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The working stage of group therapy is only possible upon the successful completion of the first three phases. When all the conflicts are resolved, and a comfortable environment for group discussions is created, it is possible to start the proper work on problem solving. If during the earlier stages the inclusion of a leader was acutely required, the fourth phase is concentrated on the members free communication for resolving the issues.
The leader plays the role of a guide who shows the direction of the conversations and initiates the activities but enables active participation of the patients in a collective discussion. The working stage requires members commitment to the process which should be carried out through specific interventions the success of which might be illustrated by specific therapeutic factors.
Characteristics of the Working Stage of Group Development
Due to the individual nature of the group progression, different groups will need a different amount of time to pass each stage. According to Corey (2015), considerable overlapping of stages is common in all groups and is especially vivid at the point of movement from the transition stage to the working stage (p. 94). Therefore, it is the leaders task to recognize the features of the working stage to implement appropriate actions for guiding the members through the therapy process.
At this point, a lot of attention is paid to the in-depth analysis of the issues the patients face, and the application of necessary interventions capable of generating changes in behavior (Corey, 2015). The fourth stage of group development is overall characterized by every patients inclusion in the interventions within the relationships established during the previous phases.
One of the main features of the working stage is that the participants work as one team to accomplish common goals of recovery. They develop proficiency in achieving goals and become more flexible in their patterns of working together (Ezhumalai, Muralidhar, Dhanasekarapandian, & Nikketha, 2018, p. 516). The leader might recognize the achievement of the working stage by the group when he or she feels no need for constant controlling and structuring of the patients interactions.
The members take responsibility for their actions and often volunteer to share their feelings or thoughts about the issue under discussion (Estherlim94, 2016). If the stage is initiated, a therapist can apply such techniques as feedback, reward & joining, membership, confidentiality, support, and identification (Ezhumalai et al., 2018, p. 518-519). These methods amplify the patients understanding of their needs and problems and enable them to engage in a common treatment process.
The Interventions for the Working Stage of Group Therapy
When the working stage begins, it is essential for the leader to choose the set of interventions that might be applied in group work within a particular theoretical framework. Gestalt therapy is one of the approaches that provide multiple opportunities for a therapist to work with a group. This therapy as used for group work in the USA today concentrates on awareness as its primary goal. According to Corey (2015), self-learning and reflecting on the past in its connection to the present with a patients struggle to recognize his or her feelings, mistakes, and decision-making to immerse in current experience are characteristic of Gestalt therapy (p. 294).
Thus, the core of the group interventions at the working stage should address awareness and personal change as a priority to find solutions to the problems. For patients suffering from depression, it is a critical solution that might be achieved by initiating some cognitive procedures aimed at dealing with specific issues (Estherlim94, 2016). Among the possible interventions for the working phase, there might be such as journal writing, role-playing, and others.
Starting a journal is an intervention that could be introduced by a therapist to encourage the group members to reflect on their daily experiences and emotions. Such actions contribute to self-learning and provide insight on a persons concealed feelings which can often be a cause of depression (Cupractice, 2011). Acknowledging the very issue that needs to be resolved by articulating it in a journal is the first step to finding the solution in therapy.
When discussing a particular issue at a session, a leader might initiate a role-play to imitate the conversations during which patients interact and reveal their emotions and thoughts. This intervention is very effective due to its prospective possibility to engage several group members at a time and resolve the issue under different angles. Patients take turns in expressing their opinions during the discussion which helps them find the solutions (Cupractice, 2011).
Thus, role-playing is a powerful intervention that enables experience exchange and demonstrates the strength of group psychotherapy. Constructing a dialogue between different members of the group when everyone can express what he or she feels about the events taking place at a session contributes to the success of therapy in general.
Working Phase of Group Development: Therapeutic Factors
As mentioned before, the working stage is characterized by the straightforward performance aimed at the members goals achievement. Therapists recognize the signs of the patients condition improvement as therapeutic factors. In other words, therapeutic factors are the processes that indicate progress in group work. Corey (2015) introduces a series of therapeutic factors, some of which include catharsis, cognitive reconstruction, confrontation, self-disclosure, commitment to change, and others.
If any of these factors are identifiable, it means that the interventions have been implemented successfully and give the results. That is why a leader of a group should be attentive to the participants behavior to be able to recognize the signs of improvement and to ensure that the chosen interventions are effective.
The group process advancement might be adequately characterized by catharsis. This factors, which is also called emotional ventilation has been proven by research to illustrate a positive change in patients conditions (Estherlim94, 2016, para. 7). One of the processes that might illustrate catharsis is the reflection of the group on the utterances of a particular patient. In such a way, people respond to the emotional experiences of others and project them on themselves.
The revelations found upon reflection help revealing oppressing feelings and acknowledge the perspectives for change. Also, catharsis might be observed during a group discussion; when working on a patients issue, a leader asks if there is someone in the group that one could relate to and discuss the issue with (Cupractice, 2011, 00:03:52-00:03:59). Such a type of questions helps engage the patients in the interaction and demonstrate catharsis.
Working Stage of a Group Development: Conclusion
In summary, the working stage of a psychotherapy group deals with the immediate problem solution by employing specific cognitive procedures. This phase is characterized by the members voluntary interactions, active inclusion in the discussions, responsibility for the actions, and the recognition of ones issues and needs. Such interventions as journal writing or role-playing could contribute to the experience exchange between different group members and provide diversified point of view on the same issue. It is the leaders duty to identify the therapeutic factors, one of which is a catharsis, that signalize the progress in patients treatment. The working stage in depth explores the particular issues and ensures the members commitment to the goals of therapy.
References
Corey, G. (2015). Theory and practice of group counseling (9th ed.). Boston, MA: Cengage Learning.
Cupractice. (2011). Group 1 working stage. Web.
Estherlim94. (2016). Chapter 7: Working stage of a group. Web.
Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. Indian Journal of Psychiatry, 6(4), 514-521.
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