Planning Groups Preparing a Session Chapter 4 SomayaMalkawi, PhD

1. Planning GroupsPreparing a SessionChapter 4SomayaMalkawi, PhD

2. Outline: 1 3 2 Aims and Goals Structure the Session Choose an Activity

3. 1 Aims and Goals

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

5. The value of Aims and Goals: • To ensure purposeful activity. • To provide policies and guideline for structuring the session. • To provide the criteria for evaluating the group. • To motivate and direct the patient or client. • To monitor patient or client progress.

6. A. Establishing Group Aims • Woodwork • Gardening • Bingo • Pottery • Swimming • Discussions • Social Skills training • Drama therapy • Psychotherapy

7. Other Dimensions in a continuum • A) Orientation End Product_ _ _ _ _ _ _ _Group Process • B) Development Individual Development_ _ _ _ _ _ _ _ Group Development • C) Directedness Therapist Directed _ _ _ _ _ _ _ _Group Directed

8. Examples • Work Group • Bread Baking Session • Psychodrama Session • Craft Session • Supportive psychotherapy group

9. Examples on continuum TASK SOCIAL/EMO D.I.Y. group Cooking Quiz Discussion Psychodrama

10. 1. Work Group Task Skills _ _ _ _ _ _ _ _ _ _ _ _ _ _ Social Emotional End Product _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Group Process Individual Dev_ _ _ _ _ _ _ ___ _ _ _ _ __Group Dev Therapist Directed _ _ _ _ _ __ _ _ _ _ _ Group Directed

11. 3. Psychodrama Session Task Skills _ _ _ _ _ _ _ _ _ _ _ _ _ _ Social Emotional End Product _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Group Process Individual Dev_ _ _ _ _ _ _ ___ _ _ _ _ __Group Dev T. Directed _ _ _ _ _ __ _ _ _ _ _ Group Directed

12. B. Formulating Goals • Goals (Objectives): • Precise statements of intended results, and serve as measurable targets for both patients or clients and therapists. EFFECTIVE

13. THEORY INTO PRACTICE • Aims: • Group goals: • Learn the difference between being passive/assertive/aggressive • Share/disclose assertion situations experienced as difficult • Use appropriate assertive behavior in at least one role play • 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. Group Goals vs. Individuals’ Goals

14. 2 Choosing the Activity

15. Factors influencing choice of activity:

16. 3 Structuring the Session

17. How? Orientation Introduction Warm-up Action Wind-down Post group Orientation: Welcome members and offer tea as they arrive • Introduction: • 10 minutes • Introduce self, then ask each person to say their names • Acknowledge newness of group to all members • Establish aim of not trying to paint “pretty” pictures but to express self and gain support • Describe typical format of painting then talking about picture • 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. • Wind Down: • group picture • Feedback about the group • Each client to say one positive thing about today’s session. • Action: • How I see myself, what is important to me in my present life • How I would like to be • Each painting to take ~ 15 min including sharing and discussion time. Post group: ~ 30 min to write notes and feedback to team

18. The environment Planning groups:preparing a session

19. 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.

20. Practical aspects Take into account furniture, equipment and physical safety.

21. 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?

22. The important of furniture layout members teacher

23. 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.

24. Members Members Members Members Members teacher

25. 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.

26. Teacher and members

27. 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.

28. 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 )……..

29. Physical safety Safe handling materials, equipment and substances. Adequate light, warmth, ventilation and space for comfort. Kind of the activity (energetic)

30. 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.

31. 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.

32. 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.

33. 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

34. 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

35. 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…. Anxiety Too obvious…… boring 2. role

36. 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.

37. The reluctant attender 5 scenarios are offered with some ideas about how then to handle the situation. 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.

38. 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 )

39. 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.

40. 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.

41. Encouraging attendance Positive strategies a) persuasion by explanation b) negotiated contract c) preparatory interview d) involvement in planning Negative strategies

42. Any questions? What’s Your Message?