Introduction
When a psychotherapeutic group has passed the storming stage, it reaches the next level of its development, which therapists call a transition stage. At this point, a group that has gone through the initial phase faced some challenges of recognizing the rules of behavior, and established places in the group communication are still not ready to start resolving the issues of concern. The transition stage that leads to the working one ultimately aims at guaranteeing the atmosphere that could ensure comfort for reflective communication for each member of the group.
The main challenges of this phase are anxiety, reluctance, and conflict (Corey, 2015). The task of a therapist during the transition stage is to recognize and resolve the conflicts, handle reluctance, and make sure that each participant is involved in the sessions to provide quality therapeutic care.
Recognizing and Addressing Conflict
When working with a group, the stages that precede the working one are characterized by a variety of conflicts. Patients might encounter opposing points of view and develop conflicting relationships with each other. In many cases, both a leader and the members of the psychotherapy group find it easier to pass by the signs of conflict not amplifying the outcomes. If such problems are ignored, they “destroy the chance for genuine contact” (Corey, 2015, p. 86).
However, it is vital to recognize the conflict before working on it for effective counseling during future stages (Corey, 2015). Facing the conflict and explicitly addressing it in a conversation provides an opportunity to find the reason for the detected conflict and eliminate it. Once the cause is dismantled, the conflict becomes resolved, and the group members have experience of overcoming the difficulty that could seem a dead-end situation.
It is the therapist’s priority to detect the situations of conflict on time and openly articulate the positive outcomes of their resolution. Listening attentively to the utterances of each patient, as well as observing his or her non-verbal emotional reactions to the words of others can be an effective method of recognizing a conflict. It is vital to address the conflict at once and ask relevant questions to elicit more background information.
The questions should be of a reflective character and address the feelings of conflicting patients toward the situation and the possible ways to find the solution (Corey, 2015). The therapists might introduce his or her vision of the situation presenting it without bias or subjective opinionating. Overall, integrated work on the issues of conflict contributes to group cohesion, trust, and the establishment of connections between group members. Thus, accurate recognition and working on conflict is the beginning of group work on their issues.
Handling Reluctance
Effective counseling is based on a patient’s reflection on his or her past experiences which, in case of depression symptoms, might be painful. An individual’s natural reaction to uncomfortable or unpleasant memories is to ignore them which produces a reluctance to discuss certain issues during psychotherapy sessions (Kemper, 1994). Another reason for a reluctant behavior is connected with the patients’ questioning of the necessity of their involvement in the process and their desire to demonstrate protest in the form of unwillingness (Corey, 2015, p. 91). A group process is impossible when reluctance is not handled. Such a defensive behavior restrains a patient from active inclusion in the group activities.
The task of a therapist is to recognize such individuals and help them reflect on their thoughts and feelings. It is essential to demonstrate respect toward their “struggles yet continuing to explore them in-group” (Corey, 2015, p. 92). In Irvin Yalom’s opinion, group therapy contributes to the recovery process more effectively due to the patients’ engagement in interpersonal relationships (PsychotherapyNet, 2009a).
Being involved in open discussions with the group, a patient experiences support, understanding, and compassion that he or she might have lacked in life. When dealing with reluctance in a group, Yalom uses the emotional sphere of a person trying to retrieve verbal expressions of what a person feels about him- or herself, or towards others (PsychotherapyNet, 2009b). Thus demonstrating and teaching empathy, the therapist provides a two-way psychotherapeutic effect.
On the first hand, a patient who refuses to participate in the discussion receives feedback about his or her feelings from other members of the group. On the other hand, after the feedback is received, a resistant patient gets involved in the conversations trying to respond to the attention with the assistance of a therapist. Such an approach shows that empathy is an influential tool that provides multiple recovery opportunities for the clients if a group therapist competently addresses it during the session discussions.
However, when confronting separate individuals with an attempt to involve them in the session discussions, a group leader might face some interpersonal difficulties which require even more skill and professionalism to ensure positive outcomes of the interventions.
Dealing with Challenging Client
The transition stage is marked with the emergence of resistant or challenging clients who either actively demonstrate their lack of interest in the interventions or question a therapist’s competency and professionalism. At this point, it is essential to follow the ethical principles and attract such a patient to group participation, thus ensuring that such work is a step toward recovery (Makuch, 2014). There exist different strategies and tools that help a counselor to resolve difficult situations with difficult patients. Corey (2015) suggests some categories of such group members and introduces several guidelines that might help to resolve the issues.
One of the types of challenging patients is an involuntary client who resists the interventions and is reluctant to open to the group. When working with such an individual, a leader needs to separate his or her resistance to such behavior and validate the positive outcomes of the person’s inclusion in the collective work on the issues. During a conversation with an involuntary patient, a specialist must not employ a defensive strategy and should place the responsibility for the actions onto the client (Corey, 2015).
It can be performed through a series of questions about the feelings a person experiences, as well as through reflections and sharing the therapist’s thoughts about the issue under discussion. The inclusion of a group is vital at this stage because a challenging client will understand how the relationships with other patients who have similar mental health issues contribute to the solving process.
Conclusion
To sum up, the transition stage of a group development process inevitably presents a variety of challenges for a therapist. They are remaining interpersonal conflicts inside the group, reluctance, resistance, and other forms of demonstration of defensive behavior of separate individuals. The therapist’s responsibility is to consider this phase as the introduction to the actual work on the depression issues and involve each member of the sessions in the collective discussions. The process of conflict solving and reluctance handling will not only contribute to trust and cohesion inside the group but also will ensure flawless counseling during the consecutive stages of group psychotherapy.
References
Corey, G. (2015). Theory and practice of group counseling (9th ed.). Boston, MA: Cengage Learning.
Kemper, B. (1994). Dealing with resistance in group therapy. Perspectives in Psychiatric Care, 30(3), 31–33.
Makuch, G. (2014). How therapists and counselors effectively handle resistant clients. Web.
PsychotherapyNet. (2009a). A conversation with Irvin Yalom video. Web.
PsychotherapyNet. (2009b). Irvin Yalom inpatient group psychotherapy video. Web.