Group Dynamics

Cole's Seven-Step Group Format

A structured approach for group therapy consisting of Introduction, Activity, Sharing, Processing, Generalizing, Application, and Summary.

Introduction

First step where the leader introduces self, members, purpose, expectations, and sets the mood.

Activity

Central part (15-20 mins); activity is selected to meet therapeutic goals and adapted to members' abilities.

Sharing

Members share their experiences or products from the activity.

Processing

Members express feelings about activity, leader, and each other; group dynamics are analyzed. Hardest to do by OT.

Generalizing

Cognitive learning aspects. Leader draws learning points and principles from members' responses.

Application

Members discuss how group learning applies to real life situations.

Summary

Leader reviews goals, content, and process; ends group positively and on time.

Leader Responsibilities in Introduction

Tasks the leader must perform during the introduction phase, including introducing self, members, warm-up exercise, setting expectations, explaining purpose, and providing outline.

Setting Limits

A good leader will guide the group assuredly but will not dominate or intimidate its members.

Leadership Theories

Different styles of leadership including Autocratic, Democratic, Laissez-faire, Telling, Selling, Participating, Delegating, Transformational Leadership, and Path-Goal Theory.

Autocratic (Lewin)

Leader controls decisions, little input from members.

Democratic (Lewin)

Leader encourages shared decision-making.

Laissez-faire (Lewin)

Minimal leader involvement.

Telling (Situational)

leader focuses on workers getting the job done with very little interaction or input from them.

Selling (Situational)

leader focuses on tasks, but also encourages relationship building and worker development

Participating (Situational)

leader focuses on building relationships and supporting worker initiatives

Delegating (Situational)

leader gives workers independence in how they do their jobs, with minimal direction

Transformational Leadership

create a vision and give followers the encouragement and resources needed to achieve that vision

Path-Goal Theory

Leader adapts to members' needs:
directive - syllabus
supportive - friendly climate
participative - leader consults
achievement-oriented - football coach

OT-Specific Leadership Styles

Leadership styles specific to occupational therapy including Directive, Facilitative, and Advisory.

Directive

Leader defines the group, (selects activities), and structures the group for therapeutic purposes.

Facilitative

Facilitator earns the support of the members, (members make decisions) with leader's guidance, and the therapist serves as a resource person and educator.

Advisory

Leader offers expertise as needed or requested but (does not provide structure or goals); motivation comes from within the group

Co-Leadership Strategies

Strategies for co-leaders including Retreat, Consensus, and Power Position. should not exceed 8 members

Brazaitis (2014)

suggests several alternative courses of action for leaders in a conflict situation:
Beating a hasty retreat
Finding a consensus
Using a power position

Team building

The team leader tasks most predictive of positive outcomes are: 1) involving employees in decision making, 2) coaching team members, and 3) promoting effective communication

Group

consist of people with a shared goal achieved through collaboration. They are systems of interconnected and interdependent individuals.

can be thought of as an intentional coming together to produce a change for the members

Group Dynamics

forces that influence the (interrelationships) of members and ultimately affect group outcomes.

Group Process

Process concerns the interpersonal relationships among the participants

here-and-now self-reflective loop (Irvin D. Yalom)

Group Content

The content of a group is what is done and what is said

Therapeutic Factor

"an element occurring in group therapy that contributes to (improvement in a patient's condition) and is a function of the actions of a group therapist, the patient, or fellow group members"

Yalom's Therapeutic Factors

Therapeutic factors "are interdependent and neither occur nor function separately"

Yalom's Primary Therapeutic Factors of Groups

Interpersonal Learning (Input and Output)

learning about and from others in the group, developing an awareness ofothers, correcting past misinterpretations about others, knowing how to express feelings and thoughts

Catharsis

sharing feelings and experiences, expressing and releasing emotions

Group Cohesiveness

sense of belonging, developing relationships based on trust, support, and caring

Self-Understanding

discovering and accepting previously unknown aspects of the self, developing insight

Existential Factors

Factors relating to the human condition, such as acceptance of pain and death as realities of life and realizing that life is not always fair

Universality

recognizing shared feelings, developing an awareness that one is not alone and that others have similar problems and experiences

Instillation of Hope

receiving reassurance, experiencing optimism and positive expectations based on observation of improvement in others

Altruism

sharing with others, reaching out to others, giving of oneself to help others

Family Reenactment

With guidance from the leader, members have the opportunity to break free from rigid family role scripts in which they have "unknowing been long locked"

Imparting Information

learning about one's health, illness, or disability through discussion with other group members

Imitative Behavior

observing the behaviors of others and then experimenting and applying positive behaviors modeled by other group members and the group leader to one's own life

Examples of Intervention Groups

Psychoeducational Group
Social Skills Group
Activities of Daily Living (ADL) Group
Reminiscence Group
Leisure Group
Sensorimotor Group
Fall Prevention Group

Client Centered Group

The client's perspective is the only relevant frame of reference.

