Groups

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Author:
brau2308
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300179
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Groups
Updated:
2015-04-11 12:34:36
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NBCOT
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Description:
Ch 3 group
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  1. Group development stages:
    • origin
    • orientation
    • intermediate
    • conflict
    • cohesion
    • maturation
    • termination
  2. Origin phase
    leader composing the group protocol and planning for the group (e.g., the size of the group, member characteristics, location of meetings)
  3. Orientation phase
    members learning what the group is about, making a preliminary commitment to the group, and developing initial connections with other members
  4. Intermediate phase
    involves members developing interpersonal bonds, group norms, and specialized member roles through involvement in goal-directed activities and clarification of group's purpose
  5. Conflict phase
    members challenging the group's structure, purposes, and/or processes, and is characterized by dissension and disagreements among members
  6. Cohesion phase
    members regrouping after the conflict with a clearer sense of purpose and a reaffirmation of group norms and values, leading to group stability
  7. Maturation phase
    members using their energies and skills to be productive and to achieve group's goals
  8. Termination phase
    dissolution of the group due to lack of engagement of members, inability to resolve conflict, administrative constraints, goal attainment, or task accomplishment
  9. Instrumental roles:
    functional and assumed to help the group select, plan, and complete the group's task (e.g., initiator, organizer)
  10. Expressive roles:
    functional and are assumed to support and maintain the overall group and to meet members' needs (e.g., encourager, compromiser)
  11. Individual roles:
    dysfunctional and contrary to group roles, for they serve an individual purpose and interfere with successful group functioning (e.g.,aggressor, blocker)
  12. Directive leadership
    • therapist responsible for planning and structuring group
    • needed when members' cognitive, social, and verbal skills, as well as engagement, are limited
    • select the activities
    • provide clear verbal and demonstrated instruction
    • provide group maintenance roles and feedback
    • goal = task acomplishment
  13. Facilitative leadership
    • therapist shares responsibility for group and for group process with members
    • members' skill levels and engagement are moderate
    • collaborate w/ group members to select activities
    • share instruction throughout group process
    • group maintenance roles and feedback provided by members with leader facilitating
    • goal = members acquire skills through experience
  14. Advisory leadership
    • therapist functions as a resource to the members, who set the agenda and structure the group's functioning
    • members' skills and engagement are high
    • members select and complete activity with leader's advice
    • group maintenance roles are assumed by members
    • feedback occurs as natural part of group's self-directed process
    • goal = members understand and self-direct the process
  15. Medicare indicators for group membership
    • engage willingly in group
    • attend to group guidelines/procedures
    • actively participate in group process
    • benefit from group leadership input
    • benefit from group membership/peer input
    • respond appropriately throughout group process
    • incorporate feedback
    • complete activities toward goal attainment
    • attain greater benefit from the group intervention than from 1:1 intervention
  16. Medicare criteria for group leadership
    • provides active leadership
    • instruct members as a group
    • monitors and documents individual's participation and response to intervention
    • provides individualized guidance and feedback
    • documents person's progress toward goals defined in the individual intervention plan in objective, measurable, functional terms
  17. Mosey's taxonomy of activity groups:
    • evaluation group
    • thematic group
    • topical group
    • task-oriented group
    • developmental group
    • instrumental group
  18. Evaluation group
    Purpose/focus:
    enable client and therapist to assess client's skills, assets, and limitations regarding group interaction
  19. Evaluation group
    Assumption:
    to accurately evaluate an individual's functional abilities, one must observe the person in a setting where the skills can be demonstrated
  20. Evaluation group
    Type of client:
    all individuals who will be involved in groups or who lack group interaction skills
  21. Evaluation group
    Role of therapist:
    • selects and orients clients to group's purpose
    • selects activities that require collaboration and interaction and provides needed supplies
    • does not participate or intervene in group, but observes and reports members' interaction and functional skill level to the treatment team
    • asks for clients' input
    • validates assessment and establishes treatment goals with each individual client
  22. Evaluation group
    Suitable activities:
    tasks that can be completed in one session and require interaction to complete
  23. Thematic group
    Purpose/Focus:
    to assist members in acquiring the knowledge, skills, and/or attitudes needed to perform a specific activity
  24. Thematic group
    Assumptions:
    • improvement of ability to engage in activities outside of group can result from teaching of these activities within group
    • learning is facilitated by practicing and experiencing needed behaviors, with reinforcement of appropriate behaviors given
