Updated date:

Mothers Suffering with Postpartum Depression: A Group Counseling Proposal

Bachelors degree in Psychology, Minor forensics, mother of 5, dedicated to making the mental health stigma dissipate as quickly as possible.

SAMPLE GROUP PROPOSAL

This is a sample full group proposal. This text is for reference only on a few sample sessions. Plagiarism is a crime as is claiming to be a professional Psychologist. The places, prices, licensure, and companies within this document are fictitious; the authors, education, and research conducted for this article are real.

Group Counseling Proposal: Mothers With Postpartum Depression

Group Counseling Proposal: Mothers With Postpartum Depression

Talbot County Counseling Associates
By Lain Golden

Abstract

Postpartum depression (PPD) is a potentially debilitating disorder, diagnosable within the first year of the postnatal period. According to Hansotte, Payne, and Babich, in their article “Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: A systematic literature review” (2017), the prevalence rates range from 10-20%. Other statistical documentation ranges from 5-25% diagnosed cases, with an estimated 50% undiagnosed population. The effects PPD can be extremely devastating, not only affecting the mother but also the infant and others in the mother’s life. Twenty percent of mothers diagnosed with postpartum depression ultimately commit suicide (Babich, Hansotte, & Payne, 2017). Infants can experience developmental, cognitive, and language delays as a result of maternal debilitation. The following group proposal is a psychotherapeutic approach to the education and treatment of postpartum depression. Treatment is based on grounded research of PPD and systematic application of counseling theories.

Topic and Rationale

The widespread rates for postpartum depression range from 5% to 25% depending on the characteristics of the population (Gaynes et al., 2005). Many things are believed to contribute, interact with, or trigger postpartum depression including psychological, social, and genetic factors. The stress of being a new mother, the responsibility of caring for an infant, and the hormonal and physical changes to the body may also strongly affect the mood and mental state of women who have recently given birth.

Postpartum depression is often undiagnosed and untreated. It can be debilitating and affect not only the mother but also the infant. Twenty percent of the population diagnosed with postpartum depression commit suicide (Babich, Hansotte, & Payne, 2017). Postpartum psychosis is a potential result of PPD and has serious implications including suicidal/homicidal ideations. Infants can experience developmental, cognitive, and language delays as a result of maternal debilitation. Barriers to treatment include lack of transportation, lack of childcare, and financial strain (Babich, Hansotte, & Payne, 2017). Due to the underdiagnosis and undertreatment of postpartum depression in lower income populations there is a great need for community based intervention.

The topic or primary focus for this psychotherapy group is the psychotherapeutic treatment and education of mothers with postpartum depression. The group will cover the introduction of members’ newfound difficulties and roles that come with motherhood, as well as sharing emotional and physical stories of their journeys. This not only includes discovering their roles as mothers and wives, but adjusting to their new bodies and the mental, physical and spiritual effects of the process of childbirth and postnatal care. This group will serve as a safe, sharing space for women who suffer from depressive symptoms after childbirth. This will allow them to share their experiences, and to grow and heal, in a place where they can avoid the judgment and stigma placed on mothers with postpartum depression by society.

This group is needed because it is clear that women go through both physical and psychological changes after childbirth. In some cases, these changes can trigger symptoms of depression, anxiety, or other symptoms that can cause serious harm to the mother, her child, or those around her. The mother’s mental wellbeing is important not only for her own personal wellness and health, but also for the development and safety of the infant. Postpartum depression can be debilitating and may negatively affect the bond and attachment between mother and newborn child that is so important in early childhood development. It can also lead to neglect or mistreatment of the child if the mother’s symptoms and behavior cause significant dysfunction in her life. Group psychotherapy can help women with postpartum depression to cope with the changes in their lives, and to prevent the aforementioned damage to the wellbeing of both the mother and the infant.

In addition, this group is a healthy and medication-free option for women who do not wish to use medication while breastfeeding, who do not respond well to medication, or who wish to explore non-medical options to treat depressive symptoms for the safety of the infant. Women who do choose to use medication for their postpartum depressive moods may also benefit from this group, as it can help them to find a community of others who are struggling with similar life experiences and symptoms. Postpartum care is often a neglected aspect of Women's Healthcare, and women are not always ready for the immense change that comes during and after childbirth. Healthcare is often more focused on the actual pregnancy or the health of the baby, and it is not uncommon for the chemical, physical, hormonal, and psychological effects that childbirth can have on the mother to be forgotten or neglected. New experiences, along with the brand new role and responsibility of caring for a newborn, can be frustrating and incredibly taxing on a woman’s physical and mental health, and this group may allow new mothers to relate to others, and to share experiences and advice for coping and handling stress and depressive symptoms. This group can show its members that they are not alone in dealing with their feelings and problems pertaining to postpartum depression, and may allow them to learn from other group members how to cope.



