major life transitions like retirement or deteriorating health (Maass et al., 2020). Losing a loved one can negatively affect an individual’s mental, emotional, and physical health.
Given the multifaceted nature of grief, a group setting may prove optimal for meeting the requirements of this demographic. It was stated that older people who have lost might benefit more from participating in a psychotherapy group than a counseling group (Maass et al., 2020). Psychotherapy groups can offer a secure and supportive space for older adults who have lost a spouse to talk about their feelings and learn from the experiences of others who have gone through the same thing (Moore et al., 2020). The isolation and loneliness that often accompany grief can be alleviated this way.
It is important to note that psychotherapy groups can give seniors a feeling of belonging and direction as they work through their grief. Support group members can gain from one another’s stories and insights (Gibson et al., 2020). However, a psychoeducational group might not work as well with this clientele. This is because they can help teach participants about the grieving process and coping skills; they often lack an emphasis on emotional inquiry (Moore et al., 2020). Elderly people who may feel alienated or alone in their sorrow may not receive the same amount of social support and validation from a psychoeducational group as they would from a psychotherapy group.
Different methods of group leadership have been created to better serve the specific requirements of grieving people. One of the most productive leadership styles for bereavement support groups is the person-centered leadership style. The person-centered method emphasizes empathetic and sympathetic group facilitators (Luo, 2021). It also emphasizes providing a secure and nonjudgmental environment for members to express their emotions and work through their grief (Luo, 2021). A facilitator of a person-centered group lets group members take the reins in delving into their feelings of loss.
Another approach that can be used for counseling within the framework of the discussed problem is the cognitive-behavioral method of leading support groups. Cognitive restructuring and behavioral modification are at the heart of this method since they are based on the belief that one can influence one’s ideas, feelings, and actions. Thus, like the person-centered leadership style, this approach makes a more significant bias towards the experiences and emotions that individuals experience, which is their strong point.
Cognitive-behavioral treatment is beneficial in helping people overcome the negative thoughts and actions that typically accompany grieving and loss (Luo, 2021). At the same time, unlike the first approach, the facilitator of a cognitive-behavioral grief support group utilizes certain predetermined activities in this method. They are aimed at helping group members recognize and alter destructive patterns of thought and action.
It is also worth paying attention to the benefits of transformational leadership for bereavement counseling groups. The strength of this approach is the leader’s focus on inspiring and motivating their followers to reach their full potential and work toward a common goal (Luo, 2021). This kind of leadership is very useful in bereavement counseling groups because it fosters an environment where members feel safe discussing their feelings, learning new coping mechanisms, and progressing in their healing. The weak side of this approach is that it is necessary to attract highly skilled professionals.
Relationship-building skills are a hallmark of transformational leaders and can be crucial in bereavement counseling. As in the previously mentioned styles, transformational leaders can facilitate a safe and supportive space for group members to work through their grief by forming meaningful connections with them. Another distinct strength of this style is the focus on one’s leadership development. A transformational leader can aid group participants in building the skills and resilience necessary for their grief journey by encouraging personal agency and self-efficacy.
Theory and Group Leadership
The next step is researching and establishing the theoretical foundation for the counseling group. The group under research implements a cognitive behavioral therapy (CBT) theoretical framework. This method focuses on recognizing and altering dysfunctional ways of thinking that underpin destructive emotions and actions (Treml et al., 2021). The suggested group’s leadership structure should have elements of both a single leader and shared authority.
A qualified mental health practitioner with expertise in CBT should serve as the group’s facilitator (American Counselling Association, 2014). On the other hand, bringing in new co-leaders may be helpful since they can provide different perspectives and expertise. Individualized attention and the group’s adaptability to members’ needs and goals can be further facilitated by having many leaders. That way, the group may benefit from a wide variety of expertise and points of view while being more cohesive and efficiently run.
Moreover, it helps to understand how a safe and supportive environment can be created for patients who have experienced loss. It aims to help people in a grief support group work through their feelings by discussing and questioning their assumptions and misconceptions about the grieving process. The group leader must consider the following:
- Identify how many people will be involved; six-to-ten-person teams are most productive (Gibson et al., 2020).
