Ch. 8 Interventions in Groups

define groups

a collection of individuals who share interests, values, norms, or purposes. formed by choices, chance, or by circumstances

define group therapy

clients meet together with a therapist for sharing, support, gaining personal insight, and improving coping strategies (have a common set of concerns)

what are the functions of groups?

•Socialization: teaching social norms and skills

•Support: security and understanding

•Task completion: accomplishing tasks

•Camaraderie: friendship and belongingness

•Information sharing: learning

•Normative influence: regulate behavior and communication

•Empowerment: encouragement to bring about change

•Governance: setting and enforcing rules

what is the following exemplifying:

•Socialization: teaching social norms and skills

•Support: security and understanding

•Task completion: accomplishing tasks

•Camaraderie: friendship and belongingness

•Information sharing: learning

•Normative influence: regulate behavior and communication

•Empowerment: encouragement to bring about change

•Governance: setting and enforcing rules

the functions of groups

what are some different group types?

task, teaching, supportive or therapeutic, & self-help

what type of group type is being exemplified:

•Hospital committees

•Interdepartmental team meetings

•Planning committees

•Discharge planning committee

•Nursing faculty curriculum committee

SNA leadership

task

what is the following exemplifying:

•Instillation of hope (that issue can be resolved)

•Universality (that you are not alone)

•Imparting information (instruction and advice

•Altruism (sharing and concern for others)

•Corrective recapitulation of the primary family group (acting out a do-over)

•Development of socializing techniques (social behaviors

•Imitative behaviors (role model positive behaviors)

•Interpersonal learning (interaction and personal insight)

•Group cohesiveness (sense of belonging)

•Catharsis (expression of feelings – getting it off your chest)

•Existential factors (change to improve quality of life)

curative factors

what type of group type is being exemplified:

•Social skills

•Daily living skills

•Prepared childbirth class

•Parenting classes

•Medication information class

•Diabetes – new patient class

•Transition to discharge group

teaching

what type of group type is being exemplified:

•Grief support

•Divorce support

•Assertiveness training

•Cancer support groups

Sexual assault survivors

supportive or therapeutic

what type of group type is being exemplified:

•Alcoholics Anonymous

•Parents without Partners

•Weight Watchers

•Narcotics Anonymous

self-help

what characteristics are ideal physically, with regards to seating in a group?

No barriers between members, circle shape allows eye contact

what characteristics are ideal physically, with regards to size of a group?

7-8 members is optimal for interaction and relationship development (Range 2-15)

what characteristics are ideal physically, with regards to membership of a group?

Open (flexible attendance and on-going) vs. closed (set time frame and consistent members)

what are “curative factor”?

things that can help in recovery essentially

what are some curative factor examples?

•Instillation of hope (that issue can be resolved)

•Universality (that you are not alone)

•Imparting information (instruction and advice

•Altruism (sharing and concern for others)

•Corrective recapitulation of the primary family group (acting out a do-over)

•Development of socializing techniques (social behaviors

•Imitative behaviors (role model positive behaviors)

•Interpersonal learning (interaction and personal insight)

•Group cohesiveness (sense of belonging)

•Catharsis (expression of feelings – getting it off your chest)

•Existential factors (change to improve quality of life)

what are the phases of group development?

initial orientation → middle or working → final or termination

what phase of group development is being described:

•Establish rules, goals, rapport, and social norms.  Begin discharge planning. 

initial or orientation

what phase of group development is being described:

•Prepare early for ending and potential feeling of loss.  Review goals and progress.  Celebrate accomplishments. (identify who needs additional support) 

final or termination

what phase of group development is being described:

•Facilitation of problem solving and decision making.  Resolve conflicts (finding solutions).  Taking action.  Group member feeling of ownership develops. 

middle or working

what’re the different types of leadership styles?

autocratic or authoritarian, democratic, laissez-faire, visionary, transactional, and transformational

what is the ideal leadership style?

transformational

what leadership style is being described:

•Focus is teamwork and shared decision-making

•Ideal style

•Leader is seen as trustworthy and respected

•May include a unit-based council giving input from all perspectives

•Higher morale and enthusiasm, feel involved

transformational

describe the transformational leadership style.

•Focus is teamwork and shared decision-making

•Ideal style

•Leader is seen as trustworthy and respected

•May include a unit-based council giving input from all perspectives

•Higher morale and enthusiasm, feel involved

describe the transactional leadership style.

•Focus is on a transaction

•Reward for a task completed which can be a motivator for some workers

•Leader is keeper of the rewards

•Worker is motivated only by reward, not intrinsic or internal motivation

describe the visionary leadership style.

•Focus is on the future and a better world

•Leader inspires the team to a common goal or purpose through innovation and collaboration

•Encourages creativity

•Problem if misaligned with company strategy or priorities

describe the laissez-faire leadership style.

•Focus undetermined

•Leader is hands-off and non-directive

•Low productivity

•Low morale and enthusiasm, high frustration

•No direction

describe the democratic leadership style.