Goals and Objectives

The main goal for the psychotherapy group is to allow women who have postpartum depression to understand that they are not alone in their struggles with their newfound motherhood. The support group will promote improved mental health and a healthy relationship between mother and child. This will be achieved by addressing and recognizing their frustrations and depressive symptoms and the effects that they have on their lives and the lives of their loved ones. It is important to address the negative implications and ideas presented by society, and ensure members that their struggles and symptoms do not make them bad mothers, weak, or insufficient. Another goal within the group will be to discover a way for each member to manage their depression, whether through the psychotherapy group alone or by consulting a medical professional.


Goals will be measured upon completion as well as weekly evaluation. Facilitators will develop goals for each session. Initial focus of the group sessions will be on education regarding PPD including prevalence, disease process, and implications. The following sessions will focus on depressed mood, irrational thoughts/beliefs, and improvement of internal dialogue. The sessions will apply coping skills and thought improvement exercises to attain the desired goals for each session.


Practical Considerations

Group Details

Group sessions will be held at the Talbot Community Center in the Skipjack Room. Each group will accept 5-10 members, to keep groups at reasonable sizes for individual facilitators. The sessions will be 60 minute weekly psychotherapeutic meetings. Attendance at each meeting is strongly recommended. Meetings will be held on Wednesdays at 6:30 pm, starting March 22, 2017, to conclude after 36 sessions.

Talbot County Counseling Associates is a nonprofit organization. The Mothers With Postpartum Depression group will be free of charge. Childcare will be offered onsite for members. Bus schedule and tokens will be offered to low income populations. The organizational cost is $42.00 for use of the room. Supplies and tokens are an additional estimated cost of $800.00. Funding will be sought from the Maryland Task Force for Mental Health.


Facilitators:

Jennifer Brooks, CRC

Kelly Evans, LPC

Emery Golden, LPC

Shania Gregory, LCADC

Rachel Hyler, LBSW

Samantha McCreary, LPC


Rules and Guidelines

Upon acceptance in the group members will be informed of the group expectations. Participation is a strong determinant for successful treatment, therefore members will be expected to participate. Regular attendance and respect for other group members will be included upon acceptance as well. Group members will be informed of termination guidelines. Members will be notified that the group is not mandatory but if they choose to leave, a reason for their departure would be expected.

Confidentiality will be discussed upon acceptance to the group, as well as reminders every session. Group members will be reminded that though we expect members to respect confidentiality, we can not necessarily enforce it. In addition, members will be informed of information that is in exception of confidentiality, including suicidal or homicidal ideations and reports of sexual or physical abuse. It would be beneficial to include resources for mothers in crisis, such as crisis hotlines, social services, etc.

Methods and Research

The Mother’s With Postpartum Depression group will be using an integrative approach. This multimodal psychotherapeutic group will include techniques from a number of theories. The integrative approach will be used due to research revealing notable improvements with the use of Cognitive Behavioral therapy, Cognitive Therapy, and Interpersonal Therapy in clients with postpartum depression (Baker, Fitelson, Kim, & Leight, 2010).

Cognitive Behavioral Therapy will be the primary form of treatment. Cognitive behavioral therapy has been noted to have great success and is systematically structured for optimal improvement. This approach addressing five areas; 1) Decrease PPD symptoms, 2) Decrease negative emotions, anxiety, and decrease depression, 3) Increase positive emotions, 4) Decrease dysfunctional attitudes, and 5) Decrease frequency of automatic thoughts (Babich, Hansotte, & Payne, 2017). This approach places focus in the beginning stages of group therapy on education, evolving in later sessions on strategic applications to reduce negative aspects of PPD while increasing positive internal processes.


Group Session 1: The Initial Phase

Introduction

This will be session 1 of 6 extensive therapy sessions for women who are suffering from Postpartum Depression. The first session of group therapy is part of the initial phase. This phase usually involves orientation and is usually a time when member’s responses will be socially acceptable. During this phase most members of the group may feel anxiety and be unsure of their place in the group. There will be an uncertainty of what will be expected as members of this group, questions of confidentiality and concerns on acceptance. This will be a time of getting to know what each member feels is socially acceptable to say and what the norms of the group will be. These dynamics will undoubtedly change through subsequent sessions. It will be up to the leader to explain the group rules, confidentiality expectations, objectives and goals of the sessions.

