Group Process Midterm

Yalom’s Therapeutic Factors

• Instillation of Hope

• Imparting information

• Altruism

• Development of socializing techniques

• Imitative behavior 

• Interpersonal learning 

• Cohesiveness

Group Protocol

• Provides a framework for the entire program

• Developed based on population or group needs and evidence

• Establishes the long term goals

• If the original leader cannot run the group, a new person uses the protocol to help plan and run the group in their absence

• This is a living document and will likely need to be reformulated periodically 

• Used to create documentation process

Anatomy of a Group Protocol

• Create a name that represents the group and encourages people to attend

• Rationale - can be pulled from assessment

• Frequency and length of meetings - first open or closed and the length, then if closed how many groups you will do total

• Meeting space - can be pulled from assessment 

• Goals - 

• Composition - need to decide whos in and not

• Leadership is simple - OT & OTA

• References for your intervention - reflects goals 

Group methods and procedures - use cole steps. In each section list some of the things you might use for that section  

Cole Group Roles

• Initiator-Contributor

• Information Seeker

• Information Giver

• Opinion Seeker

• Opinion Giver

• Elaborator

• Coordinator

• Orienter

• Evaluator-Critic

• Energizer

• Procedural Technician

• Recorder

Cole Group Building and Maintenance Roles

• Encourager

• Harmonizer

• Compromiser

• Gatekeeper/Expediter

• Standard Setter

• Group Observer/Commentator

• Follower

Cole Individual Roles

• Aggressor

• Blocker

• Recognition Seeker

• Self-Confessor

• Playboy

• Dominator

• Help-Seeker

• Special Interest Pleader

Initiator-Contributor (Group Task Role)

suggests new ideas, innovative solutions to problems, unique procedures, and new ways to organize

Information Seeker (Group Task Role)

asks for clarification of suggestions, focuses on facts

Opinion Seeker (Group Task Role)

seeks clarification of values and attitudes presented

Information Giver (Group Task Role)

Offers facts or generalizations “automatically”

Opinion Giver (Group Task Role)

states beliefs or opinions

Elaborator (Group Task Role)

spells out suggestions and gives examples

Coordinator (Group Task Role)

clarifies relationships among various ideas

Orienter (Group Task Role)

defines position of group with respect to its goals

Evaluator-Critic (Group Task Role)

subjects accomplishments of group to some standard of group functioning

Energizer (Group Task Role)

prods the group into action or decision

Procedural Technician (Group Task Role)

expedites group’s movement by doing things for the group, such as distributing materials, arranging seating

Recorder (Group Task Role)

writes down suggestions and group decisions, acts as the “group memory”

Encourager (Group Building and Maintenance Roles)

 praises, agrees with and accepts the contributions of others

Harmonizer (Group Building and Maintenance Roles)

Mediated the differences between other members

Compromiser (Group Building and Maintenance Roles)

modifies their own position in the interest of group harmony

Gatekeeper/Expediter (Group Building and Maintenance Roles)

keeps communication channels open by regulating its flow and facilitating participation of others

Standard Setter (Group Building and Maintenance Roles)

expresses ideal standards for the group to aspire to

Group Observer/Commentator (Group Building and Maintenance Roles)

comments on and interprets the process of the group

Follower (Group Building and Maintenance Roles)

passively accepts the ideas of others and goes along with the movement of the group

Aggressor (Individual Role)

deflates the status of others; expressed disapproval of the value, acts or feelings of others; attack the group or group task

Blocker (Individual Role)

tends to be negativistic or stubbornly resistant, opposing beyond reason or maintaining issues the group has rejected

Recognition Seeker (Individual Role)

calls attention to self through boasting, acting in unusual ways, or struggling to remain in the limelight

Self-Confessor (Individual Role)

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

Playboy (Individual Role)

displays lack of involvement through joking, cynicism or nonchalance

Dominator (Individual Role)

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

Help-Seeker (Individual Role)

