Treatment plan for Counseling Group on Divorce
Discuss the initial process of divorce
Introduction
The initial process of divorce mostly begins when one or both parties to a marriage relationship
realizes that whatever hope they had on the marriage has not materialize or whatever they had
between them has gone away. A period of emotional divorce commences and is mostly
characterized by feelings of disillusionment, alienation, fear, dissatisfaction, anxiety and rage.
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The partners or couples seeking therapy at this stage are combative, sad, argumentative and even
violent. (Alexandria, 1983)
CBT (Cognitive Behavioral Therapy) is a therapy that has very strong empirical support in
treating anxiety disorders and mood swings. CBT targets the emotions that are hard to change by
challenging the thoughts and behaviors that cause the distressing emotions. CBT assists in
building a set of skills that creates awareness in an individual or group of people of the emotions
and the thoughts and also to assist them to identify particular situations and behaviors that mostly
influence these emotions hence improving their feelings by basically changing or influencing
their dysfunctional thoughts and also their behaviors.
Discussion
Before commencing on the CBT therapy, the group has to be aware of their rights to privacy,
informed consent and the general provisions of the ACA (American Counseling Association)
ethical standards for marriage, divorce and family therapy. (Lasky & Riva, 2006) The
responsibilities, confidentiality and the therapist’s guidelines regarding informed consent. Where
family members are also part of the counseling group extra care must be exercised to avoid
conflicting values on family members. The ACA (2005) provisions that apply to group therapies
should be adhered to in the treatment process. (Fallon, 2006) To effectively tackle the
confidentiality and informed consent, the members of the group must set all the ground rules
regarding how they prefer to conduct themselves and what they basically expect from their
leader. These issues are discussed in the first week.
Case Conceptualization
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The main objective of case conceptualization is to assess each patients needs and concerns
during the second week of the treatment therapy and to establish the treatment plan (goal setting
and the desired outcome) Also to identify the problems or obstacles that may be encountered in
the therapy sessions.
Most problems associated with divorce are social isolation where in extreme situations some
partners lock themselves in the house six out of seven days in a week. These results in minimal
social contact and a highly distressing and a social debilitating life devoid of friends and family.
This leads to more pain and inability to work. A person starts feeling worthless and suicidal
thoughts begin crossing one’s mind. He or she becomes fatigued and unable to complete simple
tasks. (Cormier & Cormier, 1991)
Provide a rationale for setting goals that will guide the treatment process to reach the desired
outcome. To elicit the desired outcome the therapists has to guide the patient and assist him to
specify and define the reasons for seeking the treatment. For example, the therapist may ask the
patient the expectation of his therapy. The behaviors related to the goal should also be discussed.
Interventions approaches. These issues are for the second week.
The behavioral principles of CBT describe how behaviors’ generally influence moods. The
therapist makes it clear that a positive behavior like exercise will certainly happen more
frequently if it’s associated with a sense of satisfaction after the exercise. This is the result of a
behavioral activation. Behavioral interventions are specifically powerful for depressed moods.
Behaviors that include any form of physical activity in either planning or accomplishing is
appropriate. The therapist needs to understand that group members who have marital problems or
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those whose depressions stem from their marriage then these is the right time to bring out the
issues.
Lowered
mood
Decreased
activities.
decreased
Activity
Maladaptive thoughts and beliefs.
The objective is to understand how maladaptive thoughts and also beliefs affect the CBT. The
aim is to educate the patient on its role and importance in the therapy session. The general
cognitive – behavioral model indicates that are three layers of basic cognitive dysfunction that
usually exist in a particular individual who is struggling with social problems that are
psychological in nature. These problems are automatic thoughts, Core or central beliefs and
intermediate beliefs. (Greenberg & Padesky, 1995) To identify and rate thoughts and beliefs the
patient is required to maintain a Daily Thought Record. (DTR) It’s assigned as a home work and
it’s intended to basically generate an alternative evidence of either positive or negative thoughts.