Session Procedures:

  • Review and discuss contracts that each member signed upon acceptance to the group.
  • Discuss confidentiality and its limitations. Responses from each session will be documented for later therapy sessions.
  • Handout brochure on Postpartum Depression: answer any questions.
  • The counselor will state their qualifications and purpose of the group.
  • Explain objectives and possible goals of the group.
  • Icebreaker #1: What is your name and what are you hoping to get from this group?
  • Icebreaker #2: What one word describes motherhood to you? (Compare the differences in postpartum depression and motherhood.
  • Overview of postpartum depression and national stats.
  • (Prop) counselor will show the jar of various jellybeans, showing the statistics on PPD.
  • Dyad: What would the perfect day look like to you?
  • Discuss the outcomes of the dyad.
  • Discussion on fears and questions about the counseling group.
  • “Homework” of keeping emotions/thoughts journal for the next week to be discussed at the next session.
  • Close out session.

First Round-Robin Discussion: Group Rules, Objectives, and Icebreaker

  • The group leader will thank everyone for attending and welcome them to the group, offering water bottles/coffee.
  • Review and discuss contracts.
  • Leader will go over confidentiality and its limits. Ask if there are any questions.
  • Group leader will then say their qualifications and the purpose of the group.
  • Group leader will let the group members know that the group is a safe place and that everyone is there for the same common goals.
  • First Icebreaker: Have group members state their name and what they hope to get out of the group.
  • State the group objectives and purpose.
  • Discuss what postpartum depression is, who it affects and give stats.
  • The counselor will show the members the jar of jelly beans. The yellow beans showcase the women who do not suffer from PPD (35%); the Red ones showcase the women who go undiagnosed (50%) (Therefore left untreated) the green ones show the women who are diagnosed (15%)
  • The counselor says: “You are not alone. There are more women who are going through this than you may be aware of. You are all aware and you are all seeking help. That takes strength and shows a desire to want to change how you are feeling.”
  • Handout about PPD. National Institute for Mental Health: Postpartum Depression Facts.
  • https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/postpartum-depression-brochure_146657.pdf

Second Round-Robin Discussion: Getting acquainted/Dyad

  • Ask each member ages and sex of children.
  • Icebreaker #2: What one word describes motherhood to you?
  • The counselor will record the responses from both icebreakers to use in later sessions.
  • The counselor will then have the group members divide into groups of two. This will be a dyad that is posing the question: What would the perfect day look like for you?
  • After 5-7 minutes the dyads will rejoin the group and discuss their partner’s results.
  • The counselor will attempt to link members who have similar answers.



Final Round-Robin Discussion: Fears and Questions

  • The counselor will open the final round-robin discussion with this question: What concerns you the most (if anything) about group therapy? Go around the group and allow each group member a chance to state their concerns.
  • The next question will be: Is there anything that you would like to discuss or any questions that you would like to ask before the next session?
  • Provide “homework” for each member. Keep a small notebook by your side to record your emotions/thoughts throughout the next 7 days until the next group meeting. Then we will discuss these things in the next session. (counselors will hand out small journals with a pen for each of the members to record their thoughts.)

Closing Out the Session:

  • The counselor will say: It looks as if our time is coming to a close.
  • Once again ask if there are any questions.
  • Review next week’s meeting time and date.
  • Remind them of their journal homework.
  • Reiterate the importance of confidentiality.
  • Closing thoughts and reminders that we are all here for the same purpose and no one is alone.
  • Give the main office’s outreach/after hour’s numbers if someone needs to reach out.



Materials Needed:

  • Small writing journals for each member and pens.
  • Brochures/handouts.
  • Tissues.
  • Water bottles/coffee.
  • Notepad and pen to record results of dyads/icebreakers.

Session Objectives:

  • Review and discuss group rules, meeting times, contract and confidentiality.
  • Make members feel comfortable and become aware of their goals for the group.
  • Understand the background of PPD.
  • The use of dyads and icebreakers to help members relate to each other.
  • Give homework and discuss the objectives of the next session (2).

Statistics and Information Regarding PPD

In the article, Postpartum Depression: Screening, Diagnosis, and Management Programs 2000 through 2010, the authors state the postpartum depression (PPD) is very common among mothers with children around 6-12 months of age. Around 15% of women are diagnosed, while another 50% go undiagnosed and therefore untreated. Any woman regardless of her race, age, or socioeconomic background can develop PPD. If PPD is left untreated it can not only affect the mother and her relationship with her child/ren, but also other relationships in her life. That is why it is important for the medical field to begin a screening process in order to vet out women who may potentially develop PPD. (Bertram, Dietrich, Olson et.al)


Postpartum Depression Vs. Baby Blues: What's the Difference?

