ot7 - seven step format

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GROUP LEADERSHIP


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Professionalism carries with it an authority

and a directness of purpose which will need to

be practiced by students before they begin

interacting with patients.


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Seven-Step Format for Activity

Groups


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Step 1: Introduction

Members get to know and greet each other. The

therapist introduces himself among the members of

the group and the group does the same. In the

following sessions, it is no longer deemed necessaryto say their names out loud but the presence of each

member of the group is acknowledged by a simple

greeting.


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INCLUDES:

A. Warm-Up

The leader should be concerned with the receptivityof each member. The OTs should choose a warm-up

that challenges members enough to hold their

interest but is not beyond their capabilities. It

doesnt need to be a formal warm-up, a simple

conversation about how members are feeling is

enough.


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B. Setting the mood

Factors include the environment, the therapists facialexpression and manner of speaking and the media used.

C. Expectation of the Group

The therapists manner and expression should generally

reflect her expectation of the group. The therapist will always

serve as the model for the members to follow.


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D. Explaining the Purpose Clearly Usually depends on the type of group and the

patients level of understanding. A higher levelgroup of patients will want to know why they arebeing asked to do a particular activity. Lowercognitive patients are unlikely to understand suchabstract explanations of purpose. Goals mayneed to be spelled out in concrete terms.

E. Brief Outline of the Session

The timeframe, the media, and the proceduresare told. Gives clues to the members about thesessions focus.


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STEP 2

THE ACTIVITY


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Many factors should beconsidered whenplanning the activity. Thisis a complex process.

Selecting a therapeuticactivity involves theentire process of clinicalreasoning.

The following issues willbe presented forconsideration in selectinga therapeutic activity:

Timing

Therapeutic Goals

Physical and MentalCapacities of members

Knowledge and skills ofthe Leader

Adaptation of an Activity


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TIMING

The activity should be simple and short and should last nolonger than one third of the total session.

THERAPEUTIC GOAL

Goals and desired outcomes are something a patient and atherapist strive together to accomplish. A therapeutic goal forpatient involves assessing their needs and applying the therapists

knowledge of the patients abilities and disabilities. The group goalshould be chosen to meet the needs of most of the members. Oncethe goal is defined, an activity is selected or designed to helpmembers achieve that goal. If goals are more socially oriented,structured group task involves interaction of the members.

PHYSICAL AND MENTAL CAPACITIES OF THE MEMBERS

Selection of the activity or experience is further determined bythe physical and mental capacities of members.


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KNOWLEDGE AND SKILLS OF THE LEADER

Student leaders usually choose activities for the

group that they themselves are comfortable with orhave done before.

ADAPTATION OF AN ACTIVITY

Adaptation of the activity requires someknowledge of activity analysis and synthesis. Activityanalysis is the breaking down of an activity into its

component parts and matching each part with humanfunction required to accomplish it. Modifications canbe made in the activity to suit the patients abilities


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Step 3: Sharing

Sharing of work or experience with the group

The structure and process for sharing may

vary with each activity


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Making sure each members contribution is

acknowledged.

Acknowledgement may be done verbally or

nonverbally

Empathy is an important factor.

Therapist may need to support and encourage

client to share but if the member refuses then

it must be accepted.


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The order of members sharing does not

matter but it is easier to keep track if the

members just go around in circles

Volunteers are appreciated in a group sharing.

So that the client feel some control over the

group


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The Therapist can start to role model for the

group what is expected to be shared

Best Friend Exercise from Pfeiffer and Jones Therapist gets up standing behind a chair saying This is

my best friend, Beth

Moral Decision A group decision-making task which involves

extensive discussion as part of the activity


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Step 4: Processing

Most difficult step for student to learn

Inexperienced group leader often skip this

steps

It involves expressing how the members feels

about the experience, the leader and each

other


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If these emotions remain unexpressed, the

outcome of the group can never be fully

understood

Expressing feelings is not difficult if the

experience is positive but if it negative, people

often avoid expressing them.

Best way to release anxiety, embarrassment

and belittling themselves while doing an

activity


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Therapist has the opportunity to incorporate

them into the subsequent discussion and to

help the clients understand the significance ofthe feelings related to the group experience

It also includes discussion of the nonverbal

aspects of the group. Underlying issues (struggles for power and

control, subgrouping, scapegoating, conflict,

attraction and avoidance) are dynamics thatmay never be verbalized, but will have a

powerful influence on the group.