- Consider the diverse ages, genders, cultural backgrounds, and present difficulties of members. Group members should feel at ease opening up to one another and discussing their own experiences (Zhou et al., 2023).
- Lay out strict policies on privacy and security. Individuals should feel comfortable opening up about themselves and receiving positive reinforcement.
Group Plan
Legal and Ethical Issues
It is worth paying attention to the fact that grief might elicit hospitality or conflict because it touches on profound forms of emotional anguish, which can be challenging to address in conversation. Thus, when touching on this kind of topic, it is also necessary to consider legal and ethical issues. This kind of problem can be caused by aspects such as the group’s topic or the population. Confidentiality must be upheld during the counseling session to protect the members’ privacy and provide a comfortable setting for them to talk about their problems (Harris & Winokuer, 2019).
Section B.1.c states that counselors protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or sound legal or ethical justification (American Counseling Association, 2014). Leaders of groups are obligated to get members’ consent after briefing them on the sessions’ goals, logistics, potential hazards, potential rewards, and informational boundaries.
As stated in A.2.a of the code of conduct, counselors must review in writing and verbally with clients the rights and responsibilities of counselors and clients. Informed consent is an ongoing part of the counseling process, and counselors appropriately document informed consent discussions throughout the counseling relationship (American Counseling Association, 2014). Counselors also must ensure that the information they communicate is appropriate for their clients’ developmental levels and cultural context (American Counseling Association, 2014). The professionals utilize easily understandable language when discussing obtaining informed consent with their clientele.
It is essential to ensure the group facilitators have the experience and education to guide a grieving support group. Facilitators of bereavement support groups should be familiar with grief counseling, group therapy, and the grieving process to meet ethical requirements (Luo, 2021). There is also the potential for dual ties between the group leader and some group members, which is another ethical concern in group counseling. This could lead to bias and compromise the quality of the group treatment session. Leaders of groups should set clear boundaries with their followers and avoid conflicts of interest.
Cultural Factors
When working with groups of patients from different backgrounds, paying attention to cultural factors is of value. Cultural norms and beliefs heavily influence individuals’ perspectives on death and mourning. It is clear from a literature review that the cultural aspects surrounding grief are intricate and multidimensional.
Beliefs, customs, and rituals around death and mourning may vary from one culture to the next. Death, for instance, may be seen as a regular aspect of life in some societies while being seen as a tragic event in others (Moore et al., 2020). Cultural factors such as religion, race, and socioeconomic status may influence how one deals with loss (Zhou et al., 2023). This demonstrates the need for counselors to be culturally aware and cognizant when supporting clients through grief.
Group leaders must consider how cultural elements may affect the bereavement experience and how these issues may be brought up when preparing for a varied client group. Leaders should be cognizant of their cultural prejudices and work to foster an atmosphere where all members feel welcome and respected (Luo, 2021). Group leaders can better meet the needs of people from different cultural backgrounds who are grieving by being aware of and responding to cultural aspects. For elderly patients, it is necessary to consider that this group is particularly susceptible to serious adherence to older traditions.
In other words, their attitude to death and grief can manifest in a different form than that of the modern generation. Thus, the leaders of such groups need to conduct a full investigation of this aspect. Moreover, it is necessary to take into account that the psychological state of these individuals has a severe impact on their overall well-being. Thus, it is critically important to be mindful of this aspect and very carefully touch on the topic under study.
Therapeutic Factors
Therapeutic factors are precious when working with groups of older people experiencing loss and grief. Colvin and Ceide (2021) stated that “a common theme was loneliness and lack of desire to express their grief because they did not want to be a burden on the remaining family” (p. 2). Thus, leaders need to gain awareness and understanding before embarking on any intervention. These factors are used to obtain the most productive results and create the most favorable and safe environment.
One of the leading therapeutic factors is the manifestation of empathy and support toward older individuals. The leaders are tasked with providing such a setting in which patients will feel calm and open. This skill includes careful listening to what individuals say, in what tone and emotions they do it, and which aspects cause the most feelings (Silberman, 2021). This is especially important for older individuals, as they often struggle with feelings that they may be burdened with, which can cause inconvenience when sharing their experiences.
