Chapter 12: Group Interventions

The nurse is planning the first meeting of a symptom management group. The nurse should anticipate which situation during this initial meeting? Select all that apply. - Participants will likely disclose little information about themselves - Participants are likely to exhibit civil and restrained behavior - Conflict is likely to occur between participants with differing backgrounds - Participants may exhibit behavior that does not genuinely reflect their feelings - Roles and functions of participants will be solidified

Answer: - Participants will likely disclose little information about themselves - Participants are likely to exhibit civil and restrained behavior - Participants may exhibit behavior that does not genuinely reflect their feelings

A group member is describing some of the painful events experienced during childhood. The member does not elaborate on the feelings surrounding the events apart from saying that they made the member feel "upset." How should the group leader best apply the leadership technique of probing? A.) "When you say that these things made you 'upset,' how exactly did you feel?" B.) "Do you feel like someone else in similar circumstances would have felt that way too?" C.) "It sounds like the events you're describing were very upsetting." D.) "It's important that you know that these events were in no way your fault."

Answer: A.) "When you say that these things made you 'upset,' how exactly did you feel?"

A support group member talks at length about the situations that trigger the member's anxiety. Other group members offer thoughtful suggestions from time to time, and the member consistently agrees with them but then goes on to explain why they would be ineffective. What is the nurse leader's best action? A.) Ask the member to suggest specific alternatives to what the other members suggest B.) Confront the member with the fact that the member's responses devalue the contributions of the other members C.) Remind the member that the ultimate purpose of the group is to offer solutions to other members D.) Ask the member whether the member believes the situation to be unsolvable

Answer: A.) Ask the member to suggest specific alternatives to what the other members suggest

A psychiatric-mental health nurse will soon begin a medication group for clients who have been prescribed atypical antipsychotics. What is the nurse's best initial action? A.) Assess each member's knowledge of his or her drug regimen. B.) Educate the members about the roles of nutrition and exercise in managing adverse effects C.) perform a mini mental state examination (MMSE) with each member. D.) partner each member with another member to hold each other accountable for adherence to treatment.

Answer: A.) Assess each member's knowledge of his or her drug regimen.

A psychiatric-mental health nurse has been leading a symptom management group for several weeks. The nurse and the participants express satisfaction with the group's activities and the nurse has identified that an indirect leadership style will be appropriate. How should the nurse apply this leadership style? A.) Avoid intervening during a meeting unless absolutely necessary B.) Loosen the requirements around consistent attendance and punctuality C.) Transition the group from being closed to being open D.) Have each member of the group take turns leading when the nurse is unable to attend

Answer: A.) Avoid intervening during a meeting unless absolutely necessary Rationale: Indirect leadership entails giving little guidance or direction to the group. However, this does not mean that attendance and punctuality become unimportant or that the group must become open. Indirect leadership does not mean that the nurse delegates leadership to participants.

The nurse has been asked to sit in and observe a support group for individuals who were once addicted to drugs. The nurse notices that one group member disagrees with statements made by all other group members. What role is this individual playing in the group? A.) Blocker B.) Dominator C.) Follower D.) Gatekeeper

Answer: A.) Blocker

The working stage of group therapy is marked by which characteristic? A.) Conflict and cooperation among group members. B.) Members' propensity to leave the group. C.) Therapists' tendency to "back off" to allow the group to work. D.) Group members' concern about confidentiality issues.

Answer: A.) Conflict and cooperation among group members.

During which type of leadership does the group leader offer little guidance to the group? A.) Indirect B.) Direct C.) Co-leadership D.) Autocratic

Answer: A.) Indirect

A psychiatric-mental health nurse is leading a symptom management group for clients diagnosed with anxiety disorders. One of the members consistently asks for information to be clarified and explained further. This member is acting in which role? A.) Information seeker B.) Coordinator C.) Recorder D.) Opinion giver

Answer: A.) Information seeker

When leading a medication group, which educational method is least effective? A.) Lecture B.) Audiovisual materials C.) Videotapes D.) Handouts

Answer: A.) Lecture Rationale: Using a lecture method of teaching is less effective than involving the members in the learning process. The nurse should expose the members to various audio and visual educational materials, including workbooks, videotapes, and handouts.

Which is an accurate characteristic of small groups? A.) They are usually no more than seven to eight members. B.) They tend to be less cohesive than large groups. C.) They usually form subgroups. D.) They have fewer interpersonal experiences than large groups.