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Step 5: GENERALIZING

Addresses the cognitive learning aspects of

the group

The therapists mentally review the groups

responses to the activity, and sum them up

with a few general principles.

If the activity has gone as expected, some of

the general principles derived from the group

should closely resemble the original goals.


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The general principles discussed in the groupshould not be preplanned, but should comedirectly from the response of the members.

General principles may be arrived at in severalways:

A. Look at the patterns of response amongmembers: opinions they have in common/

Common elements of their stories. B. Look at areas of disagreement: conflicted areas

in the group

C. Groups energy: thx should follow up on issuesthat seem to energize the group and stimulatespontaneous conversation


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Step 6: APPLICATION

Therapist helps the group to understand how

the principles learned during the group can be

applied to everyday life.

Goal: each member should understand how

he will apply the results of this group

experience to help make his own life more

functional outside the group


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Step 6: APPLICATION

Knowledge of each patients background ishelpful. The therapist discusses with eachmember how the principles learned in the

group relate to the problems or issues eachhas expressed earlier.

Application may sometimes resemble a kindof group problem-solving: members help eachother find ways to apply the newly learnedinformation


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Step 7: SUMMARY

Purpose: to verbally emphasize the most

important aspects of the group so that they

will be understood correctly and remembered.

The points to emphasize should come directly

from the groups responses and may take 4-5

mins. It reviews the goals, the content, and

the process of the group


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Step 7: SUMMARY

Therapist asks the group members to help summarize

by remembering the activity and giving their ideasabout what was learned. General principles areincluded in the summary. Having members explaintheir own views of the group and how it can be

applied, reinforces the learning that took place. Emotional content of the group is also important to

summarize. One way for the therapist to acknowledgefeelings is to thank the members for their participation

in the group. Addressing and thanking individuals fortheir openness, honesty, and willingness to share ortrust in the group is always welcomed.


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Step 7: SUMMARY

Final responsibility of the therapist is to end

the group on time. if the group is well planned

and led, this will mark the completion of all

seven steps. If for some reason, all the stepshave not been completed by the end of the

session, the missing parts and the reason s for

this can also be discussed within thesummary.


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Step 7: SUMMARY

Before leaving the how to section, for

additional factors of leadership need to beexplored:

1. Group motivation

2. Setting limits

3. Leadership styles 4. Co-leadership

All are the responsibility of the leader and shouldoccur throughout the seven steps as they areneeded.


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LEADERSHIP STYLES


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Leadership styles profoundly affect the

outcome of the group

Different FORs require very different

leadership approaches

3 fundamental leadership styles:

Autocratic

Democratic

Laissez-faire


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Directive Leadership

Directors defines a group, selects activities, andstructures the group

Uses authority sparingly

If too much authority, may feel inadequate andcan stunt growth and development

Absolutely necessary for lower functioningpatients

Therapists decision should not be based on ownpreference, but on expert assessment on theneed of the group


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Facilitative Leadership

A facilitator is a resource person

Provides information, equipment or supplies

Gains support from members by allowing

them to make choices and shows care andconcern for members

Facilitators also are educators

Facilitations also has limitations

MOHO depends on a facilitative leadershipstyle


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Facilitation is most useful in motivating

patients and getting them invloved

The more cognitively aware they are, the

more they resent goals that are imposed on

them


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Group Leader as Adviser

-The most passive of the leadership styles

-Its use in therapy is limited to the highest functioninggroups working on goals like problem-solving orattitude change

-The adviser offers expertise as needed or requested,but does not provide structure or goals. Motivationcomes from the group itself, and change is producedintrinsically as a result of internal processes of each

member.

-FORs for which adviser leadership is most appropriateare psychoanalytic, humanistic and MOHO


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General Principles of Group Leadership

Designing the group involves:

choosing the members

setting or acknowledging the goals

setting the time and place

organizing the environment

and choosing the activity or media.


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The ongoing functions of the group are: to

help achieve its goals (task function) and helpmaintain the groups integrity (maintain

function).

Setting group norms (confidentiality, respect)

Giving members feedback and helping

members to give and receive feedback

keeping the communication channels open is

vital to the survival and growth of groups

ot7 - seven step format

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