The Baby Blues or Maternity Blues is usually within the first 10 days after the baby is born, with the 3rd day after childbirth being the peak day. Baby Blues are thought to be due to the physical, hormonal and emotional toll that childbirth has on the mother. The hormones that once filled the expectant mother dropped drastically and that can lead to an emotional rollercoaster. The physical and strenuous act of childbirth (regardless of the type) is also rather strenuous for a woman’s body. Emotionally a new mother has tons of fears and anxiety of the new responsibility of taking care of the new baby. “The symptoms of postpartum blues vary by case in intensity and duration. They include crying, anxiety, insomnia, irritability, headache, confusion, minimal clouding of consciousness, dysphoria, emotional liability, fatigue, anger, tension, poor sleep (not related to baby care), and a sense of vulnerability.” (Bennett, Sylvester 2013) If no support is given to the mother during this time it may lead to the development of postpartum depression.

“PPD is a mood disorder that can affect women after childbirth. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others.” (NIH, 2012)

Some of the more common symptoms a woman may experience include: Feeling sad, hopeless, empty, or overwhelmed. She may cry more often than usual for no apparent reason. Feelings of worry or anxiousness; accompanied by being moody, irritability or restlessness. A woman with PPD may suffer bouts of anger, have difficulty concentrating, and making decisions. She may also suffer from physical symptoms such as aches and pains, including headaches, stomach problems and muscle pain. Lack of eating or eating too much and withdrawal from family and friends are often symptoms of PPD. A mother may also have trouble bonding with her baby or forming an emotional attachment with her child. A woman with PPD may doubt her ability to care for her baby and even have thoughts of harming her baby. While all of these symptoms are common with PPD, it is important that the mother seek help for this disorder immediately. (NIH, 2012)


Group Session 2: The Transition Phase

Introduction

This will be session 2 of 6 extensive therapy sessions for women who are suffering from Postpartum Depression. The second session of group therapy is part of the transition stage. At this stage, members may be displaying anxiety, defensiveness, resistance, control issues, conflict with other members, conflict with leaders, and patterns of problematic behaviors. In order for members to get past this stage, members must be able to deal and work through resistance, come to terms with fears, and work through conflict and control issues that may come up. In the transition stage, the goal will be to form a safe and trustful atmosphere that allows members to gain confidence by seeking out and investigating their fears. Members and leaders in this stage will determine whether the group develops into a cohesive community. This stage is sometimes challenging for the leaders. Leaders must keep in mind that certain behaviors that are displayed may be the result of member’s fear and confusion.


Focus: Expanding self-understanding and building a relationship within the group

Objective: Identifying unique things about oneself and how it makes them different from others in the group and seeing those differences as beneficial.


Materials:

  • Pencils
  • “I am a Person Who? group activity worksheet, Thoughts, and Beliefs Handout
  • Tissues
  • Water bottles
  • Coffee


Session Procedures

  • Opening: Welcome the group to the second session
  • Introduction of leader and qualifications
  • Review of rules, confidentiality, and contract
  • A reminder of what took place in the first session
  • Orient to homework from the week before
  • Orient to topic: Self-understanding and building a relationship within the group
  • Icebreaker #1: What was your first thought this morning?
  • Discussion
  • Distribute Thoughts and Beliefs Diagram
  • Group activity: “I Am a Person Who?” worksheet
  • Discussion
  • Closeout session

First Round Robin Discussion:

Homework of Keeping Emotions and Thoughts in Journal

  • The group leader will thank everyone for coming and welcome them back to the group, offer water bottles and coffee.
  • The group leader will introduce themself and their qualifications
  • The group leader will remind the group of contracts, confidentiality, and rules. Ask if anyone has any questions.
  • The group leader will remind the group of the homework journal given out in the first session.
  • Icebreaker #1: Group leader will ask if any member would like to discuss any emotions or thoughts in their journal.
  • The group will discuss any emotions or thoughts that group members bring up.
  • The group leader will ask if anyone else shares the same emotions or thoughts at this time.
  • Individuals will learn that they are not alone in some emotions or thoughts.
  • Icebreaker #2: Group leader will ask the group the question, What was your first thought this morning?
  • Every member will state their first thought.
  • The group leader will have the group contemplate why they felt that way.
  • The group will discuss similarities and differences in morning thoughts.
  • The group leader will distribute the Thoughts and beliefs chart.
  • Group will discuss how thoughts and beliefs about a situation can influence the choices of an action
  • Group leader will discuss why the activity was done and orient to topic of self-understanding as a unique person or awareness and ability to understand one’s own actions and reactions.

Second Round Robin Discussion:

I Am A Person Who?

  • Group Activity
  • The group leader will hand out “I Am a Person Who?” worksheet with pencils: Appendix
  • The group leader will ask the group to complete the worksheet, allowing 5-6 minutes.
  • The group leader will ask each member to pick a question about themselves to share and discuss.
  • The group leader will ask the following questions:

    • Which question or answer was unique to you?
    • Identify something that you have in common with the people in the group?
    • How does it feel to share about yourself in the group?
    • Do the differences in the group make you curious about other group members?
    • What would this activity look like if all answers in the group were the same?


