The paper presents an analysis of group therapy scenes in the movie "Patch Adams." Patch Adams is a movie about a true hero who is determined to become a medical doctor because of his love to help people. He chooses to use humor and laughter as a way of treatment, something no doctor has ever done before. Interestingly, his approach is successful at it. Group therapy refers to a form of psychotherapy involving one or more therapists or doctors working with several patients or people at the same time. Group therapy is a widely used approach to treatment in hospitals, in therapeutic practices, community centers, and mental health clinics ( Spirou, 2016 ). Irvin Yalom, in his book titled " The Theory and Practice of Group Psychotherapy ," lists some of the primary therapeutic principles derived from self-reports from persons who have participated in the group therapy process: group therapy installs hope, helps the sick understand what they are going through, impart information, share their strength, develop Social techniques, imitate behavior, learn from each other, and creates group cohesiveness.
The groups in a therapy session can be as few as three of four people; however, group therapy sessions normally involve about eight to twelve people. It is also possible to have a larger number of participants I a group therapy session ( Kashner et al., 1995 ). The groups have a meeting once or two times in a week or more for about half an hour to two hours. Groups can be as small as three or four people, but group therapy sessions often involve around eight to twelve individuals (although it is possible to have more participants). The group typically meets once or twice each week, or more, for an hour or two.
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GROUP THERAPY SCENE 1: "Beanies" Session
Scene trailer : https://www.youtube.com/watch?v=Sk9mR3zjrkk
In a scene, A therapy doctor is seated in a room on a chair facing five patients. The patients are sitting on a chair, bed, and one on a wheelchair. It is a therapy session about to begin. Patch Adams is seated with the other patients in the bed ( Stewart, 2018 ). The setting is a hospital room. Before the session begins, one patient asks the doctor, "Why are we meeting in here? It's crumped!" The doctor boldly replies that "we are meeting in here so that everyone can participate." He asks whether any one of them "have a thought on that?" but the patients begin to become adamant: one shouting "cramped" the other one yelling, "I think he asked a question." One patient is continually raising his hands; it seems like a condition.
The therapist replies rudely, asking why the other patients are making fun of a sick person. Dr. Adams steps in; he makes jokes about the situation too. He asks the hilarious question of the moment, which makes the patients burst out in laughter. "Beanie! Which way is heaven?" a patient joins Adams asks another hilarious question "Beanie! How much taller is a … much taller than you?" the situation continues with the patients cracking jokes about the patient, laughing out their hearts with Adams encouraging them to continue ( Geier, 2016 ). The therapist doctor tries to stop the jokes, but it continues. The therapist doctor cannot contain it anymore; he walks out of the room. The jokes continue in his absence. The therapist comes back with a team to dismantle the session ( McEvoy, 2007 ). They take out all the patients in a hurry, leaving Dr. Abrams with just one patient in the room. The session ends with the patient making the best comments ever "This was a good session, I thought!"
Type of Therapy Group
This scene therapy group was a medication group. Medication groups are adopted for treatment purposes, for example of bipolar disorder or recurrent depression. The doctor here emphasizes being compliant with medication ( McEvoy, 2007 ). The doctors help the patients understand the importance of taking their medication, educating them about their condition, reducing their isolation, and expressing how they feel.
Interaction of Group Members
This was the very first laughter scene in a therapy session. Dr. Adams was present in the room as a patient. The session was supposed to be a typical therapy session, where the therapist asks a question and does things usually. It is from this session that Adams realizes the power of laughter in treating terminally ill patients. The interaction more of a patient to patient relating to other patients. The doctors try to prevent this interaction, but it continues. The doctor tries to introduce normalcy to the traditional way of doing things, but the patients make more jokes ( Foulkes, 2018) . They laugh more as they interact with one another. However, one patient's condition seems to be worse. His hands are always raised, the patient makes it a joke, and they laugh a lot about it.
Technologies used by Group Facilitators
The therapist did not implement any technology in this therapy session. The therapist only came in the room with a book and a pen to take notes. It was a simple ask and answer session, with no use of any technology or device.