  25. Thematic group
    Type of client:
    • determined by the specific goals of the group
    • members' needs, concerns, and goals must match the objectives of the group
    • members must have a minimal group interaction skill level equal to a parallel group skill level
  26. Thematic group
    Role of therapist:
    • selects, structures, and grades suitable activities to teach needed skills
    • interventions vary according to group's level, needs, and goals
    • may range on a continuum from a highly structured, supportive director to a resource advisor
    • reinforces skill development
    • attention is not paid to inra- and inter-personal conflicts unless they interfere with or are directly related to the activity
  27. Thematic group
    Suitable activities:
    • simulated, clearly defined, structured activities which enable members to practice and learn needed skills, attitudes, and knowledge within the group
    • activities selected are directly related to the skills needed to perform the activity outside of the group (e.g., cooking group to learn how to cook)
  28. Topical group
    Purpose/focus:
    to discuss specific activities that members are engaged in outside of group to enable them to engage in the activities in a more effective, need-satisfying manner
  29. Topical group
    Concurrent topical groups:
    concerned with activities already engaged in outside of group
  30. Topical group
    Anticipatory topical groups:
    concerned with activities that are expected to be done in the future
  31. Topical group
    Assumptions:
    • improvement of ability to engage in specific activities outside of group results from discussion of these activities
    • discussion of problem areas and potential solutions, reinforcement of appropriate behaviors, and experiential learning facilitate skill acquisition
  32. Topical group
    Type of client:
    • individuals who share similar current or anticipatory problems in functioning
    • members must be at an egocentric-cooperative group skill level
    • sufficient verbal and cognitive skills to engage in discussion and to problem-solve are present
  33. Topical group
    Role of therapist:
    • facilitate group discussion while maintaining focus on the circumscribed activity
    • help members problem-solve, give feedback and support, reinforce skill acquisition
    • share leadership with members; act as a role model
  34. Topical group
    Suitable activities:
    • group activity is verbal discussion on a circumscribed activity that members are engaged in or will be engaged in outside of group
    • discussion may include members' current or anticipated fears and problems, potential solutions, and coping mechanisms
    • role play and "homework" may be utilized
  35. Task-oriented group
    Purpose/focus:
    • to increase clients' awareness of their needs, values, ideas, feelings, and behaviors as they engage in a group task
    • to improve intra- and interpsychic functioning by focusing on problems which emerge in the process of choosing, planning, and implementing a group activity
  36. Task-oriented group
    Assumptions:
    • activities elicit feelings, thoughts, and behaviors
    • activities are the means by which members can explore and experience these thoughts, feelings, and actions
    • through activities members can increase their self-awareness and practice new behaviors
  37. Task-oriented group
    Type of client:
    • individuals whose primary dysfunction is in the cognitive and socioemotional areas due to psychological or physical trauma
    • clients with fair verbal skills who can interact with others
  38. Task-oriented group
    Role of therapist:
    • initially, very active, defines group goals and structure
    • assists with activity selection, offers guidelines and suggestions
    • facilitates discussion among members
    • gives feedback and support
    • assists members in exploring relationships between thoughts, feelings, and actions
    • encourages members to experiment with new behavior patterns
    • as group develops, the leader is less active, helps members give more feedback and input; however, the therapist remains the leader and ensures that the task is a means to an end, no the end itself
  39. Task-oriented group
    Suitable activities:
    • activities that are chosen by members and will create an end product or demonstrable service for the group itself or for persons outside the group
    • activities are selected, planned, and carried out by members with the understanding that the task is a means to study, understand, and practice behavior
  40. Developmental group
    a continuum of groups consisting of parallel, project, egocentric-cooperative, cooperative, and mature groups
  41. Developmental group
    Purpose/focus:
    to teach and develop members' group interaction skills
  42. Parallel
    Purpose/focus:
    • enable members to perform individual tasks in the presence of others
    • minimally interact verbally and nonverbally with others even though task does not require interaction for successful completion
    • develop basic level of awareness, trust, and comfort with others in group
  43. Project
    Purpose:
    • develop ability to perform a shared, short-term activity with another member in a comfortable, cooperative manner
    • develop interactions beyond those that the activity requires
    • enable members to give and seek assistance
  44. Egocentric-cooperative
    Purpose:
    • enable members to select and implement a long-range activity which requires group interaction to complete
    • enable members to identify and meet the needs of themselves and others
  45. Cooperative
    Purpose:
    • enable members to engage in a group activity which facilitates the free expression of ideas and feelings
    • develop sense of trust, love, and belonging, and cohesion
    • enable members to identify and meet socio-emotional needs
