Everybody needs a group: A qualitative study looking at therapists’ views of the role of psychotherapy groups in working with older people with dementia and complex needs

Abstract

Our objective was to evaluate clinicians' views of the impact of conducting inpatient psychotherapy groups for older adults with enduring mental health issues and/or cognitive impairment. We conducted a literature review. A focus group was held with four group facilitators using a semi-structured format and open questioning. The transcript was analysed by the interviewer using Interpretative Phenomenological Analysis. Using guidelines provided by Smith and Osborn, themes were identified, clustered and a final set of themes developed. On completion, the researcher reported the findings back to one participant to increase the validity and trustworthiness of the analysis. Facilitators described impacts that were intra-personal, interpersonal and extra-personal. The capacity and desire to communicate and belong demonstrated by group members challenged their own views (and ageism) and that of staff members. The facilitators' experience was of the beneficial and normalising effects of these groups in enabling and enhancing communication, emphasising common humanity, facilitating the expression of emotion and combating isolation by promoting a sense of belonging. Research is needed into the views of the group members. Thought is given to the challenges inherent in this.

The role and impact of therapeutic counselling on the emotional experience of adults living with dementia: A systematic review

“…In general, adverse effects were not reported. A handful of studies raised issues for future attention including: the negative impact of directive facilitation ( Cheston, 2017 ); discriminatory attitudes and behaviour/therapeutic nihilism ( Hsiao et al, 2016 ); non-reflective staff responding as a root cause of participant misunderstanding and emotional disengagement ( Luxmoore & McEvoy, 2017 ); challenges to staff undertaking the interventions ( Perren & Richardson, 2018 ); financial, relational, practical and attitudinal barriers; lack of staff training ( Pybis et al, 2021 ) and, tensions between minimal resources, equitable access, and delivery of person-centred care ( Plunger et al, 2020 ; Pybis et al, 2021 ).…”

Relational counselling as a psychosocial intervention for dementia: Qualitative evidence from people living with dementia and family members

“…However, research has explored psychotherapeutic interventions for people with dementia and indicated positive impacts (e.g. Perren & Richardson, 2018). Additionally, whilst clinicians are aware that many people with dementia, especially those with mild cognitive impairment, are able to communicate effectively, no therapeutic interventions have been tested with those with more severe dementia who would be expected to have increased cognitive impairment (Shoesmith et al, 2020).…”

Response to ‘Everybody needs a group: A qualitative study looking at therapists’ views of the role of psychotherapy groups in working with older people with dementia and complex needs’

“…The acknowledgement by the facilitators was that cognitive impairment can constitute a façade behind which a person hides, leaving him or her alone in an uncommunicable inner world. In the words of one of the facilitators, ‘We should have higher expectations as actually they are capable of far more than we give them credit for’ (Perren and Richardson, 2018).…”

“…In relation to this issue, one facilitator stated, ‘I’m never quite sure what the task is apart from to be there in the room together and see what happens. And that might seem to be nothing, but it never is nothing’ (Perren and Richardson, 2018). There is no doubt that for these impaired people to be together is by no means nothing.…”

“…. for the group to happen at all, the rules and boundaries that characterize psychotherapy groups had to be adapted (Perren and Richardson, 2018)’.…”