Leadership Style
There is no specific out of the box definition of leadership. There are several definitions of leadership, based on the context under which it applies. The paper defines leadership in a broader context; traditional leadership, modern time leadership, and different thought schools. Merriam-Webster gave a foundation for the definition of leadership. He defined leadership in three ways: the position or office of a leader, an instance of leading, or the capacity to lead ( Mandell, B., & Pherwani, 2003 ). Several behavioral competencies can be identified in a high-performing leader. Carson F. Dye and his co-authors identified more than 100 personal attributes that define what exceptional leadership requires. According to Mandell, B., & Pherwani, (2003), the primary leadership competencies include a compelling vision, properly-cultivate self-awareness, relating with other people, and a master of a style of execution. The paper critically examines modern time leadership, the expectations of a leader in the contemporary world. A brief conclusion is given at the end.
A leader must first have a natural feeling, urge, or desire to lead the people. Richard green coined the term "servant leadership" to define leadership focus on the well-being and growth of the communities they belong to and the people they serve. Servant leadership is usually compared to traditional leadership; traditional leadership entails the accumulation and exercise of power by the person at the top of the pyramid. Servant leadership involves giving service to the people. A servant leader puts the people's needs first, shares power, and helps people under him perform much better and grow ( McEvoy, 2007 ). A servant leader's characteristics include empathy, listening, awareness, persuasion, stewardship, healing, conceptualization, foresight, commitment to see his people succeed, and building community.
Patch Adams is a servant leader, and as can be seen from this scene, he loves impacting on the people around him. He shows leadership skills by putting others before him; he is more interested in supporting his subjects. Patch Adams focuses explicitly on his subordinates, and in the end, he gets positive results ( Foulkes, 2018) . Patch takes his desire to help others by creating a community that helps him to do the job of caring for other people to heal.
Personal Thoughts on the Therapy Group
Even though this was meant for a regular medical therapy session, it turned out to be chaotic, at least in the therapist's mind. However, the entire therapy session was a success. The patients laughed out loud; for the first time, they interacted with one another, they shared conversation and jokes. The doctors could have followed up and taken the opportunity to change their usual boring model where the patients never even paid attention.
GROUP THERAPY SCENE 2: The Children's Ward
Scene trailer : https://www.youtube.com/watch?v=byPJ22JDFjI&list=PL7A9200584AE4CFC1&index=5
Type of Therapy Group
This was an encounter type of therapy group. Encounter groups involve interaction amongst the patients or interaction between the patient and the therapist, doctor, or technician. In the encounter groups, the relations and interactions between the patients and the therapist are usually made more rapid and intense, hoping to contribute to huge changes. The encounter can be by bringing in an entertainer, a cheerleader, making it a verbal conversation, having the members hug each other, talking to each other, and touching between the participants. In some situations, the experience can be further intensified by making the group sessions longer for the entire day or even much longer to get the desired outcomes. For this type of approach, there is a need to ensure that the right method is used to treat the patient's correct type ( Foulkes, 2018) . Dr. Adams is using the encounter approach to interact with his cancer patients. As can be observed from the scenes, the patients were asleep, but after the doctor came to the room and began doing his comics, they were elated. They were jumping everywhere and laughing. This interaction and happiness is expected to go to greater length in helping the patients in some way.
Interaction of Group Members
Dr. Adams walks into the children's ward for the first time. The children are laid on the beds, and the room is quiet and chilly. Dr. Adams walks in and changes the mood. He makes the children laugh by acting comics and cracking children's jokes. He uses all kinds of tricks to make the children laugh. A nurse walks in, finds children jumping all over, happy and laughing. "What's going on here?" Robin Williams: "Come on, I'm just entertaining the kids to make them feel good, don't be so narky!" . To the nurse, it's chaotic, but to the kids, they are healed by laughter. Adams walks out, a satisfied doctor.
