Download - OT7 - Seven Step Format
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GROUP LEADERSHIP
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Professionalism carries with it an authority
and a directness of purpose which will need to
be practiced by students before they begin
interacting with patients.
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Seven-Step Format for Activity
Groups
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Step 1: Introduction
Members get to know and greet each other. The
therapist introduces himself among the members of
the group and the group does the same. In the
following sessions, it is no longer deemed necessaryto say their names out loud but the presence of each
member of the group is acknowledged by a simple
greeting.
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INCLUDES:
A. Warm-Up
The leader should be concerned with the receptivityof each member. The OTs should choose a warm-up
that challenges members enough to hold their
interest but is not beyond their capabilities. It
doesnt need to be a formal warm-up, a simple
conversation about how members are feeling is
enough.
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B. Setting the mood
Factors include the environment, the therapists facialexpression and manner of speaking and the media used.
C. Expectation of the Group
The therapists manner and expression should generally
reflect her expectation of the group. The therapist will always
serve as the model for the members to follow.
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D. Explaining the Purpose Clearly Usually depends on the type of group and the
patients level of understanding. A higher levelgroup of patients will want to know why they arebeing asked to do a particular activity. Lowercognitive patients are unlikely to understand suchabstract explanations of purpose. Goals mayneed to be spelled out in concrete terms.
E. Brief Outline of the Session
The timeframe, the media, and the proceduresare told. Gives clues to the members about thesessions focus.
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STEP 2
THE ACTIVITY
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Many factors should beconsidered whenplanning the activity. Thisis a complex process.
Selecting a therapeuticactivity involves theentire process of clinicalreasoning.
The following issues willbe presented forconsideration in selectinga therapeutic activity:
Timing
Therapeutic Goals
Physical and MentalCapacities of members
Knowledge and skills ofthe Leader
Adaptation of an Activity
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TIMING
The activity should be simple and short and should last nolonger than one third of the total session.
THERAPEUTIC GOAL
Goals and desired outcomes are something a patient and atherapist strive together to accomplish. A therapeutic goal forpatient involves assessing their needs and applying the therapists
knowledge of the patients abilities and disabilities. The group goalshould be chosen to meet the needs of most of the members. Oncethe goal is defined, an activity is selected or designed to helpmembers achieve that goal. If goals are more socially oriented,structured group task involves interaction of the members.
PHYSICAL AND MENTAL CAPACITIES OF THE MEMBERS
Selection of the activity or experience is further determined bythe physical and mental capacities of members.
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KNOWLEDGE AND SKILLS OF THE LEADER
Student leaders usually choose activities for the
group that they themselves are comfortable with orhave done before.
ADAPTATION OF AN ACTIVITY
Adaptation of the activity requires someknowledge of activity analysis and synthesis. Activityanalysis is the breaking down of an activity into its
component parts and matching each part with humanfunction required to accomplish it. Modifications canbe made in the activity to suit the patients abilities
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Step 3: Sharing
Sharing of work or experience with the group
The structure and process for sharing may
vary with each activity
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Making sure each members contribution is
acknowledged.
Acknowledgement may be done verbally or
nonverbally
Empathy is an important factor.
Therapist may need to support and encourage
client to share but if the member refuses then
it must be accepted.
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The order of members sharing does not
matter but it is easier to keep track if the
members just go around in circles
Volunteers are appreciated in a group sharing.
So that the client feel some control over the
group
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The Therapist can start to role model for the
group what is expected to be shared
Best Friend Exercise from Pfeiffer and Jones Therapist gets up standing behind a chair saying This is
my best friend, Beth
Moral Decision A group decision-making task which involves
extensive discussion as part of the activity
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Step 4: Processing
Most difficult step for student to learn
Inexperienced group leader often skip this
steps
It involves expressing how the members feels
about the experience, the leader and each
other
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If these emotions remain unexpressed, the
outcome of the group can never be fully
understood
Expressing feelings is not difficult if the
experience is positive but if it negative, people
often avoid expressing them.
Best way to release anxiety, embarrassment
and belittling themselves while doing an
activity
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Therapist has the opportunity to incorporate
them into the subsequent discussion and to
help the clients understand the significance ofthe feelings related to the group experience
It also includes discussion of the nonverbal
aspects of the group. Underlying issues (struggles for power and
control, subgrouping, scapegoating, conflict,
attraction and avoidance) are dynamics thatmay never be verbalized, but will have a
powerful influence on the group.
