Setting Up a Groupchapter 5

Setting Group Demands - Planning- Organisation - Judgement - Problem- solving- Willingness to look for creative solutions.

Planning sequence • Series of tasks and stages.• It depends on the group, the stages will create

different problems and different degree of importance.

Planning sequenceFlowchart page 122

1. Demand for the group - by patient or client need or interested staff member 2. Deciding the type and level of group - wider context - resource ** who should be involved ** how long, how often should the group meet

Memberships issues

Time factors

3. Defined Aim – Group goals4. Referrals >> the group make advertisements 5. Choosing members 6. Prepare the members 7. Planning the content of sessions in detail8. implement 9. Evaluation – modify each session.

We should not be rigidly ruled by our plan.

Select members

Prepare members

Plan group session

Implement

Evaluate group session

Selling the group and gaining referrals

Define aim

Decide on type of group

Demand of GroupIdentify staff / material resources

Consider wider context –demands

of setting

Leadership decisions and preparation

Planning Membership and

time-factors decisions

Formulate goals

Consider individual needs and groups compatibility

Marketing

Managing

Interviewing

Membershipe decisions • Open or Close • Size of group • Composition of group membres.

Open Vs. Closed • Closed - Start and finish with the same group member. - Fixed # of sessions - Members have the ability to build relationships and trust - people who feels anxious

• Open - allows members to join and leave the group as they want - a group run on an acute admission ward. - accommodate new members.

• Semi-open group : membership is stable but takes new members if anyone leaves.

• Support Group• Needs period of stability for members to build up trust and feel safe in the group. • Closed or semi-open group.

• Activity Group• Focus on the activity or in individual achievements.• Open Group .• “ may benefit from the process of changing faces”

• Check table 5.1 on page 125 .. Advantages , disadvantages

Size of the group • It depend on the aim and needs of the group

• Work or task group participants require individual attention or teaching, 4-6 members.

• Psychotherapy group 5-9 members. - small intimate - large to operate a group

• Social or communication group 8 or more - large to give group energy, blend in with crowd - small ensure personal recognition • 20-50 members community meetings within therapeutic environments.

• Balance the amount of attention each individual needs / staff resources / type of activity.

• Group needs to be large enough to include diversity or balance of members

• Small enough to feel comfortable but not to small to increase self-consciousness.

Composition of group members • Combination of particular individual characteristics.

- Gender

- Age - Status of individual - Functional level - Particular problems area

• Important points should be in your consideration : 1. Avoid any arrangement which unduly isolates one individual ( women w group of men )2. Pts should be able identify with each others. ( acutely ill inpatients – stable )

Time factor decisions • Day and time of the group - availability of recourses - the activity or groups that our pt attend before or after - individual natural rhythm - the wider unite • Length of session - too short frustration and unfinished buiesness , ppl less motivated to become involved next time - too long boring and too physically and emotionally demanded - support group tend to need more time than individual sessions.

• Frequency of meetings - type of group, needs. - we should balance 3 criteria: 1- intensity, 2- importance, 3- continuity. - intensity: increased with more frequency - importance: relationship inside the group may become more importance the the real life. - continuity: make links between sessions

• Weather the group should be open ended or time limited - open ended indefinite period of time, activity group, continuity. - Support group Time limits - social skills training course - anxiety management

Gaining Referrals1. Advertising the group

2. Establishing an appropriator referral system

Advertising the group• It depends on the settings:

1. Inform the team member of the start time and request referral

2. Send out a formal letter about the group to the relevant referral agencies

3. Employ more active marketing strategies in order to sell the group

Referral System1. “Blanket” (unplanned) versus planned

referrals

2. Sources of referrals

3. Written versus verbal referrals

“Blanket” versus planned referrals• Blanket : the therapist has access to all patients

without having to wait for official referrals.

It may be practical where there is a high turn over of patients OR their unstable health means the group membership cannot be predictable from week to week.

“Blanket” versus planned referrals

• “blanket” referrals has its drawback:1. The OT cannot adequately plan a group and gear it to

individual’s need2. When we slot people into activity without adequate

assessment we are in danger of providing diversion rather than applying treatment

3. We are likely to be confronted with people we don’t know and this is at least disconcerting

Sources of referrals• Certain sources : Doctors, treatment team or

OT themselves ( often ensure appropriate referrals)

• Various sources : Self-referrals ( the member is motivated to join the group)

Written versus verbal referrals• The current emphasis on documentation suggest

that in the absence of a written referral, we should record the details of the verbal request.

• When designing a form it may include: the fact of the prospective members, date of referral, who it is from, reason for referral and any precaution

Referral form

Preparing a prospective member

The pre-group interview• It has multiple aims:

1. To introduce2. Give information3. Provide a baseline assessment4. Negotiate aims and goals5. Clarify the member’s expectation

The pre-group interview6. Acknowledge reservation and anxieties 7. Establish ground/group rules (written/ verbal contract)