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What is a group?
a collection of individuals whose association is founded on shared commonalities of interest, values, or purposes; memberships is generally by choice, chance or circumstance
What are the characteristics of a group?
size, defined purpose, degree of similarity among members, rules, boundaries, climate, content, process
What are the functions of a group?
Socialization support, task completion, camaraderie, informational, normative, empowerment
What are the types of groups? examples of each?
- Time-limited therapy groups: cognitive-behavioral groups, spiritual groups, behavioral therapy groups
- Self help groups: Alcoholics anonymous, Al-Anon
- Support groups: bereavement, cancer, sexual assault
What are the types of groups in medical health?
psychoeducational groups: medication, health promotion/restoration, dual-diagnosis, symptom/stress managment
What conditions influence groups?
Seating, size, membership
Group therapy whereby a number of people with emotional problems meet with a therapist in a structured setting for what purposes?
- developing a better understanding of themselves/others
- modify behavior in a socially acceptable manner
- improve relationship with others
What are Yalom's curative factors?
- instillation of hope: see progression of others
- Universality: you are not alone
- imparting of information: sharing knowledge
- Altruism: helping others = felling good in return
- development of skills: learn new skills
- imitative behavior: role modeling
- interpersonal learning: gain insight into perception of self by others
- group cohesiveness: sense of belonging
- Catharsis: open expression of + and - feelings
- Corrective recapitulation of primary family group
what are facilitating techniques for a group?
seeking clarification, encouraging description, presenting reality, focusing, re-framing, giving feedback, helping to gain insight
What are the phases of group development?
- phase I: initial/ orientation
- Phase II: middle/working
- Phase III: final/termination
Describe Phase I
- group activities: goals are being established, meeting times/duration, acquaintance phase
- Leader expectation: promote environment of trust, depend on leader for direction
- Member behaviors: trust not yet established
- honeymoon phase( best behavior)
Describe phase II of group
- Group Activities: cohesiveness established, productive work, problem solving/decision making
- Leader expectations: role of leader diminishes to facilitator, stay on course with group goal
- Member behaviors: turn more to each other rather than leader, accept criticism, (watch for subgroups)
Describe Phase III of group
- Group activities: session before last; discuss sense of loss/grief felt by termination
- Leader expectations: encourage expression of grief. review goals and outcomes, encourage peer feedback
- Member behaviors: grief, abandonment, anger
What does successful termination of groups look like/do?
It is successful if the clients are sad about leaving, and helps group members develop necessary skills to cope with life losses
What are the different leaderships styles?
- Autocractic: My was is the best way; group members depend on leader fo problem solving
- Democratic: leader provides guidance as needed, group members make own decisions
- Laissez-Faire: Leader gives no direction, undefined goals; members make no decisions, no problem solving, no actions
What are the different member task roles?
- coordinator: clarifies ideas, brings people together
- evaluator: examines plans and performance
- Elaborator: explains/expands on group's plans
- Energizer: motivates group
- InitiatorL gets things started
- Orientier: maintains direction
What are the different member maintenance roles?
- Compromiser: assists members to compromise
- Encourager: offers recognition of others
- Follower: passive participant
- Gatekeeper: encourages participation
- Harmonizer: decreases tension
What are the different member individual (personal) roles?
- Aggressor: sarcasm, negative, hostile
- Blocker: resists group efforts, rigid
- Dominator: control, authoritative
- Help-seeks: uses group to gain sympathy, no concern for group
- Monopolizer: dominates conversation
- Mute/silent: fear of self disclosure or attention
- Recognition seeker: talks about self to gain attention
- seducer: shares initmate details early on & frightens
What is a family?
whatever the patient says it is
What are the different frameworks of family therapy?
- Strategic model: assumes that changing any single element in the family system will bring about change in the entire system
- structural model: explains family problems from perspective of dysfunctional boundary and role structure
What does Bowen's system approach theory include?
- differentiation of self
- Identified patient (member that everyone defines as the problem)
- multigenerational transmission (genogram)
What are the types of boundaries?
- Rigid: communication, support
- Permeable: input from others, clear boundaries
- Diffuse: dependent, over involved, enmeshed
What is considered a healthy system? Dysfunctional?
- Healthy: open to information/ external resources, able to problem solve, effective communication ,clear boundaries
- Dysfunction: closed to outside information/people, reliance on internal resources, unable to problem solve, poor communication, triangulation, blurred boundaries, double-bind communications
What is the goal of therapy? What are the therapeutic roles of the practitioner
- Goal: increase level of differentiation of self by encouraging I positions
- Role of practitioner: coach
- minimize triangles. define/clarify relationships between family members
How can you apply the nursing process to the family?
- assessment: constructing a genogram
- goals/technique: paradoxical intervention- continue to engage in behavior you want to change
- reframing: relabeling behavior/putting it into a positive perspective
What is a genogram?
a way to plot multigenerational assessment; teaching tool for families; illustrates sibling positions-personalities, overly close or conflicting relationships, nodal events
What is the nursing care for electro-convulsive therapy?
- Consent form, NPO after midnight, administer pre-med (atropine) ask client to urinate, remove dentures/hairpins, monitor VS before, during, and after,
- after procedure: monitor resp. difficulties, mental statues/reorientation, VS q 15 mins, monitor short term memory loss