Research Paper: Group Counseling Attitudes and Perspectives of Clients

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Group Counseling

Attitudes and Perspectives of clients who Are Involved in Cancer Care Group Counseling

Organization of the Research

Group Counseling

Quality of Life

Group Counseling

Chapter-III Research Methodology

Grounded Theory Research

Participants sample

Measures

Attitudes and Perspectives of clients who Are Involved in Cancer Care Group Counseling

While survival rates have climbed due to advances in medical knowledge and technology, patients and survivors of cancer are often excluded from psychological studies as their illness and treatment modalities are interpreted as different from and more damaging than other types of illnesses (Radcliffe, 1996). This is due to both the physiological harm caused directly by the tumor, and the various treatment methods used to combat the tumor (i.e. surgery, radiation, chemotherapy, and high dose medications that may affect the central nervous system) (Radcliffe et al.). In comparison to other illnesses, cancer is considered to be particularly stressful, burdensome and traumatic.

Patients with pediatric cancer and brain tumors face several potential stressors including, but not limited to, threats to physical health and well-being, frequent invasive procedures, significant alteration in appearance, and unpleasant treatment methods with various somatic side effects (Phipps, 2007). For survivors, there is the threat of relapse and treatment related late effects (Hudson et al., 2003). Late effects occur after an individual has been treated for cancer or a brain tumor. In patients with brain tumors, late effects are side effects of neurologic brain damage caused both by the brain tumor and the treatment methods used to combat the tumor (detriment to the brain caused by surgical resection, long-term effects of chemotherapy and effects of irradiation on the central nervous system). Late effects in patients with a brain tumor or cancer may include threat of metastases, or recurrence of the tumor, cognitive deficiencies, including learning difficulties and short-term memory loss, diabetes, visual and auditory impairments, seizures, endocrinopathies, hormone deficiencies resulting in delayed or early puberty, or growth abnormalities. Late effects may also increase the risk of problems in the digestive, musculoskeletal, respiratory, immune, urinary and cardiovascular systems (National Cancer Institute, 2011). The term "late effects" encompasses physical disabilities related to movement, coordination, speech and swallowing, as well. Psychological late effects include social difficulties, anxiety, depression, suicide ideation, and behavioral problems (Taylor et al., 2007; Turner, Rey-Casserly, Liptak & Chordas, 2009; Turner et al., 2009).

Both patients and survivors also face social-related stressors, such as extensive absences from work, missed social activities and familial stress (Barakat, Hetzke, Foley, Carey, Gyato, & Phillips, 2003; Radcliffe et al., 1996). Individuals who have been treated for cancer have exhibited decreased social competence, an increase in problematic behavioral issues and more isolation than their peers (Barakat, 2003). These issues may be attributed to the aforementioned health, treatment, and social stressors. Deficits in cognitive functioning may also contribute to decreased social skills. For patients whose central nervous system and brain have been effected by the tumor or various treatment modalities, this could be due to white matter damage secondary to cranial radiation therapy (Barakat, 2003), or the use of some medications, such as intrathecalmethotrexate (Schultz, 2007). Central nervous system involvement is also associated with poor psychological adjustment, higher levels of psychopathology, academic difficulties and functional impairments (Schultz et al.; Radcliffe et al.). According to a study, individuals with cancer show increased difficulty in internalizing, including somatic complaints and lower scores of social competence (Dunn, Rodriguez, Miller, Gerhardt, Vannatta, Saylor, Schuele & Compas, 2010;Mulhern, Carpentieri, Shema, Stone, & Fairclough, 1993). Individuals who have/have had cancer also have a tendency towards peer conflict/social withdrawal, antisocial behaviors, and decreased social skills (Schultz, 2003).Due to treatment schedules and illness secondary to treatment, individuals who have or have had cancer may not have the opportunity to participate in the volume of social activities that are available to their peers (Barakat, 2003). This lack of social exposure and peer involvement may hinder the development of social skills, resulting in decreased social competence and the maladaptive social behaviors previously mentioned.