Technologies used by Group Facilitators
During the children's therapy, Dr. Adams uses comics to make the children laugh. Dr. Adams learned from his earlier experience at the Jude Hospital that laughter is the best therapy, and he is trying to implement it in his new job.
Leadership Style
The most compatible leadership theory to Adams Patch's leadership style in this scene is transactional leadership theory. He has also demonstrated a transformational leadership style because he actively participates in other people's development and growth through learning and training and promoting nursing technology and innovation strategy. Patch also actively supports my part-time working hospital program, which was designed to connect the facility leadership with its young experts' voice ( Linz & Lorenzo Ruiz, 2020) . A transformational leader is an emotionally intelligent person. According to my understanding, a transformational leader also needs to have a good account of their surroundings and point out the company's problem and introduce new changes and ensure that they are implemented through effective teamwork. Every leader is unique in his or her own space; they bring different characteristics and qualities. However, in my opinion, emotional intelligence is one of the essential leadership qualities and character that makes a transformational leader ( Geier, 2016 ). Adams Patch is a transformational leader because he is an emotionally intelligent individual. He can also bring other people together and work as a team to implement his group therapy and laughter techniques of treatment.
Personal Thoughts on the Therapy Group
This therapy group was specifically an encounter between a doctor and his patient. Patch Adams struggled with depression and was admitted to a mental hospital. He decides to become a doctor. He chooses to take a medical course at Virginia Medical University. He is surprised at how the school approaches treatment and patient care ( Geier, 2016 ). Adams is helped by a wealthy friend to open his medical facility. Adams chooses to use his life experience and laughter to change the lives of people. In the children ward scene, Adams demonstrates a perfect example of a true-life scenario where actual cancer patients, children, have a smile on their faces for the first time. As a personal opinion, let us strive to use laughter at the medical facilities, not only as a therapy but also to bring life to people. Sick persons, especially children with cancer, undergo a lot ( Foulkes, 2018) . A simple joke or a simple smile of their faces makes the world for them and their families.
GROUP THERAPY SCENE 3: Spaghetti Scene
Scene trailer : https://www.youtube.com/watch?v=xVZikNgD5h0
Type of Therapy Group
The Spaghetti scene begins when Patch walks into a patient room in the hospital. He finds a doctor attending to Mrs. Kennedy and another male patient besides them. Patch politely asks the doctor, "You still want help with Mrs. Kennedy? Patch then invites another doctor. Together they move Mrs. Kennedy outdoors using a wheelchair. They take her to a noodle pool, surrounded by other doctors. The doctors cheer at the patient. They hug her and let her jump and play in the pool alongside Patch as the doctors cheer. This is a group therapy; it involves patient interaction with many people away from the usual hospital environment ( Linz & Lorenzo Ruiz, 2020) . The patient responds positively by laughing out loud, cheering with the others, and feeling loved in the process.
Interaction of Group Members
The scene occurs in just outside the hospital. More than ten nurses and doctors are standing around the spaghetti pool. They cheer along as Mrs. Kennedy is brought in a wheelchair. T The doctors shout "surprise!" as she is helped to the noodles pool. Mrs. Kennedy is thrilled. She picks a handful of noodles and drops them on Patch's head. She hugs him and falls over him. Her interaction is between Mrs. Kennedy and the doctors and between Patch and Mrs. Kennedy. The patient is the center of attraction ( Mandell & Pherwani, 2003 ). The objective is to make her happy and laugh during the session. As expected, the old lady seems to be positively responding. She loves the audience, she is elated, and she jumps around like a young child in the pool.
Technologies used by Group Facilitators
The group facilitators are very creative in this session. They choose to set up a surprise therapy session for Mrs. Kennedy. It is not the usual dull session done at her bed. They get a pool full of noodles and make her enjoy her fan day ( Geier,, 2016 ). This made her feel appreciated; she felt a sense of belonging and love, which helped her a lot.