Answer: A.) They are usually no more than seven to eight members.

The nurse leader of a group observes a group member attempting to stimulate the group to action or decision. The nurse interprets this member as fulfilling which role? A.) energizer B.) recorder C.) orienter D.) coordinator

Answer: A.) energizer Rationale; The energizer attempts to stimulate the group to action or decision. The recorder writes suggestions, keeps minutes, and serves as group memory. The orienter defines the position of the group with respect to its goals. The coordinator shows or clarifies the relationships among various ideas and suggestions.

Which therapeutic factor refers to the group members' relationships to the therapist and other group members? A.) group cohesion B.) catharsis C.) altruism D.) universality

Answer: A.) group cohesion

Which maintenance role is responsible for mediating differences among group members and relieves tension in conflict situations? A.) harmonizer B.) encourager C.) compromiser D.) gatekeeper

Answer: A.) harmonizer

The nurse is counseling a group of clients in a closed group system. The nurse should explain to the group members that one advantage of a closed group system is that the ... A.) participants become more cohesive as a group. B.) group can be functioning on an ongoing basis. C.) focus of the group's work can be more specific. D.) group can be led by only one person.

Answer: A.) participants become more cohesive as a group.

A client diagnosed with schizophrenia is having hallucinations. Which type of group would be beneficial for this client? A.) symptom management B.) self-care C.) anger management D.) medication

Answer: A.) symptom management Rationale: In symptom management groups, members learn when a symptom indicates that relapse is imminent and what to do about it. Handling hallucinations, being socially appropriate, and staying motivated to complete activities of daily living are a few common topics. In self-care groups, the leader reinforces basic self-care skills and helps identify strategies that can motivate the clients and provide structure to their daily lives. The purposes of anger management groups are to discuss the concept of anger, identify antecedents to aggressive behavior, and develop new strategies to deal with anger other than verbal and physical aggression. A medication group can be used primarily to transmit information related to medications, such as compliance, management of side effects, and lifestyle adjustments.

A psychiatric-mental health nurse practitioner is conducting a psychotherapy group and applying Yalom's model of psychotherapy. The nurse integrates understanding of this model, emphasizing the importance of which aspect? A.) Need for a small group size B.) Development of interpersonal relationships C.) Assumption of multiple roles of group members D.) Avoidance of imitative behavior

Answer: B.) Development of interpersonal relationships

A nurse is planning to start a new group on the unit. To ensure a well-functioning and successful group, the nurse needs to consider individual suitability for membership and consider: A.) Can a potential member bring anything that will benefit the rest of the group? B.) Does the purpose of the group match the treatment goals of the potential member? C.) Can the potential member lead the group in case the leader is unable to attend? D.) Does the purpose of the group suit the potential member's needs and, if not, could the client observe by sitting outside of the actual group and watching?

Answer: B.) Does the purpose of the group match the treatment goals of the potential member?

Which is an example of group cohesiveness? A.) Using a member as a scapegoat B.) Members wearing T-shirts that they made to a group session C.) Monopolizing the therapy session D.) Discussing a client's personal issues in front of other group members

Answer: B.) Members wearing T-shirts that they made to a group session

During a group session, a member says, "I believe the group should try to focus on the feelings that we are all experiencing, not the end result of the behavior." Based on this statement, the nurse leader determines that this member is assuming which role? A.) Initiator-contributor B.) Opinion giver C.) Information giver D.) Energizer

Answer: B.) Opinion giver

During a group session, a nurse leader observes a member look down at the floor and change position in the chair, each time the topic of anger and violence comes up. The nurse leader says to the member, "I've noticed that any time the discussion involves anger and violence you look away and change your position. Is something going on?" The nurse leader is using which technique? A.) Reflecting feelings B.) Reflecting behavior C.) Clarification D.) Summarizing

Answer: B.) Reflecting behavior

A nurse is trying to manage the situation of a disliked member in the group and is encountering difficulties in managing the situation. The best action of the nurse is to ... A.) ask the person to leave the group. B.) get supervision from an experienced group leader. C.) identify another leader to take over the group. D.) disband the group.

Answer: B.) get supervision from an experienced group leader.

