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Therapeutic groups - University of Maryland, Baltimore

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Therapeutic groups
Victoria Selby, MS, PMHNP-BC
Objectives
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
Co-leading
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
OrientationConflictCohesiveWorking
FormingStormingNormingPerforming
Yalom
Tuckman
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
References
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