Leadership Style
From the noodles scene, I believe Patch is a transformational leader. Having moved from just a mental hospital as a patient to attend a university n=medical course, training as a doctor and becoming a doctor himself, and finally setting up his hospital to help people ( Mandell & Pherwani, 2003 ). Patch uses his creativity to bring significant change and how patients are treated. This is a method never seen before anywhere. It is an innovative approach to treatment.
According to my understanding, a transformational leader uses his position, the people around him, and the available resources to bring changes to the organization. The leader has his own missions and visions and makes other employees understand the vision in his own way and understand the need for change. Together they work smart and effectively to successfully implement the changes. The leader, therefore, mobilizes the team to implement his vision. Adams Patch dreamt of laughter as a form of treatment. This was something new, never tested, and tried before ( Kuru & Kublay, 2017 ). Most people were skeptical about it; he was even legally challenged by the institutions he worked for. However, as a leader, he explained his idea, put it to practice, and demonstrated that it worked better than the traditional therapies. Patch also actively supports the creative therapy programs which are required to help the patients recover. He plays critical roles as part of the teams. Dr. Patch is championing the company's efforts to give better results regarding innovating new ways t treat patients without necessarily sitting in a dull room, having the patients in a bad mood. Through interaction between the patients, laughter, and the use of comics, the patients can heal.
Practice makes perfect. The best way to become a transformational leader is to begin working towards it. I also believe that transformational leaders are not born; they are made and nurtured with time ( Linz & Lorenzo Ruiz, 2020 ). This implies that one has to be in the right environment, get the right training, be with the right leadership coaching to execute the objectives through examples.
Personal Thoughts on the Therapy Group
First, the noodle therapy session was a success. Mrs. Kennedy had once in a lifetime surprise therapy session by more than ten doctors, something she could not think could happen. Second, I also think the facilitators did an excellent job selecting the kind of activity that they could engage a senior patient like Mrs. Kennedy ( Foulkes, 2018) . It is not tiring. The session was just long enough, not too long, and had the intended outcome.
Personal Thoughts on the Movie
Adams Patch movie is a perfect demonstration of a healthcare innovation born out of passion and love to give therapeutic care to patients. Studies have revealed beyond reasonable doubts that actually laughter is a cure, and when done properly, it can be useful in helping certain mental conditions. While this movie never got the hype and the attention it deserved, I believe as a healthcare student that the medical fraternity needs to give much thought to using laughter, to cure patients.
References
Geier, M. T. (2016). Leadership in extreme contexts: Transformational leadership, performance beyond expectations?. Journal of Leadership & Organizational Studies , 23 (3), 234-247.
Kuru, N., & Kublay, G. (2017). The effect of laughter therapy on the quality of life of nursing home residents. Journal of clinical nursing , 26 (21-22), 3354-3362.
Mandell, B., & Pherwani, S. (2003). Relationship between emotional intelligence and transformational leadership style: A gender comparison. Journal of business and psychology , 17 (3), 387-404.
Spirou, P. (2016). O Captain, My Captain! Robin Williams and Transformative Learning in Dead Poets Society, Good Will Hunting and Patch Adams. In Teaching and Learning on Screen (pp. 27-43). Palgrave Macmillan, London.
Kashner, T. M., Rost, K., Cohen, B., Anderson, M., & Smith Jr, G. R. (1995). Enhancing the health of somatization disorder patients: Effectiveness of short-term group therapy. Psychosomatics , 36 (5), 462-470.
McEvoy, P. M. (2007). Effectiveness of cognitive behavioural group therapy for social phobia in a community clinic: A benchmarking study. Behaviour research and therapy , 45 (12), 3030-3040.
Stewart, T. (2018). Positive attitude to fluency: a group therapy programme. In Stuttering Therapies (pp. 72-86). Routledge.
Foulkes, S. H. (2018). Group therapy: Survey, orientation, classification. In Therapeutic group analysis (pp. 47-53). Routledge.
Linz, S. J., & Lorenzo Ruiz, A. (2020). Learning about mental healthcare in today's Cuba: An interview with the president of the Cuban society of psychology. Perspectives in Psychiatric Care .
