Final Exam Flashcards
Group definitions (4 points)
a gathering of two or more people based on a common goal
- a dynamic interaction among people
- group consciousness that exists among members
- NOT simply a random mix of people ….a group implies a connection between members
Therapeutic Group
formalized process where there is a gaol, and there is expected change in knowledge, skills or personal beliefs
Why Groups (4 points)
a natural environment to promote social interaction
- some outcomes can only be achieved in groups
- convenient in setting with homogeneous client populations
- Perceived as cost-effective by administrators
11 Therapeutic Factors
- Installation of hope
- Universality
- Imparting information
- Altruism
- Corrective recapitulation of the primary family group
- Development of socializing techniques
- Imitative behaviour
- Interpersonal learning
- Group cohesiveness
10 Catharsis - Existential factors
Historical evolution of OT groups 7 time periods
-Promoting moral treatment of patients
-1920’s and 30’s: Project era
-1937 - 1953: Socialization era
-1954 - 1961: Group dynamics-
1962-1969: Psychodynamic era
1970s to 90s: adaptive era
1990 to present : wellness era
What makes it an OT group?
common characteristics:
- Groups are one type of “client”
- The CPPF addresses individual or group clients
Common characteristics:
- small group (6-10members)
- Task oriented vs. verbal
- Focused at increasing performance or specific skills
- Directed at increasing skills for daily living
Why do OTs use therapeutic groups as a means of change?
-members can…… (4 points)
- Experience feeling of belonging
- be with others who have common problems that can be shared
- observe the problems, struggles, behaviours, interactions styles and coping mechanisms of the others
- Experience support to enable individual growth
Ot group Advantages
- Provide an occupational-based experience
- Natural environment for social support, teaching and learning
- Empower group with shared leadership and opportunities to excel
- Can be cost-effective ….
- -> BUT requires therapist skill to ensure individual attention
Leadership Functions
- Emotional activation
- Caring
- Meaning attributions
- Executive function
Group formats (4 main points)
- Less structure and more client choice:
- -> higher quality social interactions and increased personal meaning
- Need to tailor structure to functional levels of participants
- The occupational base of groups can have a positive effect on member wellness
- must balance activity with member interaction
Where do OT groups happen and why?
Duncombe and Howe (1985) survey (300 surveys with 40% response rate)
- 60 % of respondents used groups asa form of treatment
1. large general hospitals
2. Schools
3. rehabilitation centers and psychiatric hospitals - types of groups used included exercise, cooking activities of daily living, task, arts and crafts, self-expression, feeling-oriented discussion, sensorimotor and sensory integration, and education groups.
Duncombe and Howe (1993) survey (309 surveys with 62% response rate)
- 52% of respondents used group as a form of treatment
- Fewer therapists in hospitals and more in community programs and schools
- Most groups activity based and fewer were discussion based
Higgins, Schwartzberg, Bedell and Duncombe, 2014 ( 323 respondents with 273 complete online surveys (85%) using snowball sampling through state associations (8%% OTs and 14% OTAs)
-50% of OT respondents used groups in current practice
-69% of OT respondents had some kind of training or education on therapeutic groups
Settings:
1. School
2. Hospitals
3. Outpatient settings
-Exercise, including yoga and range of motion, was the most common group modality used, with task groups and sensory-based groups reported as high use
-groups use increases directly with years of experience for occupational therapists, with the highest group use by occupational therapists with more than 20 years of experience
Higgins, Schwartzberg, Bedell and Duncombe, 2014 (the reported benefits of group treatment seemed to fall with two categories)
a) environmental benefits, which include time and cost-effective forms of treatment
b) vclient factors, which include peer role modeling and support, improved communication and social performance and feedback and advice from peers
Figure 1. Practice area by role (OT and OTA )
Higgins, Schwartzberg, Bedell and Duncombe, 2014
OT: 1. School 2. OPT 3. Hospital 4. Other OTA: 1. LTC 2. School 3. Rehab 4. Hospital
Higgins, Schwartzberg, Bedell and Duncombe, 2014
Benefits of group treatment
Feedback cohesiveness communication/Participation Self-Esteem Instillation of hope Role Modeling Insight and Learning Skill Performance Goal Outcome Time
The changes over time from 1985–>1993–>2014 (4 points)
- Groups remain an important intervention for OTs
- 50-60% of respondents used groups as a therapeutic modality
- decreased use over time in physical health settings
- Consistent in mental health settings
- Increased in school and community settings
Group Norms
Shared expectancy of what is appropriate
-should be made explicit, particularly in groups that are long term, involve risk or personal investment for members, and/or deal with personal issues
Group major characteristics (5) Of what a group is
- Dynamic interaction among members
- A common goal
- A proper relationship between size and function
- A dependence on volition and consent
- A capacity for self-determiniation
Group Structure is influenced by a number of elements including:
- Historical context and climate
- Composition of members
- Group purpose and member goals
- Leader and member interaction
- Group norms and size
Historical Context and climate
historical and environmental context
historical: elements of social and environmental context outside the group, is a unique factor influencing the structure of the group
environmental: the mission of the group
climate: physical and interpersonal or emotional environment
Group Composition
Open versus closed groups
number of sessions
Voluntary or involuntary membership
Two factors that have found to attract members to a group are:
- The group itself is viewed as desirable object, and
2. Group membership is viewed as a way to satisfy needs that exist outside the group
Group Purpose and goals
-composite of the goals of individual members
-groups fare better when members are clear about the group’s purpose and goals as well as their individual goals
might have more than one goal
might have individual goals
spend more time together on objectives agree on goal faster