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Use of Self Final

Terms in this set (42)

What is a group
An aggregate of people who share a common purpose and who are interdependent in the achievement of that purpose (1973). -Mosey (Developmental theorist)
Primary Groups

Secondary Groups
offering close face-to-face and personal relationships
--Support groups

more formal, distant, or task-related in nature and less personal
--Legislative committees
Why do OTs use Groups (6)
Time and money
Some People are more comfortable in groups
Learn from each other
Motivation
Altruism
Social Participation
THEORIST named RUDESTAM: Five advantageous group actions that support using groups as therapy
Miniature society leads to feelings of belonging
--Being part of a community

Common problems can be shared and solved

Observation of others allows one to assess the self in comparison to others
--My broken thumb isn't near as bad as that amputation

Facilitation of individual growth occurs through support

Economics suggest that groups save time and money
--Need to find out what medicare considers a group
Consider psychologist Yalom's ten categories of therapeutic factors of groups
Imparting of information
-- (giving advice to OT students coming in)

Installation of hope
--(teaching people who have lost their hair to chemo and teaching them to tie a headpiece)

Universality
--(all first year students in OT are stressed)

Altruism
--(habitat for humanity, meals on wheels)

Family reenactment
--Role play or ask them to speak to an empty chair

Development of socialization techniques
--(teaching women to give manicures)

Imitative behavior
--watch and do (workout classes, fieldwork)

Interpersonal learning
--(meditation)

Cohesion
--(teamwork)

Catharsis
--Emotional release (acting class, chair's hour)
Implicit Norms

Explicit Norms
It's often implied that group members will respect one another (the norm is not stated but understood by everyone in a civil society)
--Implicit: you wouldn't kick your feet up and drink your coffee on the first day.

It may be necessary to be more explicit about instructions for cleanup (the norm is openly stated or posted or written out for the group)
Norms is Democratic Groups

Norms in Directive Groups
Democratic:
Lead members to discuss/determine the group's norms
--If you have an investment in something the democratic group would work better

Directive:
Leader states norms outright as part of the expectations for membership
How to Convey some Norms in a group (7)
Probe to seek understanding: Can you tell me what happened in group today?

Assert negative feelings: I was disappointed today when you...

Instructional mode: When you say things like that, others may get hurt (natural consequences).

Set limits: If you continue to....I will ask... (imposed consequence)

Appeal for collaboration: I'd like your help with keeping the group a safe place...

Empathize: I understand that you may have felt....but........

Negative inquiry: Was there something that I did to offend you?
Possible Responses to the stated Norms
Conform to the norm

Try to change the norm

Remain deviant relative to the norm

Leave the group (personal or leader decision)
Therapist-Patient Strategies (8)
Direct Appeal to Values
Support from Routine
Removing Seductive Objects
Interest Boosting
Proximity Control
Planned Ignoring
Signal Interference (Ahem)
Support from Humor
Two types of group protocols in occupational therapy
General protocols (Description of the plans for a typical cooking group)

Session protocols or plans (Plan for a specific cooking group on one particular day).
--You will create a session protocol.
General Protocol Examples
For leading a group Type

Time and/or Money Management
Community Cooking Group
Prevocational Group
Goal Setting Group
Collage
Stress Reduction
Sexual Identification Activities
Learning to Organize
Our Practice Group Plan Protocol
1. Title of Group
2. Purpose
3. Brief description of activity
4. Supplies and equipment needed
5. Goals of the group
6. Questions for discussion in:
--Processing
--Generalizing
--Application
7. Points of summary
Narrative Group Note

Narrative Individual Note
a note about the entire group's process and performance

a note about the performance of an individual member within a group
Prevention of Conflict
Stressful incident occurs

You can make the situation worse or better

Stop- think- choose!
Problem-solve
Self monitor
Anger management/replacement training
1) Cognitive Reappraisal

2) Mindfulness
1) looking at the situation to see if there are non-hostile interpretations of another's actions

2) be aware of what is happening versus being subjected to the experience
Conflict Management Strategies (5)
Forcing- using formal authority

Accommodating- allow the other party to satisfy their concerns while neglecting your own

Avoiding- not paying attention or trying to resolve the conflict

Compromising- partially satisfying parties but not completely satisfying either

Collaboration- cooperating for win-win solution
To Collaborate, you must first ___
LISTEN
Helpful Conflict Resolution Strategies (5)
Active listening
Negative inquiry
Limit setting
Compromise
Assertiveness
Leadership Strategies designed to reduce Conflict
Establish and share clear norms.

Use structure that fits the developmental level and interpersonal readiness.

Have clarity of purpose for the group.

Assure that there is salience and goodness of fit of activities to population.
Nick Long's Strategies to reduce conflict (12)
Direct appeal to values
Support from routine
Removing seductive objects
Interest boosting
Hurdle helps
Proximity control
Planned ignoring
Signal interference
Support from restructuring
Support from humor
Antiseptic bouncing
Physical restraint
Limit Setting Methods to reduce Conflict (8)
Redirect or offer alternatives
Compromise
Empathic refusal
Broken record
Corrective feedback
Natural consequences
Imposed consequences
Commenting on patterns of behavior (of group members)
Signs that you need to implement Team Building (9)
Decrease productivity
Conflicts and hostility among members
Missed signals or confusion
Decisions misunderstood
--When you see the word misunderstood you think of the word communication
Apathy and lack of involvement
Lack of initiation and creativity
Complaints of discrimination or favoritism
Low participation
Complaints about the quality of the service
Team Building
Unites a group around a common goal
--Members share expectations for accomplishing group tasks
Each member's ideas are valuable
Be aware of unspoken feelings of members
--They don't want to be vulnerable
--Not wanting to hurt someone elses feelings
--Don't want to burden other people
--We don't want out emotions to take over us (embarrassed)
Resolve smaller disputes with focus on long term goals
Communication must be clear
--COMMUNICATION, COMMUNICATION, COMMUNICATION
Encourage trust and cooperation
--Start with trust from the beginning
Ways to promote Team Building
Delegate problem-solving tasks to the team
Facilitate communication by remaining open to suggestion
Establish team values and goals
Have clear (measurable) objectives (goals)
Have group norms
Arrive at a consensus
Encourage brainstorming
Leader's Role during a conflict
information seeker, harmonizer (they want things to move smoothly), clarifier, & energizer