OT services should be flexible and personalized to client needs

Developmental Group

Group interaction skills develop in a specific sequence from
parallel-group participation, through project group, egocentric
cooperative group, to a cooperative group, and, finally, to
mature group participation

Donohue's (2010) Five levels of Social Participation

Parallel Participation

Carrying out activities in the presence of others in a supportive
manner
(Directive Leadership)

Associative Participation/ Project

Brief verbal and nonverbal interactions, for example, greetings,
short conversation
(Modified Directive Leadership)

Basic Cooperative Participation/Egocentric Cooperative

Joint tasks carried out over time, with emphasis, is on the completion of
the project
(Facilitative Leadership)

Supportive Cooperative Participation/Cooperative

Emphasizes camaraderie and emotional sharing around a task
(Advisory Leadership)

Mature Participation

Combines the skills of the basic and supportive cooperative participation
levels
(Participatory Leadership)

Task Group

A task is defined as any activity or process that (produces an end product) or
provides service for the group as a whole or for persons not in the group

Activity Group

process of engaging in
meaningful activity

-positive self-concept, manage and express emotions constructively, and improve communication skills among group members

Functional Group

goal is not the product of the activity but rather the learning that occurs through group participation

promote adaptation and health through group action and engagement in occupation.
experiential in nature;

HOWE AND SCHWARTZBERG'S (2001) Functional Group Actions

Purposeful Action

meaningful for individuals and group as a whole

Self-initiated action

Member takes initiative verbally or nonverbally

Spontaneous actiom

action occurs in the here and now

Group-centered action

member actions are interdependent

Developmental Group

Parallel
Project
Egocentric-Cooperative - long term
Cooperatve - focus on interactions;less task

Taxonomy of Groups by Anne Mosey

Task-oriented group

awareness needs and feelings

thematic

focusing specific skills

topical

discussion of issues

instrumental

meeting health needs and maintaining function

Stages of Team Development by Bruce Tuckman

Forming

1st stage
occurs when team members first come together as a team

Storming

2nd stage
during this stage, teams discover teamwork is more difficult than they expected

Norming

3rd stage
begins as the team moves beyond the storming stage and begins to function as a team

Performing

4th stage
functioning as a high performance team

Adjourning

Breaking up the team when the required task is complete

Gazda's (1989) Stages of Group Development

1. Exploratory Stage
2. Transition Stage
3. Action Stage
4. Termination Stage

Wilfred Bion

Task-focused than interpersonal

1. Flight
2. Fight
3. Unite

Schutz (1958)

tends to have the clearest nterpersonal focus. He says that every individual has three interpersonal needs:

1. Inclusion
2. Control
3. Affection

Yalom's Stages

Orientation

(hesitant participation, search for meaning, dependency)
a.how group membership will reach individual goals.
(Members size
each other up.)
Dependency is another characteristic of the initial
stage.

Conflict

(dominance, rebellion)- power and control. Awareness of the
conflict through processing.

Cohesive Maturity

group spirit. high morale, and heightened mutual
support. Not until both negative and positive emotions are expressed
does the group reach true cohesiveness or maturity.

Poole's Multiple Sequence Model

breakpoints are points of change or transition
Marshall Scott Poole

Gersick's study

initial planning
establish therapeutic norms aggresively
midpoint transition

Characteristics of Groups

Group Climate

refers to the physical
and interpersonal or emotional
environment affecting the group

Group Boundaries/ Membership

Group boundaries may be flexible, rigid, or have variable degrees of
permeability

Group Goals

a future state toward which most group members' efforts
are directed. Goals determine the group's focus and may be explicit or
implicit

Group Norms

standards of behavior within the group

Group Roles

roles happen when members divide their work among themselves

Roles

set of socially agreed on behavioral
expectations, rights, and responsibilities for a
specific position or status in a group

Group cohesiveness

refers to the degree of understanding, acceptance, and
feelings of closeness group members have toward each other and the value
they place on the group.

Individual Roles

Aggressor

deflates the status of others

Blockers

negativistic or stubbornly resistant

Recognition-seeker

calls attention to self

Self-confessor

Uses group as an audience for expressing non
group-oriented feelings, insights, or ideologies

Playboy

displays lack of involvement through joking, cynicism, or nonchalance

Dominator

monopolizes group through manipulation, flattery, giving directions authoritatively, or interrupting the contributions of others

help-seeker

looks for sympathy from the group through unreasonable insecurity, personal confusion, or self-deprecation

Special interest pleader

cloaks his or her own biases in the stereotypes of social causes, such as the laborer