  • If group leader encounters conflict, they will acknowledge it as an opportunity for improvement.
  • The group leader will address any conflict that may arise by letting the group work out the issue.


Closing Out The Session

  • The group leader will remind the group of 10 minutes left in the session
  • The group leader will ask if anyone has anything left to discuss or any questions.
  • Group will be reminded to record emotions or thoughts in a homework journal for the next session.
  • The group leader will remind the group of confidentiality.
  • The group leader will review next week’s meeting date and time.
  • The group leader will remind the group that we are here together and no one is alone.
  • The group will be reminded of the main office outreach/after-hours number if someone needs to reach out.

Counseling Techniques That Will Be Used

  • Active Listening
  • Responsive Listening
  • Clarification
  • Empathy
  • Redirection
  • Clarification
  • Questioning
  • Linking
  • Summarizing
  • Eye Contact
  • Open Posture

Group Session 3: The Working Stage

Introduction

This will be session 3 of 6 extensive therapy sessions for women who are suffering from Postpartum Depression. The third session of group therapy is part of the working phase. This phase usually involves getting to the deep dark places where depression hides and bringing them to the light; exposing and challenging the things that haunt a mind throughout the day. During this phase, most members of the group may vulnerable and emotional. Some trust will be built by this session and all members should actively participate. Members will be working through emotions and will require support from other members. In this stage, we will build the members trust in themselves. While this place is safe and confidential, we cannot address all concerns when it comes to questions of confidentiality and concerns on acceptance since this an open group setting. It will be up to the leader to explain the group rules, confidentiality expectations, objectives, and goals of the sessions.


Session Procedures:

  • Welcome: Introduction of Leaders/Qualifications/Mission Statement
  • Discuss confidentiality and its limitations. Responses from each session will be documented for later therapy sessions.
  • Summarize previous sessions
  • Homework - journal review
  • Icebreaker #1: What kind of animal do you feel like?
  • Discussion: Fear
  • Group Activity: Fear in a hat.
  • Discussion: Perspective
  • Group Activity #2: Tell me a story
  • Discussion: Summarization
  • “Homework” of keeping emotions/thoughts journal for the next week to be discussed at next session.
  • Closeout session.

First Round-Robin Discussion:

Group Rules, Objectives, and Icebreaker

  • The group leader will thank everyone for attending and welcome them to the group, offer water bottles/coffee.
  • The leader will give credentials of leaders
  • The leader will go over confidentiality and its limits. Ask if there are any questions?
  • The leader will then say their qualifications and the mission of the session.
  • The leader will let the group members know that a group is a safe place and that everyone is there for the same common goals but will also stress the gaps in group confidentiality.
  • Summarize previous sessions
  • First Icebreaker: Ask members what animal they relate with today.
  • Discussion: Fear and anxiety
  • Group Activity #1: Fear in a hat

    • Members will write their fear on a slip of paper and put it in a hat.
    • Go around the circle one by one drawing out fears and explaining why they feel the person could feel this way.

Second Round-Robin Discussion:

Perspective

  • Discussion: Perspective

    • Discuss how different people see things vs. how they are experienced
  • Group Activity #2: Tell me a story.

    • Place a series of pictures on the table
    • Ask the member to put them in order
    • Then ask them to tell the story picture by picture
  • The counselor will record the responses from both icebreakers to use in later sessions.
  • The counselors will attempt to link members who have similar answers.


Final Round-Robin Discussion:

Fears and Questions

  • Closing Activity: On a scale of 1 to 10 how confident do you feel about moving past your depression?
  • Ask if there are any questions or final thoughts/words of encouragement.


Closing Out the Session:

  • The counselor will inform the group of the closing session
  • Once again ask if there are any questions.
  • Review next week’s meeting time and date.
  • Remind them of their journal homework.
  • Reiterate the importance of confidentiality.
  • Closing thoughts and reminders that we are all here for the same purpose and no one is alone.
  • Give the main office’s outreach/after-hour’s numbers if someone needs to reach out.

Materials:

  • Slips of paper
  • Hat
  • Pencils
  • Water bottles/coffee


Counseling Techniques That Will Be Used:

  • Active Listening
  • Clarification
  • Eye Contact
  • Appropriate Responses
  • Empathy
  • Summarizing
  • Questioning
  • Linking
  • Rounds

Emotional Balance

Emotion is comprised of three design levels; visceral, behavioral, and reflective. These three complementary aspects are present in even the most basic emotions, such as fear. The Visceral level is explained for this example as “gut” in reference to the concept of “gut instinct”. It’s a subconscious reaction that occurs when the body and mind are subjected to certain circumstances or experiences. The visceral reaction, also known as the initial reaction, occurs when a sensory scan is performed of the experience. It’s immediate and involuntary. The behavior level is explained by the reaction we have when we use our senses. How does it feel, look, smell, etc. Most of our experience with something comes from the time when we put it into use. These are the most meaningful of experiences because it displays “how it is” and not how we perceive it. The reflective level is explained as the experience that goes beyond the initial introduction or use; it’s the experience of association and familiarity. If the object of affection is taken away, it brings about emotion.

