Group Dynamics

Individual Group Sessions

*An outline for each group session should be attached with the following headings and information completed: --Sessions (1-6) --Group Title --Session Title --Format --Supplies --Description of each of the 7 steps of a group process with information applicable to that particular session.

Methods

*An outline of the media and leadership style to be used. *All leadership style approaches should be consistent throughout the protocol.

Dealing with Problematic Behavior Cont

*Attention seeking behaviors- There are various forms. *Self deprecator-Always putting themselves down, over and over again, you hear the same thing. Unable to accept praise from others to the point others stop offering praise. *The help rejecting complainer -Chronically rejects the very help they are asking for, they are dependent on others, but unable to trust. When feedback is given, they often say "yes, but." They use a lot of time and energy in the group with no progress, the group gets frustrated. *The narcissistic member-They feel exaggerated self-love, they feel entitled to the groups concern, compliments, gifts, although they give none to others in the group. These clients may demand others attention, but refuse to give others their attention. The group members could easily get upset about this and refuse to acknowledge the narcissist, thus bursting their bubble leading them into depths of depression.

Group Protocol

*Developing any new OT group requires a group protocol. *In order to determine the type of group needed for the population you are working with consider the following: *Identify the clients who need a group. *Assess their specific need and general level of group skills. *Identify rules and resources that are applicable to your setting. *Narrow your focus by outlining the main goals of the clients. *Write the group protocol.

Dysfunctional or Anti-Group Roles

*Disrupter/Playboy or Playgirl - Uses group meetings as fun time and a way to get out of real work. Distracts other people by telling jokes, playing pranks, or even reading unrelated material. *Dominator - Tries to control the conversation and dictate what people should be doing. Often exaggerates his or her knowledge and will monopolize any conversation claiming to know more about the situation and have better solutions than anybody else. *Help Seeker - Actively looks for sympathy by expressing feelings of inadequacy. Acts helpless, self deprecating and unable to contribute. For example, "I can't help you, I'm too confused and useless with this stuff." *Special Interest Pleader - Makes suggestions based on what others would think or feel. Avoids revealing his or her own biases or opinions by using a stereotypical position instead, for example, "The people over in Administration sure wouldn't like that idea." or "You know how cheap our suppliers are, they won't go for that."

Task Roles Cont.

*Elaborator - Takes other people's initial ideas and builds on them with examples, relevant facts and data. Also looks at the consequences of proposed ideas and actions. *Coordinator - Identifies and explains the relationships between ideas. May pull together a few different ideas and make them cohesive. *Orienter - Reviews and clarifies the group's position. Provides a summary of what has been accomplished, notes where the group has veered off course, and suggests how to get back on target. *Evaluator/Critic - Evaluates proposals against a predetermined or objective standard. Assesses the reasonableness of a proposal and looks at whether it is fact-based and manageable as a solution. *Energizer - Concentrates the group's energy on forward movement. Challenges and stimulates the group to take further action. *Procedural Technician - Facilitates group discussion by taking care of logistical concerns like where meetings are to take place and what supplies are needed for each meeting. *Recorder - Acts as the secretary or minute-keeper. Records ideas and keeps track of what goes on at each meeting.

Writing a Group Protocol (ColeCh.11

*Group Title-What are you calling your group? *Author-Group leaders name and credentials. *Frame of reference-this is what you use to guide your interactions with clients and interventions, OT typically uses MOHO frame of reference. *Purpose-What is the general intent of this group? Overall group goals and activities to be used, should summarize the scope of the group in 3 sentences. *Group Goals and Rationale-Specific intervention intended to be met by group members, there should be no less than 3 and no more than 8 goals listed. Goals should be measurable (Remember to utilize F.E.A.S.T.) Well written goals are the backbone of any well designed group. Once goals are identified activities to meet goals follows. Each group session could focus on a different goal

Group Member Roles ****ON TEST

*Group member roles are more dynamic than leadership roles, group member roles can be formal or informal and played by more than one group member. *Additionally, one group member may exhibit various role behaviors within a single group meeting or play a few consistent roles over the course of his or her involvement with a group. *Some people's role behaviors result from their personality traits, while other people act out a certain role because of a short-term mood, as a reaction to another group member, or out of necessity. *Group communication skills, DO NOT always think of these roles as neatly bounded and all-inclusive categories, they can be fluid. *We all play multiple roles within a group and must draw on multiple communication skills/behavior in order to successfully play them.

What is Group Dynamics?

