GROUP COUNSELING AS AN INTERVENTION

Group Counseling as an Intervention for Teenagers with Depression Sarah Summer Jackson October 26, 2012 HN 450 Dr. Rebecca Day Kaplan University

GROUP COUNSELING AS AN INTERVENTION

Introduction The third leading cause of death in teenagers is attempted suicide as a direct result of untreated depression; one out of 12 teens suffers severe depression by the age of 18 (Bostic, 2005). While it is normal for teens to go through stages where they separate from their parents and reach out to peers, it is not normal for teens to be depressed for weeks or months at a time, and in these cases treatment is necessary (Bostic, 2005). Sarah, a 13 year old girl whose mother has visited the counseling office at Sarahs school to discuss her concerns, is doing the right thing in taking her daughters symptoms seriously and in attempting to get her help. The clinician faced with a depressed child or adolescent cannot in good faith merely suggest waiting for the healing effects of time, therapeutic intervention is a necessity (Ryan, 2005). Assessing Treatment Needs The competently trained therapist will not automatically choose group counseling as an option for a client. Practitioners need to be able to assess whether clients are better served by being in a group rather than being in individual therapy. Specific therapy goals cannot be designed until a clear picture emerges of Sarahs past and present functioning (Corey, Corey & Callanan, 2011). A thorough assessment must be done to determine if there is any risk that Sarah might harm herself or someone else, and to determine a therapeutic diagnosis and treatment plan. Sarah is suffering from low self-esteem, she is having fits of anger and her friends are saying that she is being too negative for them; she has also gained weight and is not taking care of her personal hygiene. All of these are signs that Sarah is suffering from severe depression, and the fact that her father was found dead six months ago unexpectedly may be one of the major reasons for her condition. Sarah would more than likely benefit from seeing the therapist one on
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one to go through the assessment and informed consent process, and to prepare her for entering a group setting that focuses on helping its members with depression.

Advantages and Disadvantages of Group Counseling While a cognitive-behavioral approach and interpersonal therapy have been shown to be effective in dealing with teenagers with depression, and there is also good evidence for the effectiveness of certain types of pharmacotherapy, group therapy is being used more and it is being seen as a viable alternative and/or addition to the more conventional types of therapy (Ryan, 2005). Advantages include the fact that group counseling is being seen as a powerful force for change in the world of mental health and that in a lot of cases, it is being viewed as being every bit as effective, if not more effective than conventional one on one therapy. Sarah would have the support of other teens going through similar things in a group setting, and this could be very healthy for her in terms of helping her to open up. The disadvantages of group counseling for Sarah include the fact that she is not communicating well with her mother and friends and the group setting may make her quite uncomfortable. If Sarah is not fully prepared, she might shut down, and this could cause her more harm than good. Also, some of the issues Sarah is facing are very personal, so group limitations in regards to confidentiality should be explored with her. Ethical Concerns and Considerations Ethical concerns when it comes to putting Sarah into a group counseling environment begin with the therapist. The professional must first have clarified his or her own views about ethical issues and have been through appropriate training including intensive workshops on group counseling and techniques with appropriate supervision. He or she should strive to be

GROUP COUNSELING AS AN INTERVENTION

multiculturally competent promoting social justice, should consider participation in a therapeutic group so as to learn firsthand how to assist group members in their struggles and should also consider going through personal psychotherapy. Concerns about confidentiality include the fact that confidentiality cannot be ensured in the group setting. This must be thoroughly explained to Sarah, and it would be good to explore any concerns that she might have in regards to this. Because Sarahs mother brought her in and made the original contact with the therapist, it will also be necessary to discuss how confidential information will or will not be shared with her mother. When handled appropriately, this can be done without violating any confidences and it can strengthen Sarahs trust in the therapist (Corey, Corey & Callanan, 2011). Making sure to do a proper informed consent process and making sure that the therapist is using techniques that he or she is familiar with, and that are being used for the right purposes in group will also be important in Sarahs situation. It would be good for the professional in this situation to make Sarah aware that she has the freedom to leave the group at any time, and to inform her of the acceptable procedures to do so should she so choose. Challenges and Using Client Strengths Sarahs grades are falling, and her friends are becoming disillusioned with her, but she apparently has had relatively good grades and relationships with her friends in the past. Her weight, complexion and poor hygiene imply that she is suffering from poor self esteem and that she needs to have help addressing this and the underlying issues surrounding her fathers death. As if all of this were not enough, Sarah has basically cut off all constructive communication with her mother. A trained professional who is able to maintain control of the group environment and who can foster positive participation and interaction among group members, should be

GROUP COUNSELING AS AN INTERVENTION

successful at drawing Sarah and other group members out of their shells, empowering them by focusing on their strengths, so that they feel free and safe to explore their feelings, needs and concerns within the group. Sarahs young age is also to her benefit, getting help early like this will help her to learn to better cope with things and to avoid falling into depression in the future.

Reducing Risk, Expectations and Commitment of Group Members One of the main ways that group participation risk can be reduced is by screening and selecting those people who the professional believes will be able to benefit the most from group participation. If there is no group selection process, group therapy clients may end up discouraged and may be more harmed than helped in the process. Poor candidates for group counseling include paranoid individuals, brain-damaged people, those who are addicted to drugs and alcohol, acutely psychotic individuals and those with antisocial personalities (Corey, Corey & Callanan, 2011). While Sarah does not appear to fit into any of these categories, the professional will need to work with her in motivating her to make the best of the group experience and in making sure that she is willing to do the work necessary to overcome her circumstances. The appropriate question for professionals to ask when screening potential group participants is: Is it appropriate for this person to become a participant in this type of group, with this leader at this time? (Corey, Corey & Callanan, 2011). Another very important thing that a professional can do to mitigate risk is to do a thorough process of preparing the people who will participate in the group after selection. Exploring a potential participants expectations and possible misconceptions, and providing a conceptual framework that includes specific guidelines for group participation will help Sarah to better understand what is expected of her and the other members of the group. At both the screening session and the initial group meeting, the professional and group members should
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clarify goals and objectives, discuss procedural details, explore the possible risks and values of group participation and discuss guidelines for getting the most from the group experience (Corey, Corey & Callanan, 2011). Sarah will also benefit much more from the group experience when the human professional asks her to define her own personal goals and what she wants to achieve through the group experience. All group members should do this individually and collectively for the best results. Conclusion Sarah, being a female at or about puberty age is at more risk for depression than her male counterparts, and this condition if gone unchecked could cause her great harm. There is always the possibility of an attempted suicide which is the third leading cause of death in teenagers today. Sarahs mother has done the right thing in approaching the school counselor to get some help, and with the right diagnosis and treatment she can be well on her way to healing and living the best quality of life possible as she ages. The clinician faced with a depressed child or adolescent cannot in good faith merely suggest waiting for the healing effects of time, therapeutic intervention is a necessity (Ryan, 2005).

GROUP COUNSELING AS AN INTERVENTION

References Bostic, J. (2005). When Should You Worry?. Newsweek. Corey, Gerald. Marianne Schneider Corey. Patrick Callanan. (2011). Issues and Ethics in the Helping Professions, Eighth Edition. Belmont, CA: Cengage Learning. Ryan, N. D. (2005). Treatment of depression in children and adolescents. Lancet.