A psychiatric-mental health nurse is interviewing the family members of a client diagnosed with Alzheimer's disease. The members mention that they feel all alone and are having problems dealing with the everyday and long-term issues of caring for the client. The nurse determines that a referral to a group would be beneficial. Which type of group would be most appropriate for the nurse to suggest? A.) psychoeducation group B.) supportive therapy group C.) psychotherapy group D.) self-help group

Answer: B.) supportive therapy group

Group themes reflect the underlying concerns or feelings of the members. Identification of group themes is important for ... A.) determining the central communicator. B.) understanding the group dynamics. C.) evaluating outcomes of the group. D.) establishing future group sessions.

Answer: B.) understanding the group dynamics.

A client diagnosed with antisocial personality disorder is exhibiting aggressive behavior. Which intervention would be most appropriate for this client? A.) Symptom management B.) Self-care group C.) Anger management D.) Reminiscence therapy

Answer: C.) Anger management

Children's groups should be structured to accommodate which level of functioning? A.) Psychological B.) Motor C.) Developmental D.) Social

Answer: C.) Developmental

Which of the following is accurate when dealing with older people in groups? A.) The pace of the group should move fast because of memory deficits B.) Emphasis should be placed on learning new information C.) The pace of the group should be slowed because of possible memory deficits D.) The group should avoid using reminiscence

Answer: C.) The pace of the group should be slowed because of possible memory deficits Rationale: The pace of the group meetings should be slowed. Greater emphasis should be placed on using wisdom and experience rather than learning new information. The group should be encouraged to use life review strategies such as autobiography and reminiscence.

A client with post-traumatic stress disorder is referred to a group to help the client deal with the issues associated with the trauma and its aftereffects. Which group would be most appropriate for this person? A.) psychoeducation group B.) self-help group C.) psychotherapy group D.) task group

Answer: C.) psychotherapy group

Near the end of a medication group session, the nurse leader says, "Okay, we've talked about Mr. A's medication problems and he will be following up with his health care provider." The nurse leader is using which technique? A.) reflecting feelings B.) advice and suggestions C.) summarizing D.) clarification

Answer: C.) summarizing

A group member arrives at a group session visibly upset. The member is attending a medication group that meets once a week. The group leader observes the member's appearance. Which response by the leader would be most appropriate? A.) "If there is something wrong, maybe you should go home and come back next week." B.) "It's okay to be upset. How do other members of the group feel right now?" C.) "It's best that we deal with how you're feeling right here and right now." D.) "I can see you're upset right now. Let's take some time to talk after group."

Answer: D.) "I can see you're upset right now. Let's take some time to talk after group." Rationale: The member is attending a medication group which does not focus on emotions. Leaders should monitor the nonverbal behavior of group members during each session. Often, one or two people can set the overall mood of the group. Someone who comes to a session very sad or angry can set a tone of sadness or anger for the whole group. An astute group leader recognizes the effects of an individual's mood on the total group. If the purpose of the group is to deal with emotions, the group leader may choose to discuss the member's problem at the beginning of the session. The leader, thus, limits the mood to the one person experiencing it. If the group's purpose is inconsistent with self-disclosure of personal problems, the nurse should acknowledge the individual member's distress and offer a private session after the group. Telling the member to go home would be inappropriate and discounts the member's feelings.

A group is trying to handle issues related to dominance, control, and power within the group. In what stage of group development is this group? A.) Mature B.) Initial C.) Termination D.) Working

Answer: D.) Working

A psychiatric-mental health nurse is responsible for leading a newly formed group. Which individual would be responsible for determining an individual's suitability for the group? A.) referring provider B.) the client C.) treatment team D.) group leader

Answer: D.) group leader

The nurse is beginning a group counseling session with an open group system. The nurse should explain to the group members that one advantage of an open group system is that ... A.) it can offer the best treatment outcomes. B.) the topics for the group can be controlled. C.) relationships are more easily established in the group. D.) new members can join the group at any time.

Answer: D.) new members can join the group at any time. Rationale: One advantage of an open group system is that new members can join the group at any time and stay in the group as long as needed.

A psychiatric-mental health nurse is integrating Bruce Tuckman's model of group development to the formation of a psychoeducational group. Place the events in the order in which they would occur. Members of the group get to know one another Members work together based on norms identified Members experience tension and conflict Members develop a cooperative relationship

Answer: Members of the group get to know one another Members experience tension and conflict Members work together based on norms identified Members develop a cooperative relationship

During which group may the client learn how to avoid relapse? A.) Anger management B.) Symptom management C.) Reminiscence D.) Self-care

Answer; B.) Symptom management