Group Therapy and Leadership Functions


The careful consideration of the theoretical framework that will guide intervention is essential for the development of an effective treatment. To help combat veterans to cope with their PTSD symptoms and reintegrate into society, it is possible to employ Choice Therapy also referred to as Reality Therapy. This paradigm implies the focus on the present situation and patients’ ability to make correct choices to meet their basic needs (Haskins & Appling, 2017). This paper includes a brief analysis of the benefits of the use of this model in group therapy as well as a description of the leader’s function.

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Overview of the Theory and Those Who Can Benefit

The theory in question addresses patients’ reality and their ability to shape their behaviors and satisfy their basic needs. This therapeutic approach is based on the assumption that since people can hardly control their emotions, they should concentrate on their behaviors and thoughts (Haskins & Appling, 2017). The corresponding skills are developed to meet such major needs as power (the sense of achievement), love (belong to a family or community), freedom, fun (a sense of satisfaction), and survival (food, shelter, and the like) (Marlatt, 2014).

Behavior change is the core goal of the therapy, so it is pivotal to make sure that patients are aware of the need to change and have the necessary skills to shape their conduct. The leader of the group shows patients a variety of choices that can be made in different situations. It is also the responsibility of the leader to train clients on how to choose the right alternative in this or that case. The patients are encouraged to be more positive about their present life and become fully integrated into social life in different ways.

The use of choice/reality theory is often employed when assisting individuals and families. However, it can be specifically efficient with combat veterans with PTSD who have difficulties with establishing social links and mentally returning to the life of a civilian. Veterans benefit from the therapy as they are not exposed to traumatic experiences but concentrate on moving on. Changes are often critical for combat veterans who are unable to adjust due to the use of old behavioral patterns.

This population can be unable to meet one or more basic needs, which leads to the development of depressive symptoms, anxiety, fatigue, or even suicidal ideation (Haskins & Appling, 2017). It is also beneficial to take into account some cultural peculiarities of group members who can have diverse cultural backgrounds. Farnoodian (2016) notes that the framework is effective for improving patients’ self-esteem and their overall mental health. This approach addresses some of the most urgent issues patients have to handle.

It is necessary to add that this approach applies to PMHNP practice as it is characterized by a set of specific instruments to achieve certain results. Nurse practitioners can help patients shape their behaviors and prevent the development of serious mental issues that can potentially require hospital admission. The use of the theory is also beneficial for the use in groups consisting of veterans who can be regarded as an underserved population. Combat veterans often have limited access to mental health care, so PMHNP practice is the most appropriate platform for reaching these people.

Leader’s Role

One of the primary roles of the leader in the treatment guided by the choice/reality theory is the creation of the atmosphere of trust, collaboration, and empathy. The leader should establish the environment in which patients will be willing to interact, open up, and change (Haskins & Appling, 2017). It is essential to remember that the discussion of past events is not acceptable. This model is highly interactive, so the group sessions will include many discussions and activities aimed at helping patients to identify their needs and ways to satisfy them.

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The leader will teach patients how to avoid inappropriate behaviors such as blaming, complaining, criticizing, and so on. Conflict and anger management are also important areas to address during this type of therapy. It is noteworthy that the leader of the group may need training and certification to be able to choose this therapeutic approach. The training will involve the development of skills necessary to create the working environment, handle various issues (conflicts, reluctance to participate, and others) that can emerge, and the ability to inspire and encourage clients to change.


To sum up, it is critical to note that choice/reality theory can be instrumental in helping combat veterans to shape their behaviors and reintegrate into the community effectively. PMHNP practice is an appropriate platform for this model application as the nurse practitioner can be equipped with the necessary skills and knowledge to assist patients. The leader will train clients to manage conflicts and avoid any behaviors that can hinder the satisfaction of their basic needs.

The leader will need certain training and certification to be eligible for the use of the model. The training will address such aspects as the development of the positive and trusting environment, management of inappropriate behaviors, and building social links.


Farnoodian, P. (2016). The effectiveness of group reality therapy on mental health and self-esteem of students. International Journal of Medical Research & Health Sciences, 5(9S), 18-24. Web.

Haskins, N. H., & Appling, B. (2017). Relational-cultural theory and reality therapy: A culturally responsive integrative framework. Journal of Counseling & Development, 95(1), 87-99. Web.

Marlatt, L. (2014). The neuropsychology behind choice theory: Five basic needs. International Journal of Choice Theory and Reality Therapy, XXXIV(1), 16-21. Web.

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