*How well the group worked together or did not work together to achieve the group goals. *According to group therapy developed by Tuckman (1965),there are 5 stages that a group goes through from initiation to termination. Stage 1-Forming Stage 2-Storming Stage 3-Norming Stage 4-Performing Stage 5-Adjourning

Rules and Resources

*Identify the rules and resources of your setting. These will determine what you are able to work with. *This includes rooms that are available, equipment and materials that you can use, daily schedules that are occurring already. *Is there another discipline providing similar groups, (ie, is recreational therapy doing sports and rec already)? *Facility rules, protocols, and procedures, contraband lists etc... What is the staff to patient ratio for groups being held? *You have to learn to work within all of these boundaries.

Summary

*It is helpful to the group members to get feedback about the role they played in the group. *Several challenges presented: --What are the clients needs? --What are the groups needs? --How does a group leader handle clients needs and lead a therapeutic group? --Ideally both the client and the groups need are satisfied, not always realistic? --Group value must be preserved over individual needs! --Many of these skills are developed through experience.

Focus and Goals

*Narrow the focus of your group and outline the main goals of the group. *Do not address more than one need per group, avoid doing 15 minutes of self care, 15 minutes of leisure, and 15 minutes of meditation. *This often results in clients not understanding the purpose of your group and therefore making it a meaningless occupation. *Once you have decided on a topic, write group goals.

Writing a Group Protocol Cont. (ColeCh.11)

*Outcome criteria-The desired results of your group stated in behavioral terms. *By the end of each group, the client should be able to state the progression made in each group. *Therapist need to develop a measurable way to demonstrate the effectiveness of the group to the client, administration and responsible parties who are paying for treatment. *Specific procedures should be outline, such as a pre/post testing tools. These should be attached separately to your protocol. *Outcome criteria should relate to goals, but should directly facilitate engagement in occupations and participation in life (application).

Dealing with Problematic Behavior Cont.

*Psychotic behavior-If a client is not in touch with reality or is in crisis, they can not benefit from group interventions. You may choose to do 1:1 sessions. *Irrational and illogical clients take up lots of time and energy in a group and halt the groups progress. *However, activity based group may be beneficial for these types of clients, they can focus on task rather than discussion.

Time and Place of Meeting

*Sessions will vary accordingly. Acute clients need daily sessions, chronic clients can do weekly sessions. *The length of the session will be determined by your clients attention span. *The meeting place should be determined based on requirements. The characteristics of the setting should be described. Size of room, lighting, safety etc...

Preparing for a Group

*Success of a group depends on what kind of preparation you have put in before the group occurs. *There are 4 areas that demand attention: --Knowledge --Space --Materials --Paperwork

Dealing with Problematic Behavior Cont.

*The Monopolist-Dominant role, often utilized to avoid ones own feelings or to gain group members attention. *Scenario-Harry came to group angry, stating "I am not going to draw like I am in kindergarten, you girls don't know anything about treating alcohol abuse." *Harry is being a monopolist and an aggressor. *OTs can help de-escalate Harry by asking other group members "Why do you let Harry monopolize the group? Why are you silent?"

Dealing with Problematic Behavior Cont.

*The Silent/passive group member- They don't mind Harry's behavior they are meeting their own behavioral needs by allowing Harry to continue disrupting the group and taking the spotlight off of them. *Often other group members are feeling some resentment towards the silent group members, because the silent group members are not pulling their weight in the group.

Supplies & Cost

*The sum total of all materials and supplies are listed here. *For example, movies, assessments craft materials should be listed.

Task Roles

*These are the roles that relate to getting the work done. They represent the different roles needed to take a project step-by-step from initial conception through to action. (Individuals may fulfill many of these roles during the life of a project.) *Initiator/Contributor - Proposes original ideas or different ways of approaching group problems or goals. This role initiates discussions and move groups into new areas of exploration. *Information Seeker - Requests clarification of comments in terms of their factual adequacy. Seeks expert information or facts relevant to the problem. Determines what information is missing and needs to be found before moving forward. *Information Giver - Provides factual information to the group. Is seen as an authority on the subject and relates own experience when relevant. *Opinion Seeker - Asks for clarification of the values, attitudes, and opinions of group members. Checks to make sure different perspectives are given. *Opinion Giver - Expresses his or her own opinions and beliefs about the subject being discussed. Often states opinions in terms of what the group "should" do.

