Group Dynamics & Group Process

Developmental Group: Mature

*15 - 18 years* -Responsive to all members' needs and can carry out a variety of tasks -Good balance between carrying out the task and meeting the needs of members

Developmental Group: Parallel

*18 months - 2 years* Individual tasks with minimal interaction required

Developmental Group: Project

*2 - 4 years* Common, short-term activities requiring some interaction and cooperation

Developmental Group: Egocentric Cooperative

*5 - 7 years* -Requires joint interaction for long-term tasks; completion of task is not the purpose -Members begin to express their needs and address others' needs

Developmental Group: Cooperative

*9 - 12 years* Members learn to work together, not specifically to complete a task, but to enjoy each other's company and meet emotional needs

Group Goals

*Not a compilation of individual goals* -Provide focus/guidelines for activities

Medicare Indicators for Group Membership

-Able and willing to engage in group -Attend to group guidelines/process -Actively participate -Benefit from and incorporate group leader and member input -Respond appropriately throughout group process -Complete activities toward goal attainment -Attain greater benefit from the group intervention than from 1:1 Ix

Important Member Demographics

-Age -Diagnosis -Cognitive level -Safety concerns -Cultural considerations

Yalom's Therapeutic Group Principles

-Altruism -Catharsis -Universality -Existential factors -Insight (self understanding) -Family reenactment -Guidance -Identification -Instillation of hope -Interpersonal learning

Characteristics of Advisory Leadership

-Cognition: high -Insight: very good -Group maturity: mature -Verbal skills: high -Motivation: high

Characteristics of Directive Leadership

-Cognition: low -Insight: minimal -Group maturity: immature -Verbal skills: poor -Motivation: low

Characteristics of Facilitative Leadership

-Cognition: medium/high -Insight: fair/good -Group maturity: medium/high -Verbal skills: average -Motivation medium

Directive Intervention Intervention

-Consistent and structured format -Best for severely and acutely mentally ill clients or clients with minimal basic functioning

Social Interaction Skill Intervention

-Develop communications skills, socially acceptable behavior, interpersonal relationships skills *Could also be integrated with psychodynamic and/or modular group*

Purpose of Therapeutic Norms

-Encourage self disclosure, self reflection, and interaction -Reinforce the value of the group -Establish a safe/supportive atmosphere -Regard members as agents of change

Types of Groups

-Evaluation -Task oriented -Thematic -Topical -Instrumental -Developmental

Factors that Influence Cohesiveness

-Extensive interaction between members -Similarity/complementariness of members -Perception of group's relevance to individual needs -Member's expectation of goal attainment and group outcome -Democratic leadership and member cooperation

ADL/IADL Intervention

-Focuses on self-care and Independent living skills (cooking, money management, transportation) *Could also be integrated with psychodynamic and/or modular group*

Community Participation/Reintegration Intervention

-Identify and use of resources in the community *Could also be integrated with psychodynamic and/or modular group*

Interpersonal Learning

-Input: receiving feedback from group members regarding one's behavior -Output: learning successful ways of relating to group members

Advantages of Co-Leading

-Leaders can assume different leadership roles, tasks, and styles -Observations and objectivity increase -Useful in larger groups or group with challenging behaviors

Benefits of Having Members Participate in Setting Group Goals

-Matching member goals and group goals -Understanding of requirements of achieve goal -Appreciation of member contributions

Components of a Group Protocol

-Name -Purpose -Rationale -Frame of reference -Membership criteria -Goals/outcomes -Method/format -Role of the therapist -Quality assurance

Open Group vs. Closed Group

-Open: anyone can joint -Closed: only specific people are eligible

Situations that Warrant One to One Therapy

-Patient demonstrates aggressive/inappropriate behaviors -Patient presently cannot handle group interaction -Patient refuses a group setting

What are the two types of restraints?

