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What are the characteristics of any group?
- Size (6-12 is therapeutic)
- Defined purpose
- Degree of similarity between members
- Rules
- Boundaries
- Climate
- Content
- Process (dynamics b/t group members during therapy/interaction)
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What are the functions of a group?
- Socialization
- Support
- Task completion
- Camaraderie
- informational
- Normative
- Empowerment
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What are the different types of groups?
- Time-limited therapy groups (5wks)
- -cognitive-behavioral groups
- -spiritual groups
- -behavioral therapy groups
- Self-help groups
- -AA
- -al-anon
- Support groups:
- -bereavement
- -cancer
- -sexual assault
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What is a psychoeducational group?
- Inpatient psych unit group
- Medication education
- health promotion/restoration
- Dual-diagnosis
- Symptom/stress management
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What are Yalom's curative factors of group therapy?
- Instillation of hope: see progression of others
- Universality: you are not alone
- Imparting of information: sharing knowledge
- Altruism: helping others makes you feel good
- Development of social 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 positive and negative feelings
- Corrective recapitulation of primary family group: displaying behavior learned in family so it can be corrected
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What are the facilitation techniques of group therapy?
- seeking clarification
- encouraging description
- presenting reality
- focusing
- re-framing
- giving feedback
- helping to gain insight
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What are phases of group development?
- Initiation/Orientation
- Middle/working
- Final/termination
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Describe the orientation phase of group therapy
- Group activities:
- -goals are being est
- -meeting times/duration est
- -Acquaintance phase
- Leader Expectations:
- -promote environment of trust
- -depend on leader for direction
- Member behaviors:
- -trust not yet est
- -honeymoon phase- on best behavior
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Describe the middle/working phase of group therapy
- Group activities:
- -cohesiveness est
- -productive work
- -problem solving/decision making
- Leader expectations:
- -role of leader diminishes to facilitation
- -stay on course with group goal
- Member behaviors:
- -turn more to each other rather than the leader
- -accept criticism
- -watch for subgroups
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Describe the final/termination phase of group therapy
- 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
- **successful termination helps group members develop necessary skills to cope with life losses
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What are the different leadership styles
- Autocratic:
- -my way is the best way
- -group members depend on leader for problem solving
- Democratic:
- -leader provides guidance as needed
- -group members make own decisions
- Laissez-faire:
- -leaders give no direction, undefined goals
- -members make no decision, no problem solving, no actions
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What are the "task" roles of members of group therapy?
- Coordinator: clarifies idea, brings people together
- Evaluator: examines plans and performance
- Elaborator: explains/expands on groups's plans
- Energizer: motivates group
- Initiators: get things started
- Orientier: maintains direction of group
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What are the "maintenance" roles of members of group therapy?
- Compromiser: assists members to compromise
- Encourager: offers recognition of others
- Follower: passive participant
- Gatekeeper: encourages participation
- Harmonizer: decreases tension
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What are the "personal" roles of members of group therapy?
- Aggressor: sarcasm, negative, hostile
- Blocker: resists group effort, rigid
- Dominator: control, authoritative
- help-seeker: uses group to gain sympathy, no concern for group
- Monopolizer: dominates conversation
- Mute/silent member: fear of self disclosure or attention
- Recognition seeker: talks about self to gain attention
- Seducer: shares intimate details early on and frightens others
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What are the strategic and structural models 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
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What is Bowen's systems approach to family therapy?
- Subsystems
- Differentiation of self
- triangles
- scapegoating
- boundaries
- Identified patient: member that everyone defines as the problem
- Multi-generational tranmission
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What are the different boundary styles of family dynamics?
- Rigid: communication, support, authoritarian
- Permeable: input from others, clear boundaries
- Diffuse: dependent, over involved, enmeshed
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Describe the difference between healthy and dysfunctional family systems
- Healthy:
- -open to information/external resources
- -able to problem solve
- -effective communication
- -clear boundaries
- Dysfunctional:
- -closed to outside information/people
- -reliance on internal resources
- -unable to problem solve
- -poor communication
- -triangulation
- -blurred boundaries
- -double-bind (mixed messages/guilt trip) communication
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What are goals/techniques of family therapy?
- Goal: increase level of differentiation of self ("I" positions)
- Therapeutic role of practitioner is as a coach
- Minimize triangles in family
- define/clarify relationships between family members
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What is a genogram?
- Way to plot multi-generational assessment
- teaching tool for family
- Illustrates the sibling position
- Nodal events
- Overly close or conflictual relations
- Triangles
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Describe paradoxical interventions and reframing
- Paradoxical interventions: continuing to engage in the behavior you want to change in a structured/limited setting until the behavior becomes moot
- Reframing: relabeling behavior/putting it into a positive perspective
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What is ECT therapy? What is the nurse's role?
- Electro convulsive therapy
- Treatment of resistant depression and schizoprenia
- Nursing care:
- -consent forms
- -NPO after midnight
- -administer pre-med atropine
- -Ask client to urinate
- -remove dentures/hairpins
- -monitor vitals before, during, after
- -monitor for resp difficult after procedure
- -mental status/reorientation
- -VS q15
- -monitor for short term memory loss
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