Personal and or Social Roles

*These roles contribute to the positive functioning of the group. *Encourager - Affirms, supports, and praises the efforts of fellow group members. Demonstrates warmth and provides a positive attitude in meetings. *Harmonizer - Makes peace in regards to the differences between individuals. Seeks ways to reduce tension and diffuse a situation by providing further explanations or using humor. *Compromiser - Offers to change his or her position for the good of the group. Willing to yield position or meet others half way. *Gatekeeper/Expediter - Regulates the flow of communication. Makes sure all members have a chance to express themselves by encouraging the shy and quiet members to contribute their ideas. Limits those who dominate the conversation and may suggest group rules or standards that ensure everyone gets a chance to speak up. *Standard setter-Express the norms or standards of the group. *Observer/Commentator - Provides feedback to the group about how it is functioning. Often seen when a group wants to set, evaluate, or change its standards and processes. *Follower - Accepts what others say and decide even though he or she has not contributed to the decision or expressed own thoughts. Seen as a listener not a contributor.

Dysfunctional or Anti-Group Roles

*These roles disrupt group progress and weaken its cohesion. *Aggressor - Makes personal attacks using belittling and insulting comments, for example, "That's the most ridiculous idea I've ever heard." Actions are usually an attempt to decrease another member's status. *Blocker - Opposes every idea or opinion that is put forward and yet refuses to make own suggestions, for example, "That's not a good idea." The result is that the group stalls because it can't get past the resistance. *Recognition Seeker - Uses group meetings to draw personal attention to him or herself. May brag about past accomplishments or relay irrelevant stories that paint him or her in a positive light. Sometimes pulls crazy stunts to attract attention like acting silly, making excess noise, or otherwise directing members away from the task at hand. *Self-Confessor - Uses the group meetings as an avenue to disclose personal feelings and issues. Tries to slip these comments in under the guise of relevance, such as "That reminds me of a time when." May relate group actions to his or her personal life. For example, if two others are disagreeing about something, the Self-confessor may say, "You guys fight just like me and my wife."

Paperwork

*This consist of your attendance sheets, group protocol, and session plan. *The group leader can have a notebook available to write down group notes immediately after the session, but should refrain from writing any notes during the group, with the exception of taking attendance.

Writing a Group Protocol (ColeCh.11)

*This is a written plan that describes the goals of a group and the methods by which these goals will be achieved. It is an outline of what will be happening in the group. *Group Name *Author *Frame of Reference *Purpose *Membership and Size *Group Goals *Rationale, limitations, and adaptations *Outcome Criteria *Method *Time and place of meeting *Supplies and cost *References

Knowledge

*This refers to how well the group leader understands and analyzes the various factors in the group, as well as how they affect the functioning of the group. *The group leader must know the group members and be aware of them self and the influence they have on the group. *The group leader also must be knowledgeable of the task at hand, you cannot teach what you do not know.

Space

*This refers to the preparation of the area in which the group will meet. *Any furniture arrangements should be done before group members arrive to group.

Materials

*Tools supplies, books, handouts, sample projects should be at hand. *This will depend on the functioning level of the group. Lower functioning clients may need materials separated out for them, manic clients probably only need the material for one step at a time, and higher functioning clients can gather their own supplies.

Needs and Skill Level

*What are the specific needs and what is the functioning level of the group members you have identified? *This can be determined through observation and reviewing the OT assessment results. *You may notice that there are several clients who sit around all day watching TV and don't attend to their self-care. From this observation, you can develop a group that is focused on improving self-care or leisure exploration.

Dealing with Problematic Behavior

*You need to be able to ID what you are seeing in order to treat group members appropriately. *All clients have the potential to be a problem in a group. *Often clients are referred to group for the purpose of attempting to change the problem behavior. *Typical behaviors: --Monopolizing --Attention seeking --Silence --Psychosis

Group Leadership Styles ******ON TEST

Directive Leadership *Directive leaders, provide clear expectations for what needs to be done, when it should be done, and how it should be done. This style of leadership is strongly focused on both command by the leader and control of the followers. There is also a clear division between the leader and the followers. Directive leaders make decisions independently with little or no input from the rest of the group. *Researchers found that decision-making was less creative under Directive leadership. *Directive leadership is best applied to situations where there is little time for group decision-making or where the leader is the most knowledgeable member of the group. This approach can be a good thing when decisive and rapid decisions are needed. However, it tends to create dysfunctional and even hostile environments where the followers are often pitted against the domineering leader.

Group Leadership Styles Cont. ****ON TEST

Facilitative/Leadership *Facilitative leadership is generally the most effective leadership style. Facilitative leaders offer guidance to group members, but they also participate in the group and allow input from other group members. *Facilitative leaders encourage group members to participate, but retain the final say over the decision-making process. Group members feel engaged in the process and are more motivated and creative. Facilitative leaders tend to make followers feel like they are an important part of the team, which helps foster commitment to the goals of the group.

References

List all references that were used to create the materials for the group sessions, including all forms, worksheets and any copyrighted materials.

Members

Think about the clients you are servicing and the kind of groups that already exist, what is missing?

Tuckman's 5 Stages of Group Development

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