Pathological anxiety is derived from interference in the balance of the three levels. This imbalance interferes with the ability to cope successfully with life challenges. Once anxiety is involved panic follows and then fear shortly after that. Fear holds us back from doing things we would normally do and shelters us away from the things we love. It doesn’t always have to be a tangible object, it can be a thought that you ruminate on. Feeling exiled, physically or mentally, by your own doing or others, in any way can lead to depression.

Group Session 4: The Working Stage

Introduction

This is session 4 of 6 will be the working or performing stage of this postpartum depression group. The working stage involves therapeutic methods and applications of counseling theories. This stage begins delving deeper into the symptoms of the underlying issue. At this point in the group, the members will have built rapport with the therapists as well as their peers. This grounded rapport can be used as a therapeutic intervention by allowing not only the members to feel free to share, but also the desire to uplift one another.

Session Goals & Objectives

  • Understanding and improvement of positive self-talk
  • Understanding and application of thought replacement
  • Overall objective: Improve internal dialogue


Session Procedures

  • Topic: Positive Self-Talk & Thought Replacement
  • Review ground rules
  • Rose & Thorn Round: State one positive and one negative thought.
  • Review & Evaluation of preceding session
  • Icebreaker # 1: State one positive thing about the person to your right.
  • Icebreaker # 2: Introduce the quote “Your life is a reflection of your mind”
  • Homework: Thought restructuring exercise
  • Close session


First Round-Robin Discussion:
Couselor Introduction, Ground Rules, Session Review/Evaluation


  • The counselor will state their name and qualifications
  • Review Ground Rules

    • Confidentiality & Limitations
    • Respect for other members
    • Participation encouragement
  • Review & Evaluation

    • Review skills from the previous session
    • Application of skills learned during the last session
    • Discuss outcome
  • The topic will not be discussed until the second round

Second Round-Robin Discussion: Building Topic
Positive Self-Talk

  • Rose and Thorn Round

    • State one positive and one negative thought or feeling from the last week.

      • The counselor will write them on the whiteboard
  • The counselor will hand out “Positive Words” handout: Appendix (__)
  • Icebreaker # 1: State one positive thing about the person to your right.

    • Discussion: “How hard was it to state something nice to that person?”, “Would it have been that easy to tell them something negative?”
    • Linking: “Was it harder for you to find something positive than it was negative about yourself?”, “Are the positive statements you gave to your co-member part of your self-talk?”

Third Round-Robin Discussion: Grounding Topic

Improve Internal Dialogue

  • Icebreaker # 2: Quote: “Your life is a reflection of your mind”

    • Discussion Round: “What does this statement mean to you”
  • The counselor will discuss positive self-talk
  • Encourage members to create a positive internal dialogue

    • “Most people want to build up others but put themselves down.”
    • “Speak to yourself as if you are complimenting someone else.”
    • “When a negative thought arises, cast it out, don’t let it linger. Replace it immediately with a positive thought.”

Closing Round

  • Homework: Thought Replacement Activity: Appendix (__)
  • Thank everyone for their participation
  • Ask members if there was anything else they’d like to add before closing the session
  • Next session date and time reminder

Materials:

  • Whiteboard
  • Dry erase markers
  • Positive Words handout
  • Thought Replacement handout
  • Water bottles & coffee
  • Tissues
  • Notepad & pen

Group Session 5: Working Stage

Introduction

This will be session 5 of 6 extensive therapy sessions for women who are suffering from Postpartum Depression. This session will be a part of the performing, or working, phase. At this stage members will begin delving into deeper and more significant issues, allowing for greater progress within the group. Members have established trust and relationships within the group and can use this to grow as a group and as individuals by feeling more comfortable sharing and encouraging others to share.


Session Procedures

  • Welcome, introduction of leaders, qualifications
  • Reminders about confidentiality, contract
  • Summarize Past Sessions
  • Icebreaker: Favorite Compliments
  • Discussion Round: I feel most like myself when…
  • Discussion Round: Biggest change/difficulty since having a child?
  • Homework
  • Close Session


First Round Robin Discussion:

Counselor Introduction, Ground Rules, Session Review/Evaluation


  • The counselor will state their name and qualification
  • Review confidentiality, limitations, respect for members, and participation encouragement
  • Review topic and what was learned from previous session


Second Round Robin Discussion:

Insecurities and Confidence

  • Icebreaker: Favorite Compliments

    • Think of one very important person in your life whose opinion carries great weight. Assume they are being completely honest. What is the compliment you would most appreciate receiving from them?