(Knauss, 2006)
To take an example of one of the group members, Grace who was a high flying doctor before her
traumatic divorce settlement is greatly disturbed and depressed. Before joining the group, she
spent a whole month indoors in her apartment spending most of her time in bed. Grace says that
she “ feels like her life has been wasted” After putting everything in her marriage and sacrificing
all her energy and financial resources, there is nothing left for her only a feeling of emptiness.
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The main goal in her life is behavioral activation and identifying the maladaptive thoughts,
beliefs and their challenging aspects. These activities are earmarked for the third week.
Parenting issues that are related to the divorce also affect the children. In this session, parents
who have children who are still attending school may be requested to bring their children along.
Divorce changes even the lifestyle of most families as the parents become emotionally and even
physically drained. Children who seek treatment in a group therapy are assisted to utilize the
intervention techniques that are most appropriate depending on the child’s age and requirements.
These techniques range from drawing, role play, movies, and brainstorming and slide tapes. The
objective of this session is to reduce the sources of stress that may be related to children and also
to deal effectively with all the sources of stress in the family. The outcome expected is the
development of an emotional balance between different life stressors in the family.
In the fourth week, the main topic is the financial aspects of the divorce proceedings. The
objective of the therapy is to provide a solution if financial matters are part of the problem. The
process is also ideal to review the DTR’s, mood and activity tracking. The members of the group
should be assigned behavioral activation homework to follow up on the exercises that have been
demonstrated during the therapy sessions.
On the fifth week dating as a form of relation should be introduced. Relaxation technique as an
intervention is a brief therapy for several reasons. Relaxation focuses on the skills which can
alleviate stress, tension and anxiety. The procedures in relaxation can be applied in broad
participation as long the environment is safe, comfortable and quite. Methods of relaxation like
progressive muscle relaxation can also be adopted in the process. (Yalom, 2005)
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The objective of the exercise is to reduce depression, anxiety and tension while its outcomes are
increased self confidence; reduction in negative thoughts and a distraction from negative moods.
The sixth week focuses on rebuilding of self esteem. Members like Grace will find these session
very useful. The objective of this topic is to facilitate the dating process by enhancing the feeling
of self worth and importance for each individual member. For each member of the group to
recover fully from depression they have to be integrated socially in the society.
Resolution
The seventh week is the stage for receiving all the feedbacks for evaluation and review. It’s also
a stage where the members make resolutions to prevent relapses. The assignments are analyzed
and handed back to the members of the counseling group for self management.
Conclusion
The exercise is then concluded after reviewing the treatment processes of each member. The
members are introduced to the last session in a way that encourages them to manage their own
schedules independently. The patients should be able to continue with their own therapies
without relying on the therapist.
References
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Alexandria, V.A. (1983) Association for Specialists in Group Work. ASGW Professional
Standards for Group Counseling.
Fallon, A. (2006). Informed consent in the practice of group psychotherapy. International
Journal of Group Psychotherapy, 56(4), 431–453.
Knauss, L. K. (2006). Ethical issues in record keeping in group psychotherapy. International
Journal of Group Psychotherapy, 56(4), 415–430.
Lasky, G. B., & Riva, M. T. (2006).Confidentiality and privileged communication in group
Psychotherapy. International Journal of Group Psychotherapy, 56(4), 455–476.
Yalom, I. D. (2005). The theory and practice of group psychotherapy (5th Ed.). New York:
Basic Books.
Cormier, W.H. & Cormier, L.S. (1991) Interviewing Strategies for helpers: Fundamental skills
and cognitive behavior interventions, 3 rd Ed. Pacific grove, CA: Brooks/Cole publishing
Company. Pg 514 – 529.
Beck, J.S. (1995) Cognitive Therapy: Basics and beyond. New York; Guildford Press. Chapter
9.
Greenberg, D. & Padesky, C.A. (1995) Mind over mood: Change the way you feel by changing
the way you think. New York; Guildford Press. Chapter 5, 6 & 7.
