Leah+Ron+and+Kennisha

Kennisha's part is listed below:

** 1. Needs of Group/Background ** Inpatient hospitals often treat individuals with depression and anxiety to ensure safety (Cara & MacRae ,2005). These individuals’ depressive disorder can be so severe that many of them may experience insomnia, avolition, feelings of worthlessness, fatigue, and suicidal thoughts (American Psychiatric Association, 2000). Additionally, anxiety can cause a disruption in work habits, social relationships, grooming, and parenting. Because these patients require 24-hour care in a hospital, they are commonly treated with medication and psychotherapy (Cara & MacRae, 2005). Common medications include various antidepressants, which work to elevate mood and benzodiazepines, which strive to reduce rapid heart rate and trembling. The most effective form of psychotherapy is cognitive-behavioral therapy. Cognitive behavioral therapy (rational emotive therapy) strives to have clients acknowledge and challenge their irrational thoughts that hinder occupational performance (Bruce & Borge, 2002). These individuals are encouraged to use a scientific approach to observe and decrease any fourth coming irrational thoughts that are self-destructive.  This group is based at Chicago State University Hospital in the inpatient mental health unit. In order to be admitted members must have a referral from an ER hospital or be mandated by a court. Members are acquainted with each other through participation in other programs provided by the hospital. Group leaders will be facilitating their first group. They anticipate that members may be disinterested in group due to their severe depression and anxiety diagnosis. The group consists of 8 females and 1 male over the age of 18 years old. Four of the participants have been hospitalized more than three times this year (revolving door). Two of the remaining five have been hospitalized in the past, and the last three are first time patients. Group members will be hospitalized for 7 -10 days in an unlocked unit and are taking antidepressants medication to help elevate their mood. The rooms are furnished with a bed, bathroom (shower) and a space for belongings. No outside food or electronics are allowed in the rooms. There is a locked community area where members are allowed to have their cell phones, ipods, laptops and watch TV. Patients are seen everyday and must attend group as part of their contract to stay in the hospital. As mentioned previously this will be our first group. Subsequently, scissors will not be passed out to patients until we have had an opportunity to get to know the patients and observe their individual behaviors. At this time we have only been able to extracted information about them from their charts, other staffs members and through observations ** 9. Summary Script ** Today we learned that words have power. Prior to making our empowerment bracelets many of you thought that you would not be successful at completing this task because you did not have many positive words to say about yourself. However, each and every one of you did something positive today: whether that was identify one positive characteristic about yourself or someone you know, or simply sitting in group for an hour and listening. This activity should be symbolic to the strength and the courage that you have within your self to succeed and that is empowering. This activity was not about the amount of beads that one puts on his/her bracelet: this activity is about the meaning that you apply to it. Today’s group was designed to show you all that you are powerful individuals and that we are all capable of doing great things even if you believe in yourself. I hope you will all kept your empowerment bracelets with you as a reminder that you are all special and capable of doing great things. A wise man once said “whether you think you can or cannot you are correct” (author unknown) Please remember that saying and be cautions of your words because as we’ve learned today, words have power.

** 11. How group was designed in Yaloms’s curative factors ** This group was designed to install hope within each member. This group will be made up of newly admitted clients and clients who have been in the hospital for weeks if not months. More experienced members (the ones who will be discharged soon) will be able to provide hope to the newly admitted members by sharing their experiences of how they over came depression. Also the more experienced members will feel a sense of altruism by sharing their stories and helping others. Often times when individuals are tackling obstacles individually they feel alone and like they are the only person in the world experiencing their hardship. Universality is one of the most important parts of this group. Leaders strive to design a group where members are able to come intact with other people who are tackling similar obstacles. This is beneficial to group members because it lets them know that they are not alone in their trials and tribulations. Leaders hope that members will be able to sense this by making connections with the stories that they hear and share amongst each other. Catharsis is another important element in the design of this group. This will give members an opportunity to express and release any feelings that they may have. Expressing one’s self can be very therapeutic when members are able to do it in a safe environment where they will not be judged. Catharsis can serve as a time for discovery and realizations. We hope that group members will be able to be open and honest about their feels in a way that is healing. In addition to instilling hope, catharsis, and universality, our group was designed to create cohesiveness. Members are able to share their thoughts in a safe environment so that they can relate to one another. This should create a sense of belonging and should encourage members to want to come back. ** 12. 2 strengths of group members and their location of care ** Two strengths of group members in this location are their ability to communicate and their ability to help each other. People hospitalized for depression and anxiety often communicate that have very little volition to complete tasks (Cara & MaeRae, 2005). Communication in itself is a strength because they are able to express themselves. This means that they can learn to rationalize. Additionally, this is a strength because they are able to communicate their likes and dislikes. This strength helps the practitioner better attend to their needs. Another strength is their ability to help other group members. Often times when someone defeats a belief (for example that they are incapable of completing a task) they are not only an inspiration to themselves but also to others in the same situation. ** 14. Frame of reference ** The first frame of reference that we will be using is Cognitive-Behavioral theory (CBT) (Bruce & Borg, 2002). This frame of reference was selected because it targets the negative thoughts and feelings that are believed to influence behavior. Anxiety and depression disorders are often characterized by the overwhelming feelings of worthlessness (AOTA, 2000). We will use CBT to extract the thoughts that group members have about themselves so that we are able to disprove the negative thoughts. An approach that we will use is Ellis’s rational emotive therapy (Bruce & Borg, 2002). Ellis believed that in order to disprove irrational thought the therapist would have to get the client to acknowledge irrational thoughts and challenge the client to disprove them. We sought to do this by having the group members identify how they think they would do at completing the activity prior to starting it. We presumed that most of them would not believe that they would be able to complete the task due to their negative thoughts. However, by the end of the activity we strategically planned to point out something positive that each member did to disprove his or her negative thoughts. Leaders will emphasize positive qualities such as completing the bracelet, having the courage to share or simply attending the group and listening. Using this frame of reference we hope to teach the members to irrational thoughts with rational ideas that are concrete. ** 15. Group leadership skills ** Three group leadership skills that we anticipate using for our group are self-disclosure, reality testing and using concrete language. Self-disclosure will be used to set the tone of the group and to make group leaders seem real (Cara & MacRae, 2005). For example if members are asked to describe a strength and no one responds leaders can self-disclose. We can do this by mentioning a time when we were overcoming an obstacle and had to obtain support from outside source to triumph. When doing this group leaders must be careful as to not cross boundaries or make the group about them. Reality testing is another skill that can be used by group leaders. If a member response that they cannot do this (bead a necklace) group leaders can test this belief. We can provide objective data about the person’s capabilities that proves that they can. Hopefully through reality testing, positive feedback and consensual validation from group members this individual will persevere. However, it will ultimately be up to the person to persevere. Group planning II

Ron's part was... Question 10 & 1/2 of question 14 (psychodynamic)