•Focus is on the group

•Leader is facilitator – information flows both directions

•High productivity

•High morale, motivation, and cohesiveness

•May be slow to make decisions or take action

describe the autocratic or authoritarian leadership style.

• Focus is on the leader

• Leader likes to do things their way

• High productivity

• Low morale, enthusiasm, and ownership

• High turnover and employee dissatisfaction

• Can be used in a crisis or emergency situation

what leadership style is being described:

•Focus is on a transaction

•Reward for a task completed which can be a motivator for some workers

•Leader is keeper of the rewards

•Worker is motivated only by reward, not intrinsic or internal motivation

transactional

what leadership style is being described:

•Focus is on the future and a better world

•Leader inspires the team to a common goal or purpose through innovation and collaboration

•Encourages creativity

•Problem if misaligned with company strategy or priorities

visionary

what leadership style is being described:

•Focus undetermined

•Leader is hands-off and non-directive

•Low productivity

•Low morale and enthusiasm, high frustration

•No direction

laissez-faire

what leadership style is being described:

•Focus is on the group

•Leader is facilitator – information flows both directions

•High productivity

•High morale, motivation, and cohesiveness

•May be slow to make decisions or take action

democratic

what leadership style is being described:

• Focus is on the leader

• Leader likes to do things their way

• High productivity

• Low morale, enthusiasm, and ownership

• High turnover and employee dissatisfaction

• Can be used in a crisis or emergency situation

autocratic or authoritarian

what’re the different member roles of a group?

task roles, maintenance roles, and individual/personal roles

describe the task member roles

•help with group progress or activities

describe the maintenance member roles

•enhance group processes (summarizes what happens, allowing equal speaking)

describe the individual/personal member roles

•meet individual needs but sometimes interfere with group progress or function

what are some other tpes of roles within a group?

task roles, maintenance roles, individual/personal role

what are the different task roles?

coordinator, evaluator, elaborator, energizer, initiator, orienter

define coordinator

a task role; Clarifies ideas and suggestions made in the group; brings relationships together to pursue common goals

define evaluator

a task role; Examines groups plans and performance, measuring against group standards and goals

define elaborator

a task role; Explains and expands upon group ideas and plans

define energizer

a task role; Encourages and motivates the group to perform at its best

define initiator

a task role; outlines the tasks at hand for the group and proposes methods for solution

define orienter

a task role; Maintains direction in the group – keeps it moving

define compromiser

a maintenance role; Relieves conflict within the group by assisting members to reach a compromise agreeable to all

define encourager

a maintenance role; Offers recognition and acceptance of other’s ideas and contributions

define follower

a maintenance role; Listens attentively to group interaction;  is passive participant

define gatekeeper

a maintenance role; Encourages acceptance of and participation by all members of the group

define harmonizer

a maintenance role; Minimizes tension within the group by intervening when disagreements produce conflict

define aggressor

individual/personal roles; Expresses negativism and hostility toward others; may use sarcasm to degrade the status of others

define blocker

individual/personal roles; Resists group efforts;  demonstrates rigid and sometimes irrational behavior that impede group progress

define dominator

individual/personal roles; Manipulates others to gain control;  behaves in an authoritarian manner

define help-seeker

individual/personal roles; uses the group to gain sympathy from others;  seeks to increase self-confidence from group feedback;  lacks concern for others or the group as a whole

define monopolizer

individual/personal roles; Maintains control of the group by dominating the conversation

define mute or silent member

individual/personal roles; does not participate verbally for a variety of reasons – may be uncomfortable or is attention seeking

define recognition seeker

individual/personal roles; Talks about personal accomplishments in an effort to gain attention or approval for self

define seducer

individual/personal roles; Shares intimate/personal details about self with group;  is the least reluctant of the group to share;  may alarm others or inhibit group process with excessive premature self-disclosure

what are the characteristics of maintenance group roles?

they keep the group going — the doers

what’s psychodrama of group therapy?

•Group leader is the “director”

•Group members are the “audience” or “actors” and agree to participate

•Client is themself with an unresolved conflict

•Gives the participant a chance to try different strategies for dealing with a troubling situation that could bring a more positive outcome (gives the pt a do-over on a situation)

•All members benefit from the drama and processing the situation within the group

•Nurses may serve as audience or client, group leaders have graduate degrees

define family as a group

•Two or more individuals depending on each other for emotional, physical, and economic support.  Family itself is self-defined.

how does family therapy work

Treatment modality that sees the family as a unit, rather than an individual.  Treatment is delivered in the context of the participating family. Goal is system change, rather than change in any one individual.  Also requires a graduate degree. 

are nurses allowed to lead group therapy and/or psychodrama?

NO — that’s a higher level of education

what is the role of the nurse in a group/group therapy?

•Works in groups on a daily basis

•Leads therapeutic groups (client education, self help, discharge readiness, accessing resources)

•Uses knowledge of human behavior as individuals and groups which is essential to effective group leadership

•Advanced practice nurses lead psychotherapy, family therapy, or psychodrama groups