Lec 5.1-5.4 - Group Organization, Process, and Facilitation

Group

• Aggregate of people who share a common purpose that can only be achieved through collaboration

• Organized systems of interrelated, interactive, and interdependent individuals

• In OT, a therapeutic social system and an agent of change

Group Function

• Occupation-based experience that is reality-oriented and promotes adaptation

• Natural environment that can provide feedback and support for individual and social needs

• Setting to learn and practice skills to master and achieve competence in activities required for daily life

• Platform from which people can maintain, improve, or enhance their occupational nature to fulfill social demand

Group Process

• Interrelationships and interactions between members, leaders, and the group

• Here-and-now experience

  • How the group functions

  • Quality of relationships between and among group members

  • Emotional experiences and reactions

  • Strongest desires and fears

Yalom’s 10 Therapeutic Factors of Groups

• Factors that make a group intervention effective

• 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

Exists in a context

• Characteristics of a Group

• Group Context

  • Systems that exist within larger systems

  • Occur within historical, social, and environmental contexts

• Group Climate

  • Physical and interpersonal or emotional environment

  • An inviting physical environment and safe and accepting interpersonal climate enhances group function

Bound by criteria

• Characteristics of a Group

• May be flexible, rigid, or have variable degrees of permeability

• Inclusion and exclusion criteria for membership

• Criteria influences group size, which affects group dynamics

  • Closed Group: no new members

  • Open Group: membership changes

Assumption of roles

• Characteristics of a Group

• Set of socially agreed-upon behavioral expectations, rights, and responsibilities of a specific position or status in a group or society

• People take various roles in intervention groups

• May be related to task accomplishment or the socioemotionalneeds of group members

Requires Cohesion

• Characteristics of a Group

• Degree of understanding, acceptance, and feelings of closeness group members have towards each other

• Sense of linking, trust, and desire to work together, feeling of togetherness, and sense of security

• Cohesiveness can be enhanced through frequent group meetings, emphasizing similarities among group members, competition against other groups, and consensus

Establishment of Norms

• Characteristics of a Group

• Reflect the value system of the group

• What members believe are appropriate ways of thinking, feeling, and behaving

• Provides clear expectations of the individual and the group

  • Written and unwritten rules

  • Dos and Don’ts

• Difficult to change once established

Goal Directed

• Characteristics of a Group

• Where most group members are directed

• Determine the group’s focus

  • May be explicit or implicit

• Give the group’s identity and purpose

• A group functions best when members are clear about and invest in the group’s purpose and goals

Leader

• A person who can influence others to be more effective in working to achieve their mutual goals and maintain effective working relationship among members

• A leader or therapist must be:

  • One of concern

  • Accepting

  • Empathetic

  • Genuine

Directive

• Leader defines the groups, selects activities, and structures the group

• The goal is to accomplish tasks

• Caters to low-functioning clients

Facilitative

• Leader earns the support of members

• Members make decisions with leader’s guidance, serving as a resource person and educator

• Useful in motivating clients and getting them involved

• The goal is to learn skill from experience

• Caters to average to high-functioning clients

Advisory

• Leader offers expertise as needed, but does not provide structure or goals

• Motivation comes from within the group

• The goal is to understand the process

• Caters to high-functioning clients

Exploratory

• Forming

• Getting acquainted

• Setting ground rules and norms for group

• Clarifying goals

• Inform participants of their responsibilities

• Leader centered

Establishing roles and functions in the group

Transition

• Storming

• Conflict and polarization

• Resistance to group influence

• Emotional responses

• Insecurity

• Defensiveness and frustration

• Problems seem insufferable

• Group survival is in question

Action

• Norming

• Work and task focus

• Resistance is overcome

• Trust and cohesiveness is developed

• Increased self-disclosure

• Increased spontaneity

• Decreased reliance on the leader

• Problems are easily resolved

Termination

• Performing

• Attempts at closure

• Usually short duration 

• Decreased self-disclosure

• Need to say goodbye and move on

Client-Centered

• Gives emphasis on the client’s autonomy, preferences, and lived experiences

• The goal is to enable and empower clients to address their occupational performance issues

• Members are individuals sharing the same condition or identity

• OT acts as a facilitator and partner

Developmental

• Not age-specific, but rather reflects the group’s level of functioning

• The goal is to build skills step-by-step, following the natural stages of development

• Members are individuals who function at the same developmental age

• OT acts as a facilitator and role model

Task-Oriented

• Provide opportunity for active involvement in occupations in natural contexts

• The goal is to facilitate the development of adaptive skills

• Members are functioning at similar cognitive and social participation levels

• OT observes and encourages reflection

Activity

• Focus on the process of engaging in meaningful activity with others

• The goal is to build a positive self-concept, manage and express emotions constructively, and improve communication skills

• Members are individuals who benefit from learning, practicing, and engaging to enhance skills, motivation, and social participation

• OT designs and facilitates activities

Functional

• Experiential in nature and occupation-based

• The goal is to promote adaptation and health through group action and occupational engagement

• Members are individuals who can participate in real-life and goal-directed activities

• OT is a collaborator and guide

Parallel Participation

• Five Levels of Social Participation

• Carrying out activities in the presence of others in a supportive manner

• Working side by side

• Members show awareness of each other

• Minimal verbal or non-verbal interaction between group members

Associative Participation

• Five Levels of Social Participation

• Brief verbal and non-verbal interactions

• Evidence of some beginning cooperation and competition

• Focus is on the task; minimal interaction outside the task

• Can give and receive minimal assistance 

Basic Cooperation Participation

• Five Levels of Social Participation

• Joint tasks carried out over time

• Emphasis on completion of the project

• Members jointly select, implement, and execute activity

• Members begin to express ideas and try to meet the needs of others

• Mutual interest in the task, activity, or goal

• Members respect others’ rights and follow group rules

Supportive Cooperative Participation

• Five Levels of Social Participation

• Emphasizes camaraderie and emotional sharing around a task

• Members of the group are typically homogeneous

• Aim is to fulfill each other’s needs and derive mutual satisfaction from the activity

• Task is considered secondary to emotional support

• Feelings are frequently expressed, members grow in personal and interpersonal insight

Mature Participation

• Five Levels of Social Participation

• Combines skills of the basic and supportive cooperative participation levels

• Group members are heterogeneous

• Members take turn in complementary role teaching, learning, experimenting, and mentoring

• Goal is to complete the activity harmoniously and efficiently while enjoying the process

• Members balance task accomplishment with meeting social-emotional needs of group members

Purposeful Action

• Functional Group Actions

• Meaningful for individuals and the group as a whole

Self-initiated Action

• Functional Group Actions

• Members take initiative verbally and non-verbally

Spontaneous Action

• Functional Group Actions

• Actions occurs in the here-and-now

Group-centered Action

• Functional Group Actions

• Member’s actions are interdependent