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Step 5: GENERALIZING
Addresses the cognitive learning aspects of
the group
The therapists mentally review the groups
responses to the activity, and sum them up
with a few general principles.
If the activity has gone as expected, some of
the general principles derived from the group
should closely resemble the original goals.
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The general principles discussed in the groupshould not be preplanned, but should comedirectly from the response of the members.
General principles may be arrived at in severalways:
A. Look at the patterns of response amongmembers: opinions they have in common/
Common elements of their stories. B. Look at areas of disagreement: conflicted areas
in the group
C. Groups energy: thx should follow up on issuesthat seem to energize the group and stimulatespontaneous conversation
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Step 6: APPLICATION
Therapist helps the group to understand how
the principles learned during the group can be
applied to everyday life.
Goal: each member should understand how
he will apply the results of this group
experience to help make his own life more
functional outside the group
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Step 6: APPLICATION
Knowledge of each patients background ishelpful. The therapist discusses with eachmember how the principles learned in the
group relate to the problems or issues eachhas expressed earlier.
Application may sometimes resemble a kindof group problem-solving: members help eachother find ways to apply the newly learnedinformation
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Step 7: SUMMARY
Purpose: to verbally emphasize the most
important aspects of the group so that they
will be understood correctly and remembered.
The points to emphasize should come directly
from the groups responses and may take 4-5
mins. It reviews the goals, the content, and
the process of the group
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Step 7: SUMMARY
Therapist asks the group members to help summarize
by remembering the activity and giving their ideasabout what was learned. General principles areincluded in the summary. Having members explaintheir own views of the group and how it can be
applied, reinforces the learning that took place. Emotional content of the group is also important to
summarize. One way for the therapist to acknowledgefeelings is to thank the members for their participation
in the group. Addressing and thanking individuals fortheir openness, honesty, and willingness to share ortrust in the group is always welcomed.
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Step 7: SUMMARY
Final responsibility of the therapist is to end
the group on time. if the group is well planned
and led, this will mark the completion of all
seven steps. If for some reason, all the stepshave not been completed by the end of the
session, the missing parts and the reason s for
this can also be discussed within thesummary.
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Step 7: SUMMARY
Before leaving the how to section, for
additional factors of leadership need to beexplored:
1. Group motivation
2. Setting limits
3. Leadership styles 4. Co-leadership
All are the responsibility of the leader and shouldoccur throughout the seven steps as they areneeded.
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LEADERSHIP STYLES
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Leadership styles profoundly affect the
outcome of the group
Different FORs require very different
leadership approaches
3 fundamental leadership styles:
Autocratic
Democratic
Laissez-faire
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Directive Leadership
Directors defines a group, selects activities, andstructures the group
Uses authority sparingly
If too much authority, may feel inadequate andcan stunt growth and development
Absolutely necessary for lower functioningpatients
Therapists decision should not be based on ownpreference, but on expert assessment on theneed of the group
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Facilitative Leadership
A facilitator is a resource person
Provides information, equipment or supplies
Gains support from members by allowing
them to make choices and shows care andconcern for members
Facilitators also are educators
Facilitations also has limitations
MOHO depends on a facilitative leadershipstyle
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Facilitation is most useful in motivating
patients and getting them invloved
The more cognitively aware they are, the
more they resent goals that are imposed on
them
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Group Leader as Adviser
-The most passive of the leadership styles
-Its use in therapy is limited to the highest functioninggroups working on goals like problem-solving orattitude change
-The adviser offers expertise as needed or requested,but does not provide structure or goals. Motivationcomes from the group itself, and change is producedintrinsically as a result of internal processes of each
member.
-FORs for which adviser leadership is most appropriateare psychoanalytic, humanistic and MOHO
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General Principles of Group Leadership
Designing the group involves:
choosing the members
setting or acknowledging the goals
setting the time and place
organizing the environment
and choosing the activity or media.
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The ongoing functions of the group are: to
help achieve its goals (task function) and helpmaintain the groups integrity (maintain
function).
Setting group norms (confidentiality, respect)
Giving members feedback and helping
members to give and receive feedback
keeping the communication channels open is
vital to the survival and growth of groups