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Therapeutic groups - University of Maryland, Baltimore

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Therapeutic groups
Victoria Selby, MS, PMHNP-BC
Define a groupDescribe components of a small groupCompare the stages of group developmentAnalyze small-group factorsExamine responsibilities and qualities of nurses as group leaders and the types of groups theyleadIdentify special considerations for groups in the acute care setting
What is a group?
A collection of peoplewho havea relationshipwith one another, are interdependent,and havecommonnormsEach group has its own structureGroup power = content + process by the leader & the members
Group tasks
Primary – main purpose of the group (intrinsic to the survival of the group)Secondary – other gains
Components of small groups
Structure - underlying order; includes boundaries, communication, decision-making processes, authority relationships; offers stability and helps regulate behavior and interactional patternsGroup size - 7-10 idealLength - duration20-40 min.lowerfunctioning60-120 min.highfunctioningCommunication - feedback, group dynamics, patternsRoles are determined by behavior and responsibilities of group membersPower - Ability to influence groupNorms - group behavior (standards,expectations)Qualityof communication andinteractionConformingto thegroupTowardgroup goals and tasksCohesion - strength of members' desire to work together toward commongoals
Group roles and functions:
Maintenance roles – involve the group process and functionEncouragerHarmonizerCompromiserGatekeeperFollowerRule makerProblem solver
Group roles and functions:
Task roles – deal with completing the group’s tasksLeaderQuestionerFacilitatorSummarizerEvaluatorInitiator
Role of the group leader
Plans the groupEstablishes a therapeutic relationshipStudies the group and participatesCreates asafe space for challenge ofauthority, ideas, facilitate the group process toward the goalsIdentifiesthemesTakes opportunitiesto practice conflict mgmt, assertive communicationUses humor
Shared responsibilities of the leadership roleWill influence the group in various waysSharing group observationsDivides the work and increases diversity of ideas/creativityRole modelingMay divide the groupMay result in competition
Group roles and functions:
Individual roles – those that are not related to the tasks and maintenance of the group.MonopolizerSeducerMute/silentComplainerTruant or latecomerMoralist
Planning a group
Essentially : Where? When? Why? How? Who?Establish goalsCriteria for membership selectionExpectationsOpen and closed groups
Phases: Orientation (Forming)
Leader is directiveEstablish rulesUse of "we", "our"Evaluation of self, others, and fit into the group
Phases: Conflict (Storming)
Who is making decisions?HierarchyAccept the shared responsibilityAssess resources and limitationsHostilities toward the leader and members
Phases: Cohesive (Norming)
Desire to work togetherSharing, self-disclosureDifferent views occur without destroying the group (leader facilitates this)Value of differences and similarities
Phases: Working (Performing)Yalom’scurative factors
Imparting informationInstillation of hopeUniversalityAltruismCorrective reenactmentDev. Of social interaction techniquesImitative behaviorsInterpersonal learningExistential factorsCatharsisGroup cohesion
The end of the Group
Termination phaseGroup as a whole or individualsEvaluationRating scalesProgress notesOutcomes
Groups in the acute care setting
Rapid patient/client turnoverVariety of disordersLack of time to establish relationship pre-groupGroup boundariesGroup leader is involved with the group throughout the dayMultiple staff lead the “same” group
(Yalom, 2005)
Types of groups
Task groupsSelf-help groupsEducational groupsSupportive therapy groupsPsychotherapy groupsPeer support groups
Stuart, G. W. &Laraia, M.T. (2013).Principles and practice of psychiatric nursing (10thed.)St. Louis, Missouri: Mosby Elsevier.Yalom, I.D. (2005).The theory and practice of group psychotherapy (5thed.). New York, N.Y.: Basic Books.





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Therapeutic groups - University of Maryland, Baltimore