  46. Mature group
    Purpose
    • enable members to assume all functional socio-emotional and task roles w/in a group
    • enable members to reinforce behaviors which result in need satisfaction and task completion
  47. Developmental group
    Assumptions
    • learning principles are the basis. They are utilized throughout the five developmental levels
    • members made aware of and helped to engage in appropriate group behavior
    • feedback and reinforcement are utilized. learning of needed behaviors occurs when adaptive behaviors are reinforced and when maladaptive behaviors are not
    • maladaptive behaviors result from deviations, lags, or insufficiencies in development
    • subskills fundamental to mature group function must be acquired in a sequential manner
  48. Developmental group
    Type of clients
    individuals with decreased group interaction skills
  49. Developmental group
    Role of therapist (overall):
    • assesses individuals' level and places them in appropriate group
    • orients members to group's goals, structure, and norms
    • lower level groups require more active, direct leadership
    • as group matures and attains higher level of group interaction, leadership is shared among members
  50. Parallel group leadership role
    • provide unconditional positive regard to develop trust
    • actively fill all leadership functions and meet al members' needs
    • reinforce all behaviors appropriate to group, no matter how small
    • provide structure
    • facilitate interaction
  51. Project group leadership role
    • select and structure activities than can be shared by two or more members
    • fulfill all members' needs while encouraging members to give and seek assistance and interact beyond activity requirements
    • reinforce cooperation, mild competition, sharing, and interactions
  52. egocentric-cooperation group leadership role
    • less active, direct leader
    • facilitate and allow members to fulfill functional leadership roles to function independently
    • provide guidelines and assistance as needed
    • reinforce members' meeting needs of self and others
    • serve as a role model
  53. cooperative group leadership role
    • act as an advisor, not as a direct leader
    • leader and members are mutually responsible for giving feedback, identifying and meeting needs, and reinforcing behavior
  54. mature group leadership role
    • acts as a peer, an equal, a group member
    • members assume all roles with the therapist filling in only if and when needed to maintain group
    • all members satisfy needs and reinforce behavior while maintaining a balance b/w need satisfaction and task completion
  55. Parallel
    Suitable activities:
    • members perform activities independently of others but in the presence of others
    • interactions are not required to successfully complete activity
    • activities should be similar or utilize common tools or materials to facilitate interaction and sharing
    • activities should be relevant to a person's ability, age, gender, and interest so he/she is more able to interact with and about it
  56. Project
    Suitable activities:
    • task is short-term and requires the participation of two or more people
    • task is shareable and requires interaction to successfully complete
    • group interaction, not project completion, is emphasized
  57. Egocentric-cooperative
    Suitable activities;
    • activity allows 5-10 people to work together
    • selected and implemented by members
    • longer-term, requiring more than two meetings to complete
  58. Cooperative
    Suitable activities;
    • activities facilitate and allow for free expression of ideas and feelings
    • activity is secondary to need fulfillment and may not produce an end product
  59. Mature
    Suitable activities:
    • activity requires a number of people to work together
    • requires an end product or has an inherent time limit for completion
    • during group, activity may be stopped for members to explore what is going on within the group
  60. Instrumental group
    Purpose/focus:
    • help members function at their highest possible level for as long as possible
    • meet mental health needs
  61. Instrumental group
    Purpose/Focus:
    • to help members function at their highest possible level for as long as possible
    • to meet mental health needs
  62. Instrumental group
    Assumption:
    • individuals are functioning at their highest possible level and cannot change or progress
    • a supportive, structured environment which provides appropriate activities can prevent regression, maintain function, and meet mental health needs
  63. Instrumental group
    Type of client:
    • demonstrated in tx an inability to change or progress
    • can't independently meet mental health needs and/or need assistance to maintain function due to cognitive, psychological, perceptual-motor, and /or social deficits
  64. Instrumental group
    Role of therapist:
    • provide unconditional positive regard, support, and structure to create a comfortable, safe environment for pts
    • select/design activities that will meet member's health needs and maintain highest possible level of function
    • assist members w/ activity as needed
    • make no attempt to change client
  65. Instrumental group
    Suitable activities:
    • members can successfully complete activities with structure and assistance of therapist as needed
    • non-threatening and non-demanding
    • interesting, enjoyable and attractive to members
    • meet mental health needs of the person by enabling him/her to experience pleasure, have fun, socialize with others, etc.
    • maintain function by providing sensory, cognitive, perceptual-motor, and social input
  66. Role of OTA in group work:
    OTA is active in all aspects of group work

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