      • Why do you think this compliment, from this person, is so important to you?
      • Are there any common insecurities or shared favorite compliments within the group? Allow discussion.

Third Round Robin Discussion:

Changes and Sense of Self

  • What has been the biggest change for you since having a child?

    • Has this group helped you to adjust to that change?
    • How have the changes in your life challenged your sense of self?
  • Finish the statement:

    • “I feel most like myself when…”

      • Have you been able to do this activity/be in this state since having your child? How can you make time to do what you need to feel like yourself?

Closing Round:

  • Make time at some point this week to do an activity you enjoyed before having a baby, but haven’t had time for since (hire a babysitter and go on a date with your spouse, go out with your friends, spend a few hours by yourself, etc.)
  • Ask members if there is anything they’d like to add or discuss briefly before the end of the session.
  • Thank everyone for participating
  • Summary of session
  • Next session date and time reminder

Materials Needed:

  • Water Bottles/Coffee
  • Tissues
  • Notepad and Pen

Group Session 6: The Termination Phase

Introduction:

This will be session 6 of 6 extensive therapy sessions for women who are suffering from Postpartum Depression. The last session of group therapy is also considered to be the adjourning or termination phase. The final phase of the group is a time for members to consider what they have learned in the group and develop strategies for applying what they have learned in their daily life outside of the group. At this time the members will be encouraged to express and process their feelings and thoughts about this group. For many people, endings are difficult, and they may need to learn how to say goodbye in a productive manner. It is believed that if the group sessions have been fruitful for the members, that they will be able to extend their learning to the outside world, even though they may feel a sense of loss. During this phase, the members may put up a wall and become distant, argumentative, and problematic, as in the past they may have negative experiences and the termination of the session may bring up these feelings of negativity. If this should happen, the leader should remind the members what they have learned from the group and lead them to properly display their feelings towards situations of termination as this experience should help them translate to the outside world.


Materials:

  • Yarn
  • Tissues
  • Water bottles
  • Coffee


Session Procedures:

  • The counselor will introduce themself and state their qualifications and purpose of the group. Remind the members of the group about the importance of confidentiality.
  • Remind the members that participation is a strong determinant for successful treatment; therefore members will be expected to participate.
  • Reflect on what took place in the last session.
  • Reflect on the homework assignment from the week before.
  • Icebreaker #1: Have the members express what this group has done for them, how that they are different from the first meeting, and state where they intend on going from this point.
  • Discussion
  • Icebreaker #2: Are there any” unfinished business” within the group, and if so, after the discussion, given the limited amount of time, it’s unrealistic that the problem may be solved, however, the leader can discuss the impact of the member’s choice to leave this unfinished business at the end of the group and hopefully the members can translate to the outside issues the importance of not leaving things undone to the last minute.
  • Discussion

First Round-Robin Discussion:

Group Rules, Objectives, and Icebreaker

  • The group leader will thank everyone for attending and welcome them to the group, offer water bottles/coffee.
  • The group leader will then say their qualifications and the purpose of this session of the group.
  • The group leader will remind the group of confidentiality and that participation in every step is crucial to their progress.
  • The group leader will remind the group members to the group is a safe place and that everyone is there for the same common goals.
  • First Icebreaker: Have the members express how attending the group has been of benefit to them and their families, and how that they are feeling differently from the first meeting, and state where they intend on going from this point.
  • Discussion

Second Round Robin:

Dealing with feelings and Unfinished Business

  • Icebreaker #2: Are there any” unfinished business” within the group, and if so, after the discussion, given the limited amount of time, it’s unrealistic that the problem may be solved, however, the group leader can discuss the impact of the member’s choice to leave this unfinished business at the end of the group and hopefully the members can translate to the outside issues the importance of not leaving things undone to the last minute. Members are encouraged to share their feelings about the group closing, even if they have no “unfinished business”. At this stage, members are encouraged to provide feedback to one another, and say goodbye.
  • Discussion

Third Round Robin:

The Closing Web

  • Ask the members to stand in a circle. The group leader will be holding the start of the string as one member will pass it to another member of the group. Have each member take a moment before passing the string to another member of their choice to state how they have seen that person change since the first meeting or any other words of positivity or inspiration.
  • At the end of the game, the group leader will comment that we all played a part in creating this unique web and if one person was gone it would look different. In the same way, it's significant to realize that we all take part to make the group what it is, distinctive and special.

    • After the activity, the members will discuss how the activity made them feel and any other reflection upon what they have learned from the group sessions.


