Intervention in Groups

Professor Fickley

Group, Defined

• A collection of individuals whose association is founded on shared commonalities of interest, values, norms, or purpose

What's the difference…..

• Therapeutic groups vs. group therapy

• Group therapy- has a sound theoretical base, leaders have advanced degrees in psychology, social work, nursing, or medicine. Focus is upon long term issues and process. Ex: Adult abuse survivors

• Therapeutic groups are based to a lesser extent on theory. Focus is on group relations, interactions among group members, and the consideration of a selected issue. Ex: Anger management

•

8 Functions of a Group

• 1.Socialization- teaching of social norms occurs through group interaction.

• 2.Support- fellow group members are available in time of need.

• 3.Task completion- groups can assist in endeavors that are beyond the capacity of one individual alone.

• 4.Camaraderie- receive joy and pleasure from interactions with significant others.

Functions Continued

• 5.Informational- group members share their knowledge with the others in the group.

• 6.Normative- groups enforce established norms in various ways.

• 7.Empowerment- change can be made by groups at times when individuals alone are ineffective.

• 8.Governance- leadership that is provided by groups rather than by a single individual.

Types of Groups

• Task groups- formed to accomplish a specific outcome or task.

• Teaching groups- focus is to convey knowledge and information to a number of individuals.

• Supportive/therapeutic groups. - teaching the participants effective ways of dealing with emotional stress arising from situational or developmental crises.

Types of Groups (cont.)

• Self-help groups

• Composed of individuals

with a similar problem

• Serve to reduce the possibilities of further emotional distress leading to pathology and necessary treatment

• May or may not have a professional leader; run by members; leadership often rotates from member to member

Types of Groups cont:
Creative Arts Therapy Groups

• Music Therapy

• Pet Therapy

• Art Therapy

• Drama Therapy

• Recreational Therapy

• Psycho-occupational Therapy

Conditions that Influence Group Dynamics

• Seating- no barrier between the members; for example, a circle of chairs

• Size- seven or eight members provide a favorable climate for optimal group interaction and relationship development

• Structure- Must have rules, structure or outline and be supported by treatment team

• Leader- must be knowledgeable about group process (the way in which group members interact with each other) and group content (the topic or issue being discussed in the group).

Leader can be autocratic, democratic or laissez-faire

Open and Closed Groups

• Open-ended groups – members

leave and others join at any time

during the existence of the group ( Ex: AA,NA)

• Closed-ended groups – all

members join at the time the

group is organized and terminate

membership at the end of a

designated period ( Ex: Divorced women who meet for 6 weeks, no new members permitted)

Phases of Group Development

Phase I. Initial or orientation phase

Phase II. Middle or Working Phase

Phase III. Termination or Final Phase

How do groups help???
Yalom’s 11 Curative Factors!!

• Instillation of hope. By observing the progress of others in the group with similar problems, a group member garners hope that his or her problems can also be resolved.

• Universality. Individuals come to realize that they are not alone in the problems, thoughts, and feelings they are experiencing.

• Imparting of information. Group members share their knowledge with each other. Leaders of teaching groups also provide information to group members.

Curative Factors of Groups (cont.)

• Altruism. Individuals provide assistance and support to each other, thereby helping to create a positive self-image and promote self-growth.

• Corrective recapitulation of the primary family group. Group members are able to reexperience early family conflicts that remain unresolved.

• Development of socializing techniques. Through interaction with and feedback from other members of the group, individuals are able to correct maladaptive social behaviors and to learn and develop new social skills.

Curative Factors of Groups (cont.)

• Imitative behavior. Group members who have mastered a particular psychosocial skill or developmental task serve as valuable role models for others.

• Interpersonal learning. Group offers varied opportunities for interacting with other people.

• Group cohesiveness.

Members develop a sense

of belonging rather than

separating individual

(“I am”) from group (“we are”).

Curative Factors of Groups (cont.)

• Catharsis. Within the group, members are able to express both positive and negative feelings.

• Existential factors. The group is able to assist individual members to take direction of their own lives and to accept
responsibility for the quality
of their existence.

The Family as a Group

• Family Therapy: focus of the treatment is on the family as a unit

• Goal: to identify and change problematic, maladaptive, self-defeating, repetitive relationship patterns

• Bowens Theory: The family is viewed as a system in which the members are interdependent. A change in one part (member) within the system affects or creates change in all the other parts (members).

Genograms

• A study of multiple

generations within a

family

• Identifies roles of specific individuals

• Highlights relationships among family members

• Reveals a large amount of information in a small amount of space

• Can be used as a teaching tool with families

Role of Nurse in Group Intervention

• Nurses who work in psychiatry may lead various types of therapeutic groups, such as client education groups, assertiveness training, support groups for clients with similar problems, parent groups, transition to discharge groups, and others. Medical nurses may lead groups on common diagnosis with patients and families.

• Design groups for populations, structure groups and assure they take place

• Guidelines set forth by the American Nurses Association specify that nurses who serve as group psychotherapists should have a minimum of a master’s degree in psychiatric nursing.

Nurse Role in Group

• Family therapy may be conducted by Advanced Practice Nurses

• Generalist Nurses should have knowledge of family dynamics and contribute to the assessment and planning phases of family therapy and to ongoing observation and evaluation.

Exercise! A Fish Bowl Group

• Need 6 volunteers to be group members to form an inner circle

• Remaining students form an outer group around the inner circle

• Volunteers will receive a card asking them to assume a ROLE in the group

• Students will observe the group and identify the roles and dynamics occurring in the inner group

• Modified :FADavis