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

Special Interest Pleader (Individual Role)

cloaks their own biases in the stereotypes of social causes, such as the laborer, the housewife, the homeless, or the small businessperson

Theories of Leadership

• Research clearly indicates that leadership is not a personality trait - leadership is a relationship between the persons in a social situation. A person that is a leader is one situation, may not be in another

• Groups select their leaders according to how well the person’s skill or knowledge meets the needs of the group

Lewin

• autocratic, democratic, laissez-faire

Transformational Leadership

idealized influence, inspirational motivation, intellectual stimulation and individualized consideration - visionary

Transactional Leadership

Gets things done, deadlines, problem solving, step by step

Goal Path Theory

directive, supportive, participative and achievement oriented

Situational Leadership

coaching, pacesetting, democratic, affiliative and authoritative

Stages of Group Development

• Majority of Group Development Models share the notion that most groups will…

  • Require a period for getting to know members

  • Development strategies to relate with one another

  • Rework in the presence of challenge or stress

  • Experience loss of motivation, focus, productivity, and/or direction at some point

  • Resolve with an accepted conclusion 

Tuckman’s Model & Stages

• Stage 1 - Forming

• Stage 2 - Storming 

• Stage 3 - Norming

• Stage 4 - Performing

• Stage 5 - Transforming, Reforming, Adjourning

Factors that Influence Group Development

• Group & individual roles

• Leadership style

• Group goals

• Group cohesiveness

• Degree of assessment, planning & design

• Group membership

• Group norms

Responsibilities of Group Leaders

• Listen and Respond

• Giving and Receiving Feedback

• Using Concrete Language

• Challenging Clients Behavior or Actions

• Self Disclosure

• Meaning Attribution

• Bridging

• Reality Testing

Co-Leaders

•  allows one person to attend to the group task while the other manages the process

• Model interpersonal relationship skills either as a part of the content or within the context of the group

• Advantage during the processing of the group - they can both contribute their observations of the effectiveness of the plan and to identify and solve group issues

• Must discuss aspects of leadership ahead of time, such as leadership styles, conflict management plans, primary therapeutic modes..etc

Effective Leaders help the group…

• Come to a clear understanding of the goals

• Be aware of procedures and norms

• Understand the skills, talents and needs of its members

• Develop methods to evaluate the groups progress

• Learn to accept new ideas 

• Create new tasks and terminate outdated ones

1 - Introduction

• Leader introduces the group name, purpose and general expectations with brief outline

• Introductions as needed

• Warm up activity - usually designed to prepare participants to participate in the activity of the day

  • These steps are repeated in every group, though they may change according to the kind of group or the members

  • It is good to build in ways to help people remember names and each other 

  • This sets the mood for the group!

2 - Activity

• The primary method, mode to meet the goals for that days groups

  • Activity analysis - plan for a just right challenge

  • Consider the amount of time allotted when planning

3 - Sharing

• The process of considering the end product. If each person is doing something on their own, they might display it to other group members, or everyone steps back to consider the work they did

  • The process for sharing is largely dependent on the activity

4 - Processing

• Members are given the opportunity (encouraged to!) speak about their experience with the group activity 

  • This is primarily feelings based - and provides insight into some of the participant’s behaviors

  • Often skipped by new group leaders but very important

5 - Generalizing

• The leader considers the participation and responses of the group members and pulls together some general take aways 

  • If the group goes as planned, this will reflect the goals

6 - Application

• Takes the key concept from the summary (generalizing), and helps the members apply them to their lives

  • Can have participants speak individually, or think, pair, share. (how you do this is planned)

7 - Summary/Wrap Up

Why Groups?