Clarify similarities and differences
Keep discussion from becoming tense and ugly
--Redirect
--Limit set
Listen closely
Try to get people to listen to each other and find some commonalities
Clarify consequences of different actions
Energize by engaging group in an activity other than griping
Go with consensus not majority!
Handling a DOZER
Call by name and ask if the person is OK

Give positive feedback for having come to group in spite of fatigue

Sit near the person, pat or rub arm occasionally

Get active with the group: Stand to chat for awhile. Do some stretches. Swap chairs for everyone for a change of pace

Clinic: If you have snacks or coffee, encourage their use. Hard candy in wrappers is great to have, but be aware of diabetic needs.

Ask person if OK with a member's seated nearby helping to keep him/ her alert
A Group Introduction
Must include some brief and salient OT definition (targeting your group). This is a good habit to get into.

Must include an overarching paraphrase of your group's rationale. You may refer to a sign or poster (tape only to the window!)

Must include any reminders you believe that you may need to make about the group's norms. Norms could be posted on board or poster and the posting simply mentioned.
Discussion of Group
Start with an open-ended question

DO NOT share personal experiences during this time

You may build on an experience that the members have had and link it to a real-world application
Why do OTs lead Discussions?
Because OT discussion deepens knowledge and understanding of human occupation and related performances (ADL, social participation, work-- and performance skills necessary for occupation).

Because OT discussion taps cognitive, affective, and behavioral functioning observed in discussions

Because OTs focus on client/patient participation that includes verbal engagement within various communities and groups.

Because discussion is said to let members feel included in "making the group" what it is. Discussion is client-centered and collaborative behavior.
Environmental/Structural activities that can help individuals engage
Creating smaller subgroups for a verbal activity groups often invites quieter members to engage in the larger discussion group later. Asking someone to tell something to a partner in the activity can help that person share later

Assigning role play pairs or scenarios to everyone will press them all to engage

Happy circle will promote better discussion than sitting at long tables
Rationale Statement
is part of the justification that you would give an administrator or a billing agency for establishing the group.

A statement that substantiates that your group members need this group
The Group Purpose
A statement of what you want the group members to accomplish and how.

EX: To increase job search and interview skills (what) through the use of campus base computers and simulated interviews (how).
General Goal Statement
The goal should align with and closely resemble the group's rationale/purpose statement.

ADDITIONALLY, the goal should have a measure.

General goals describe goals (outcomes) for the group in general and over a period of time. A group will run for several weeks or months with such goals in mind.

Ex: Group members will improve at least 3 of their gross motor skills through engagement in a variety of recreational activities.
Session Goals
are goals for one session

These are goals are what you want each group member to achieve as a result of participating in your group on one specific day.

EX: Each group member will lift at least 2 objects weighing 20 lbs or more using good body mechanics during simulated household tasks.
Culture
The customary beliefs, social forms, and material traits of a group

The set of shared attitudes, values, goals, and practices of a group

The integrated pattern of knowledge, belief, and behavior that is learned and transmitted from one generation to the next

Transmission: Family, school, social media, blogs, and story telling
A culturally competent therapist is...
aware of and sensitive to his or her own culture,

aware of and willing to explore his or her own biases and values,

respectful of and sensitive to diversity among individuals,

knowledgeable about another's culture

skilled in selecting and using culturally sensitive intervention strategies
The ___ is thought as somehow ___and a cause for disregard, stereotyping, separation, or outright exclusion.

Our alternative: See otherness as ____ that invites our discovery and understanding
Other

Lesser

Uniqueness
Stereotypes
Overgeneralizations or oversimplifications (white men can't dance; all birthday parties have cakes and candles; women are poor at math) sometimes based on our own culture

Attributions/assumptions that lack consideration of individual differences (older individuals are close-minded)
How do we increase Cultural Competency
Travel, especially immersion
Having felt effects of discrimination
Training in cultural competency
Openness to complementary or alternative medicine
Global awareness
Self-awareness and reflection
Ann Cronin Mosey's 5 types of groups (psychodynamic and Developmental)
Parallel: lowest level, doing individual tasks side by side. Little interaction required and OT defines the task and provides clients with the necessary assistance and emotional support

Project: Emphasize task accomplishment. Social interaction outside of the task is not expected. The OT structures the group with tasks that require interaction of 2+ people to complete

Egocentric-cooperative: Require the members to select and implement the task. Tasks are long term and social interaction is expected. Members are expected to respond to one's social and emotional needs. OT provides appropriate activity choices and facilitates this process

Cooperative: OT leader is only an advisor. Members are encouraged to identify and gratify each others social and emotional needs in conjunction with task accomplishment

Mature: OT is a co-equal member. The group members take on all the necessary leadership roles in order to balance task accomplishment with need satisfaction of the members
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