Closing Out The Session

  • The group leader will ask if anyone has anything left to discuss or any questions.
  • The group leader will remind the group of confidentiality.
  • The group leader will remind the group that we are here together and no one is alone.
  • The group will be reminded of the main office outreach/after-hours number if someone needs to reach out.
  • The group leader will provide information for the members to other organizations that may be equal of benefit to the clients.

Counseling Techniques That Will Be Used:

  • Active Listening
  • Clarification
  • Eye Contact
  • Open Posture
  • Empathy
  • Summarizing
  • Questioning
  • Linking
  • Rounds
  • Use of Props

Evaluation Methods

Evaluating the group is a process that goes on throughout the group process. After each group session, the leader will evaluate the individual and the group to see what has happened in the session. The leader will ask if any changes came from the session and if any therapeutic and/or nontherapeutic forces are present in the group.
The leader will also teach the group how to evaluate, so they can direct the movement or flow of their own group. They can decide if any changes need to be made to make the group a cohesive community. Sometimes a follow-up evaluation can be extremely useful. Follow-up evaluation is useful to assess outcomes. The follow-up will be built into our program, and the leader will schedule follow-up meetings 6 weeks after the sessions to allow members some time on their own after sessions.
At the follow-up evaluation, the women can share and discuss the issues that they have run into since parting from the group, talk about the processes and techniques they have taken to stay open for change and remember positive moments of the group. The follow-up evaluation will give an outlet to express thoughts and feelings about their group experience.


References

Babich, S., Hansotte, E., Payne, S. (2017). Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: A systematic literature review. Public Health Reviews, 38 (1), 1-17.

Baker, A., Fitelson, E., Kim, S., Leight, K. (2010). Treatment of postpartum depression: Clinical, psychological, and pharmaceutical options.Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039003/#__abstractid577560title

Bennett, E. & Sylvester, A. (2012). “Postpartum Depression: What Every Counselor Should Know”. Counseling.org. Retrieved 7 March 2017, from http://www.counseling.org/docs/default-source/vistas/postpartum-depression---what-counselors-need-to-know.pdf?sfvrsn=12

Dubber, S., Reck, C., Müller, M. et al. Archives of Women’s Mental Health (2015) 18: 187. doi:10.1007/s00737-014-0445-4

Gehart, D.R. (2013). Theory and treatment planning in counseling and psychotherapy. Boston, MA: Cengage Learning.

Kettunen, Pirjo; Koistinen, Eeva, & Hintikka, Jukka, “The Connections of Pregnancy-, Delivery-, and Infant-Related Risk Factors and Negative Life Events on Postpartum Depression and Their Role in First and Recurrent Depression,” Depression Research and Treatment, vol. 2016, Article ID 2514317, 7 pages, 2016. doi:10.1155/2016/2514317

Mure An-Madar, A., Badan, A. (2015). The development and piloting of a CBT group program for postpartum depression. Journal of Evidence-Based Psychotherapies, 15 (1), 51-64.

NIMH » Postpartum Depression Facts. (2017). Nimh.nih.gov. Retrieved 5 March 2017, from https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml

Norman, D. A. (n.d.). Emotional Design. Cambridge, MA: Basic Books.

Schneider-Corey, M., Corey, G., & Corey, C. (2014). Groups Process and Practice (9th ed.). Belmont, CA: Brooks/Cole Cengage Learning.

Rubertsson, C., Hellström, J., Cross, M. et al. Archives of Women’s Mental Health (2014) 17: 221. doi:10.1007/s00737-013-0409-0

Schneider-Corey, M., Corey, G., & Corey, C. (2014). Groups Process and Practice (9th ed.). Belmont, CA: Brooks/Cole Cengage Learning.

Tietz, A., Zietlow, AL. & Reck, C. Archives of Women’s Mental Health (2014) 17: 433. doi:10.1007/s00737-014-0423-x

Yawn, Barbara P., Olson, Ardin P., Susan Bertram, Pace, William.,Wollan, Peter., and Dietrich, Allen J. “Postpartum Depression: Screening, Diagnosis, and Management Programs 2000 through 2010,” Depression Research and Treatment, vol. 2012, Article ID 363964, 9 pages, 2012. doi:10.1155/2012/363964

Mackin, D. (2011, September 22). Teaming: Getting Past the Storm in Team-Building. Retrieved February 13, 2017, from http://thinknewdirections.com/leadership-engagement/blog-getting-past-the-storm-in-team-building-2/

Institute, S. (n.d.). Working With Student Teams. Retrieved February 13, 2017, from http://sites.psu.edu/schreyer/stages-of-the-teaming-process/stage-2-storming/

Storming: Clouds on the Horizon. (n.d.). Retrieved February 21, 2017, from http://humanresources.umn.edu/work-group-development/storming


sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_
sample_

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Lain Golden

Related Articles