Planning Groups

Preparing a SessionChapter 4

SomayaMalkawi, PhD

Outline:

Aims Aims and and GoalGoal

ss

ChooChoose an se an ActivActivityity

StrucStructure ture the the

SessiSessionon

Aims and GoalsAims and Goals

Importance

Establishing effective aims and goals is the most critical aspect of planning a group treatment session.

The value of Aims and Goals:

1.To ensure purposeful activity.2.To provide policies and guideline for

structuring the session.3.To provide the criteria for

evaluating the group. 4.To motivate and direct the patient

or client.5.To monitor patient or client

progress.

A. Establishing Group A. Establishing Group AimsAims

Activity Groups (task) Support Groups (social emotional)

To develop work skills To explore feelings

To encourage leisure interests To encourage members to give each others support

To develop task performance skills

To gain confidence

To increase knowledge of a craft technique

To develop trust in other group members

To learn the use of community leisure facilities

To share ideas

•Woodwork•Gardening

•Bingo•Pottery

•Swimming

•Discussions•Social Skills training

•Drama therapy•Psychotherapy

Other Dimensions in a continuum

• A) OrientationEnd Product_ _ _ _ _ _ _ _Group Process

• B) DevelopmentIndividual Development_ _ _ _ _ _ _ _ Group Development

• C) Directedness Therapist Directed _ _ _ _ _ _ _ _Group Directed

Examples

1. Work Group2. Bread Baking Session3. Psychodrama Session4. Craft Session5. Supportive psychotherapy group

Examples on continuum

TASK SOCIAL/EMO

D.I.Y. group Cooking Quiz Discussion Psychodrama

1. Work Group

Task Skills _ _ _ _ _ _ _ _ _ _ _ _ _ _ Social EmotionalEnd Product _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Group ProcessIndividual Dev_ _ _ _ _ _ _ ___ _ _ _ _ __Group DevTherapist Directed _ _ _ _ _ __ _ _ _ _ _ Group Directed

3. Psychodrama Session

Task Skills _ _ _ _ _ _ _ _ _ _ _ _ _ _ Social EmotionalEnd Product _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Group ProcessIndividual Dev_ _ _ _ _ _ _ ___ _ _ _ _ __Group DevT. Directed _ _ _ _ _ __ _ _ _ _ _ Group Directed

B. Formulating B. Formulating GoalsGoals

• Goals (Objectives): Precise statements of intended results,

and serve as measurable targets for both patients or clients and therapists.

EFFECTIVE

Group Goals vs. Individuals’ Goals

Group Individual

State what the members will achieve by the end of the session

What is expected of each clientTHEORY INTO PRACTICE

-Aims: -Group goals:

1. Learn the difference between being passive/assertive/aggressive2. Share/disclose assertion situations experienced as difficult3. Use appropriate assertive behavior in at least one role play4. Demonstrate confident body language in a role play and maintain

eye contact, relaxed…-Goals of the individual:-Keith is a problem drinker and has difficulty asserting himself when he is with his friends. In particular, he is unable to say :no” when pressed to have an alcoholic drink. One of Keith’s goals is to say “no” confidently, politely and without wavering, in response to group pressure offered in a pub role play situation.

Choosing the ActivityChoosing the Activity

Factors influencing choice of activity:

Structuring the SessionStructuring the Session

How?

1. Orientation2. Introduction3. Warm-up4. Action5. Wind-down6. Post group

Orientation: Welcome members and offer tea as they arrive

Introduction:10 minutes

a) Introduce self, then ask each person to say their names

b) Acknowledge newness of group to all membersc) Establish aim of not trying to paint “pretty” pictures

but to express self and gain support d) Describe typical format of painting then talking

about picturee) Ground rule laid down of no interpretation of

paintings expect by the individual.

Warm-up: (6 min)Painting to music consisting of different moods and

tempos. Aim to have fun, relax group, introduce notion of expressing through painting. Brief

feedback comments at end.