Another therapeutic factor that has a critical impact is the validation of feelings. It is directly related to the previous concept of empathy and is valuable for working with the group of patients under discussion. The main criterion on the part of specialists is to provide an understanding that “they are reassuring them that it is okay to have the feelings they have and demonstrating that they will still accept them after they have shared their feelings (Kirk, N.D., para. 9). It also contributes to the process of making meaning of the experiences and emotions of patients. This factor must necessarily be considered, as it will assist in forming activities and procedures to limit the negative impact on the mental well-being of individuals.
Plan for Group Activities and Interventions
When creating an activity plan for the group of patients under discussion, a cognitive-behavioral theoretical approach was applied. This is because it helps to realize how to recognize and question maladaptive thoughts and replace them with more valuable alternatives (Treml et al., 2021). Thus, within the framework of this intervention, the first step of the plan is to create the most secure and comfortable environment. This can be done by introducing the members of the group to each other. This activity will perform several functions at once, which can significantly improve the following procedures.
Thus, the first function is to create a familiar environment in which individuals will experience less discomfort due to working with a group of strangers. Another function of dating is to provide an understanding that patients are not the only ones experiencing the experiences they encountered after the loss. Older people need this awareness to reduce stress levels and reassurance that they are not alone in their problems.
One of the values of developing an activity plan is paying attention to the educational component. Thus, the main task of the leader becomes to provide knowledge about what cognitive behavioral therapy will be used during work and to answer all the questions that individuals may have. In addition, it is possible to provide handouts or reading materials that will allow patients to study the proposed treatment approach independently. The next step is to explain the characteristics and emotions that prevail when faced with loss and grief. The benefit of this aspect is due to the provision of awareness and reassurance to older people, as they will understand that their emotions do not carry an eccentric character.
The next activity is sharing the experience of loss and grief that patients are experiencing at the moment. This step can be implemented both orally and in writing. If the group leader sees that patients are willing to share with others and feel comfortable enough, and if it is safe, then it is possible to offer them a written activity.
So, a specialist can offer them the opportunity to write their story and then randomly distribute the letters among the participants. Reading the experiences of everyone will allow people to analyze each situation and find ways that can help. However, it is worth noting that because the topic of loss and grief is quite sensitive, before moving on to it, it is critically important to make sure that individuals are ready.
Within the framework of the cognitive-behavioral approach, the use of cognitive restructuring can have a unique role. This intervention consists of the identification of negative emotions and their interpretation (Ciharova et al., 2021). The main task of this step is to recognize the negative feelings that individuals experience and determine how they affect them, why they appear, and how they can be dealt with. In other words, with the help of a specialist and the use of cognitive behavioral therapy concepts, patients are able to identify alternative ways to gain relief. This way, they can understand what affects them the most and which emotions and memories are better to focus on to alleviate their condition.
Journaling is one of the initiatives that can also be implemented when developing an activity plan for elderly survivors of grief. Research indicated that “different types of journaling, including reflective writing and visual journaling, are discussed through the literature as they have been suggested to improve mental health-related problems” (Keech & Coberly-Holt, 2021, p. 40). Thus, for the group under discussion, it may be suggested that they fill in journals between sessions, in which they will record their experiences, emotions, the most difficult moments, and moments of relief. The analysis of these records will provide an understanding of what can trigger negative states and how to deal with them. It will also allow you to track the progress of work in the group.
Conclusion
In conclusion, facing the experience of loss and grief has quite serious consequences for elderly patients. To garner more understanding, a review of the literature on group leadership strategies for bereavement groups was conducted, and their relative merits were compared and contrasted. In addition, an assessment of their usefulness for guiding a counseling or psychotherapy group for people with bereavement was implemented.
When deciding how to lead such a group for people who have just lost a loved one, it is crucial to consider the different leadership styles available. This is also reflected in the activity plan that will be applied to patients. It was determined that cognitive behavioral therapy provides special assistance based on ethical, cultural, and therapeutic factors.
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