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Interventions With Groups

Interventions With Groups. Chapter 14. Definitions of “Group”. A collection of individuals who identify with the leader, and other members, but who act independently (psychoanalytic definition) Parts or components that exist to perform some activity or purpose (systems theory)

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Interventions With Groups

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  1. Interventions With Groups Chapter 14

  2. Definitions of “Group” • A collection of individuals who identify with the leader, and other members, but who act independently (psychoanalytic definition) • Parts or components that exist to perform some activity or purpose (systems theory) • Two or more people who develop interactive relationships and share at least one common goal (this text)

  3. Open vs. Closed Groups • Open group • New members may join. • Members may leave at any time. • New members are at a disadvantage. • Advantage of this type is that group can continue. • Closed group • Members join at one time. • There are no replacement members. • Group is more cohesive. • Group is more likely to dissolve when members drop out.

  4. Small Eight to 10 people Cohesive Fewer subgroups Richer IP Led by one Large > 10 members Can be therapeutic More cost-effective Open-ended, ongoing Avoid intense transference and counter Group Size

  5. Group Development • Group development is a process. • Definition: Group process is the culmination of the session-to-session interactions of the members that move the group toward its goals.

  6. Group Process • Beginning • Honeymoon • Conflict • Working • Develop rules, rituals • Group realizes its purpose. • Termination • Members grieve for loss of the group. • Reestablish themselves as individuals

  7. Roles of Group Members • Formal group roles • Leader • Member • Informal group roles • Task • Maintenance • Individual

  8. Group Membership: Roles & Functions • Task roles: business of the group • Initiator, information seeker, coordinator, recorder • Maintenance roles: keeping group together • Harmonizer, compromiser, gate-keeper, observer • Individual roles: either detract or enhance group • Aggressor, self-confessor, recognition seeker

  9. Group Communication • Verbal Communication • Communication network • Sociometric analysis • Sit next to each other, talk to each other • Group themes • Mood

  10. Group Communication Non-verbal Communication • Seating arrangement • Eye contact • Posture • Body gestures

  11. Group Norms & Standards • Groups develop norms or acceptable group behaviors. • Formalized norms • Example: beginning group on time • Informal norms

  12. Group Cohesion • One of the goals is usually fostering group cohesion. • Encourages social interaction • Helps group stay together • Increases members commitment to group • Disadvantage: • In very cohesive groups, members are more likely to transgress personal boundaries. • Can become dysfunctional

  13. Groupthink • Tendency of groups to avoid conflict and adopt a normative pattern of thinking • Can lead to poor decision-making because the group is more concerned about being part of the group, rather than thinking independently • Unclear whether cohesive groups are more likely to experience groupthink • Be aware of the possibility in decision-making groups

  14. Leading a Group • Obtains and receives information • Helps in the diagnosis of group goals, obstacles and consequences of decisions • Facilitates communication • Helps integrate the various perspectives and alternative possibilities • Tests and evaluates proposals and decisions • Techniques Table 14-3

  15. Leadership Skills • Listening • Tracking verbal and nonverbal interactions • Maintaining a neutral, nonjudgmental style • Not showing preference to one member over another • Providing everyone with an opportunity to contribute

  16. Choosing Leadership Styles • Led within the context of the group leader’s theoretical background • Direct-indirect Continuum • Direct leadership • Controls the interaction • Gives direct information • Allows little discussion • Indirect leadership • Uses reflection and offers little guidance • Does not provide information to the group

  17. Selecting Group Members • Leader responsible for membership • Consider the following: • Does the purpose of group match the need of patient? • Does the patient have the skills to participate in the group? • Will other group members accept the new member? • Will the new member be able to make the commitment to attend?

  18. Seating Arrangements • Use circle seating without barriers (tables). • Rectangular tables tend to promote positions of power at the end of the table. • Classroom seating prevents effective interactions. • No one should sit outside the circle.

  19. Seating Arrangements • Members who sit closest to the leader are more likely to have more power. • Group should be held in a quiet, pleasant room with adequate space and privacy. • Large rooms inhibit communication. • Avoid eating during group.

  20. Discussion of Challenging Behaviors • Monopolizer • “Yes, but” • Disliked member • Group conflict

  21. Types of Groups • Psychoeducation • Task groups • Teaching groups • Supportive therapy groups • Psychotherapy groups • Self-help groups

  22. Nursing Intervention Groups • Medication groups (Text Box 14.2) • Symptom management groups • Anger management groups • Self-care groups

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