Action:a)How I see myself, what is important to me in my present lifeb)How I would like to beEach painting to take ~ 15 min including sharing and discussion time.

Wind Down:a)group pictureb)Feedback about the groupc)Each client to say one positive thing about today’s session.

Post group:~ 30 min to write notes and feedback to team

The environment

Planning groups:preparing a session

• When we plan a group, we need to pay as much attention to organizing the environment as we do to devising the group activity.

• This involves attending to concrete, practical aspects and involves also abstract considerations.

Practical aspects

• Take into account furniture, equipment and physical safety.

furniture• Do we need chairs and tables or would

cushions be preferable?• How should the furniture positioned?• Should separate work table be used to

separate members of different functioning levels?

The important of furniture layout

members

teacher

• Members are being given information. Person in the teacher role takes a directive and authority position. Members are expected to be more passive and listen. Group discussion is probably not being encouraged.

Members

teacher

MembersMembersMembersMembers

• Members are expected to share in a discussion which is led by the person in the leader role. Group interaction may be encouraged but the teacher retains overall control.

Teacher and members

• Group discussion is being encouraged in this situation. The leader may facilitate the discussion or simply respond as another group member. The discussion may be less under the leader’s control.

Equipment and materials• Should be planned In advance and we should

ensure that they are in adequate working condition.

• Recording devices; example video camera is to be used in the group session, have the members agreed to be filmed?

• (consent form )……..

Physical safety• Safe handling materials, equipment and

substances. • Adequate light, warmth, ventilation and space

for comfort.• Kind of the activity (energetic)

Abstract aspects• The environment can communicate much

about expectations and can set the scene by creating an atmosphere and promoting emotional safety.

• When we try to create an atmosphere, we first need to consider whether or not our group room has any other functions and associations which might impinge on the member’s experience.

• Often we take steps to create a positive atmosphere by offering a nurturing touch, such as providing tea, biscuits to end a group.

• Also we put a relaxant music.

Emotional safety• Having a room which is private and free

interruptions is fundamental to any group where feelings are being expressed and building trust is a key aim.

• Often closing the group room door is the signal to being the group.

Grading and Adaptation of treatment• We grade the demands of the activity and the

amount of stimulation or pressure within the environment.

• We adapte an activity to suit the background, ability and values of an individual and the circumstances within a situation.

• P.110-115

adaptation

• 4 common reasons why we might need to adapt:

• To allow for different levels of skills, experience, motivation and involvement

• To cope with unexpected events• To offer choice• To better meet the values and socio-cultural

background of individual

• We manipulate 2 variables :• 1. activity: complexity: the amount of skill the

activity demands.• Novelty: the familiarly or newness of an

activity• Uncertainty: the element of predictability and

chance…. No one understand…. AnxietyToo obvious…… boring• 2. role

Motivating group members• One dilemma that continually confronts us is

what to do with patients an clients who are reluctant to join an activity or group.

The reluctant attender• 5 scenarios are offered with some ideas

about how then to handle the situation.1. The individual feels the OT group will not be

beneficial or relevant. “try-it-you-might-like-it” approach may work explain the aim and the benefits of the group.

2. Ignorant or feels confused about what the group offers.

Clear but gentle explanation is the response frequently required in this situation.

3. Lacks drive and feels apathetic and disinterested. (client who are institutionalized)

Find a motivator that will increase the meaningfulness of the activity for the person. (reinforcement )

4.anxious, worried, suspicious or simply unsure of what to expect.

Reassurance in the form of “it will be all right-nothing to worry about”

5. External factors such as wider group dynamics. The individual may be modeling on other patients who are refusing treatment.

Understanding exactly what is happening.Efforts should be made to sort this out directly,

through negotiation or confrontation, rather than act it out through a confused patient.

Encouraging attendancePositive strategies• a) persuasion by explanation• b) negotiated contract• c) preparatory interview• d) involvement in planning

Negative strategies