Objectives and Research Questions

The purpose of this study was to explore the attitudes and perceptions of cancer care patients tward group counseling. The patients were asked whether group counseling has a positive effect?. For the purpose of this study, a patient is defined an individual awaiting or under medical care or treatment due to a cancer diagnosis, and a survivor is defined as an individual who has received a cancer diagnosis and is up to five years out of medical treatment.

The current study is influenced by Pope-Davis and colleagues (2002) who have noted that counselors' perspectives are what have largely informed our current understanding of psychological theory, research, and practice. As a result, much of multicultural competent counseling (MCC) literature is based on the assumption that the counselor and the client share the same definition of multicultural competent counseling. Pope-Davis and colleagues (2002) suggest that the client perspective is an untapped well of knowledge which can be used to tailor multicultural competent counseling to the client's needs. For example, little is known regarding the factors clients deem important to their psychological well-being, what qualities they seek in psychologists, and their perspectives on how current psychological practice could be improved. Incorporation of clients' views will increase the cultural validity of research, theory, and practice of group counseling help to create quality care that is based on the needs and perspectives of cancer care patients.

The research study seeks to answer what are the perspectives of cancer care patients attending group psychology. Guided by the increasing demand for group counseling and the associated need to gauge the current experiences of clients undergoing group counseling, a quantitative analysis was conducted to explore clients' reflections and stories. In addition to this following sub-questions were also addressed:

1. Was group counseling a meaningful experience for cancer care patients and counselor?

2. Whether clients had a negative interaction with your psychological counselor or group members?

3. How did they experience their relationship with the group members?

4. How the psychological counselor helps to cope with any challenges that you might be experiencing?

5. What are your suggestions to improve the quality of the care you received?

Organization of the Research Paper

Motivated to explore the perceptions of clients attending group counseling ? undergoing psychological counseling, the researcher considered a quantitative methodology as ideal for this research study.

This thesis is organized in the following manner: Chapter One outlines the background, introduction to the topic, problem statement and research questions. Chapter Two presents a literature review detailing the current status of group counseling and different areas where this approach is being used, benefits of group counseling. In chapter Three a detailed discussion of the methodology, research design, instruments, sample and data analysis approaches has been conducted. Chapter Four is a discussion of the results of the study. Chapter Five provides a discussion of the results as well as the strengths and limitations of this study. Lastly, Chapter Five concludes with a discussion of the implications of this study on research, training and practice and identification of the original contributions of this study.

Literature Review

The first section of this chapter reviews the literature on group counseling. In the second section, the current status of psychological theory, research, and practice for working with cancer care patients is presented. Benefits of groups counseling have also been discussed and how it helps to improve quality of life for cancer care patients.

Group Counseling

Group counseling may be used as a treatment strategy directed at the multiple functional limitations associated with cancer (Barakat et al., 2003; Shechtman, 2004). Group counseling has been shown to be an effective method of intervention for medically and terminally ill individuals (Elliot, Rivera & Tucker, 2004). Group interventions are especially helpful for children and adolescents who have or have had cancer, for several reasons. The level of trauma/distress associated with a cancer or brain tumor diagnosis may be too high for the individual's typical tools of stress management, rendering his/her coping skills insufficient to deal with the stress-provoking event (Kazak, 2005). Individuals who are faced with a stressful, life changing event may develop trauma-related symptoms, such as halted psychological development (Kazak; Courtois, 2004). This may result in maladaptive coping mechanisms and decreased skill in utilizing appropriate stress management techniques (Barakat et al., Courtois).

Individuals with cancer have been shown to exhibit denial behavior patterns in the form of repressive tendencies. They tend to embody a repressive adaptive style, meaning they report low anxiety when confronted with stressors, but show evidence of increased physiological reactions. They also have increased levels of numbing/avoidance when compared with peers (Phipps, 2007). Studies with adults who have a repressive adaptive style also experience increased levels of physiological reactivity to laboratory stress, and an increased risk for negative health effects, i.e. tension, ulcers, migraine headaches, allergies and hypertension (Phipps). Individuals with this adaptive style are less likely to attend to threatening stimuli and are more likely to be poorly attuned to physiological states (Phipps). This may be due to framing; individuals who have… [END OF PREVIEW]

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