-Physical -Chemical

Medicare Group Leadership Criteria

-Provides active leadership -Instructs members as a group -Monitors and documents individual's participation and response to intervention -Provides individualized guidance and feedback -Documents member progress towards goals in objective, measurable, and functional terms

Benefits of Group Therapy

-Provides an opportunity for more natural social interactions -Cost effective; allows therapist to see more individuals/day

Disadvantages of Co-Leading

-Splitting by members -Excessive competition by leaders -Unequal responsibility

Psychoeducational Intervention

-Uses classroom format with principles of learning to provide info and teach skills -Teacher/student relationship for therapist/group members -Use homework assignments to facilitate skill development and generalized learning

Stages of Group Development

1. Forming 2. Storming 3. Norming 4. Performing 5. Adjourning

Steps in Group Leadership

1. Introduction 2. Activity 3. Sharing 4. Processing: most difficult for group members 5. Generalizing 6. Application 7. Summary

Group Protocol

A description of a group, including its purpose, goals, content, structure, logistics, who would and would not benefit by participation in it, and referral process

Guidance

Accepting advice from other group members

Existential Factors

Accepts the fact that responsibility for changes comes from within oneself

Goal Setting Intervention

Activities used to identify personal objectives and treatment goals and steps to achieve them

Sensory Awareness Intervention

Activities used to promote sensory functions and environmental awareness

Group Content

Activity carried out in the group; what is said in the group (can be verbal or nonverbal)

Identification

Benefitting from the imitation of positive behaviors

Self Awareness Intervention

Clarify values, awareness of personal assets, limitations, behaviors, and one's impact on others

Thematic Group

Designed for the learning of specific skills

Basic Talk Skills Intervention

Designed to develop basic cognitive skills needed for completion of simple tasks

Insight (Self-understanding)

Discovering and accepting unknown parts of oneself

Instillation of Hope

Experiencing optimism through observation of improvement of other group members

Topical Groups

Focus on discussion of activities and issues outside of the group that are current or anticipated

Modular Intervention

Focus on each session; rotated in a way which individuals can join the group at any time and still cover each topic, sessions cycle back around

Instrumental Group

Focused with meeting health needs and maintaining function

Instrumental Roles

Functional roles that help the group select, plan, and select tasks

Expressive Roles

Functional roles that support/maintain overall group and meet members' needs

Evaluation Group

Gather info about individual's task and group interaction skills, used to establish goals and plan interventions

Altrusim

Giving of oneself to help others

Developmental Group

Help members acquire and develop group interaction skills

Task-Oriented Group

Help members become aware of their needs, values, ideas, and feelings through the performance of a shared task

Group Process

How the work of a group is carried out, including how participants relate to each other, who talks to who, how tasks are accomplished, how decisions are made, and how therapy is undertaken

Leisure Intervention

Identify interests, develop activity specific skills, ID resources, understand healthy use of unstructured free time

Coping Skills Intervention

Identify problem solving and stress management techniques to cope with life stressors

Prevocational Intervention

Identify skills for work/volunteering, limitations, interests, work behaviors, job hunting and retrieval skills

Discharge Planning Intervention

Problem solve potential obstacles and ID resources for successful community reintegration

Decision Making

Process of agreeing on problem resolution

Group Communication

Process of giving, receiving, and interpreting information through verbal and non-verbal expression

Universality

Recognizing shared feelings and that one's problems are not unique

Catharsis

Relieves emotions by expressing one's feelings

Reminiscence Intervention

Review past life experiences to promote cognition and sense of personal worth

Individuals Roles

Roles that serve an individual purpose; interfere with group success

Group Norms

Standards, either implicit/explicit, verbalized/unstated, that are often developed by a group leader or based on group interaction

Cohesiveness

The degree to which members are committed to a group and extent of members' liking for the group

Group Dynamics

The forces that influence the relationships of members and the group outcome

Group Structure

The way in which membership is organized; the way in which the activity is presented (the directions, procedures, techniques, and time arrangements)

Group

Two or more people who have a consciousness that they are a group. An intentional gathering of people for the purpose of change

Family Reenactment

Understanding what is was like growing up in one's family through a group experience