• Groups require interpersonal learning

• building social skills

• networking and building peer relationships

Humanistic Approaches

• Humanistic groups are about tapping into humanity and facilitating growth, self-development and healing through belonging and shared experience

• Concepts of humanistic groups include respect, understanding, genuineness, spirituality and self actualization

• The Recovery Model

Developmental Approaches

• Paradigm

• The developmental stage is part of personal context and inherent in every group

• Cannot consider group activities without considering the developmental level of the group members

• Levels are defined by points of growth, crisis or conflicts that need resolving

• Several theorists - Levinson, Jung, Erikson

• Considers motivation and a person’s natural desire for mastery

• Includes group development

Psychodynamic

• Ground in psychoanalytic theory that focuses on ego development and insight into the underlying processes behind behavior and thought

• Relationship to OT Groups

  • Considered symbolic meaning of activity 

    • Ex: gardening for people who are uncomfortable with being messy

  • Provision of activities that fit the person’s personality - or that help to alter the person’s personality if need be

  • Focused on the impact of unresolved childhood interpersonal issues that interfere with the person’s ability to derive pleasure from activity

  • Includes concepts of transference and object relations

Behavioral-Cognitive

• Emphasis is on learning, practice and cognitive restructuring

• Relationship to OT Groups

  • Behavioral goals and objectives

  • Conditioning and development of habits 

  • Shaping and chaining

  • Rehearsal and practice

  • Modeling and reinforcement

Sensory Motor Approach

• Include a range of Frames of References that address motor, sensory, perceptual or cognitive changes that are a result of developmental or acquired conditions affecting the brain

• Incorporates concepts from many theorists including Trombly, Rood, the Bobaths, Ayres and Dunn

  • Neurology/Brain/Behavior 

• Stress the importance of sensation as well as practice and feedback in the approach - new FoRs incorporate a holistic approach - experiencing your body doing 

• Encompasses motor learning theory which emphasized the relationship between neuroplasticity, movement and development of new patterns of movement to accomplish desired tasks

Allen’s Cognitive Disabilities

• Applied when there is need to measure and monitor problem solving ability and safety during performance tasks

• Relationship to OT Groups 

  • Designed to apply to daily function with a particular focus on available cognitive structure and process in daily tasks 

  • Used in acute and long-term settings with people who have cognitive changes due to illness or injury 

  • Quantifies ability and disability into categories and helps direct intervention to support of compensate

Ecology of Human Performance

• Self determination model - adapting to changes in life

• Ecology - the transaction between people and their contexts/environments 

  • Four contexts - personal, cultural, temporal and virtual 

  • Two environments - social and physical 

• Basic assumptions

  • Four constructs work together - person, task, context and performance

    • There is a dynamic relationship between person and task and contexts

    • Environment is a factor in performance 

    • OT promotes self determination and inclusion

    • Environment and person are constantly changing, requiring adaptation

    • Independence is achieved when wants and needs are satisfied (adaptations inc)

Person-Environment-Occupation-Performance (PEOP)

• Begins with the PEO paradigm - assuming these are not separable

• Performance - a dynamic experience of a person engaged in purposeful activities and tasks in the environment 

• 4 step process

  • Narrative (Occupational Profile)

  • Assessment of occupational performance 

  • Intervention - addressing performance barriers

  • Determining outcomes 

• Environments are considered part of performance (ex - cooking in the kitchen)

KAWA Model

• You will only use this in groups if the group is a family!!!!!

• Japanese Model of Occupational Engagement - Considers the aspects of Japanese culture (not held in western cultures)

  • Occupation is embedded in nature

  • Occupation is collective - families, social groups, work groups

  • Reason and reality are situational - problems can change depending on the situation

  • Ideas and opinions are accepted or rejected based on the hierarchy of individuals 

  • River metaphor exemplifies this - every changing and complex intervention is multifactorial - with change being determined by the collective group, the environmental changes, not just individual needs

Model of Human Occupation

• Based on the assumption that people are open systems that interact with their environment

• That there are internal processes impacted by underlying anatomy and physiology as well as motivation, life experience and daily habits 

• There is a developmental process to create occupational identity and competence

• Groups are a combination of education, engaging in processes and/or engaging in occupations of interest or value