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GROUP THERAPY
By- SIDRA ARSHAD Guided by - Mrs. RASHIDA BEGUM
MOT 2ND Year (Pediatrics) Associate professor
JAMIA HAMDARD JAMIA HAMDARD
INTRODUCTION
 Group therapy is a type of psychotherapy in which a
group of 8-10 people can be treated at one time.
 This approach provides patient a platform to share
their problems with others.
 The session for group therapy are usually held once
or twice a week, lasting 1-2 hours each.
 Occupational Therapy Groups are formed to address
specific intervention goals - Members usually have
similar issues (motor/psychological/cognitive) OR
Members may share similar experiences (e.g.
mothers, school aged children) – OR Similar age
GOALS FOR GROUP THERAPY
 To evaluate client's problems with
communication, interaction and relationship with
others.
 To engage clients with similar goals, problems
areas or life roles in activities that address common
issues.
 To develop awareness, self-understanding, self-
efficacy and insight through mutual group
feedback.
 To promote working in groups (social learning )
efficiently and working on their interpersonal skills
with social participation.
 To promote self Expression and exploration of
emotion which are shapers of behavior.
TYPES OF GROUPS
ACC. TO DIAGNOSIS OF
THE MEMBERS
HOMOGENEOUS
GROUPS
(members of the group
have similar diagnosis)
HETROGENEOUS
GROUPS
(members of the group
have different diagnosis)
Mosey's Taxonomy of Activity Groups
- The levels, types, and functions of groups are organized based on Mosey's
taxonomy, which is a structural system that helps an occupational therapist
understand the different work each kind of group can do.
1113
4
5
(18 months to 2 years)
(2 to 4 years)
6
6.i.
6.ii.
(5 to 7 years)
(9 to 12 years)
(15 to 18 years)
6.iii.
6.iv.
6.v.
 Group dynamicsare the processes that occur between group members.These
are the forces that influence the interrelationships of members and ultimately affect
group outcome.
• Group dynamics helps to understand how each person's actions make sense in the
context of the group.
 Group development refers to the stages that groups go through as they
progress from initiation to termination.
- Groups have predictable stages of development and will respond best to different
activities at different stages. As leaders, our recognition of our group’s stage of
development should influence our selection of activities.
• These influence group outcomes and thus planning and implementing group interventions. As
an OT We need to understand stages of group development as this will impact on activity
choices and Group dynamics that impact how we may lead groups.
GROUP
PROCESS
 This format reflects a client-centered approach that facilitates client
participation at every level of the process.The format is easily adapted to meet
the goals of any group.
 The primary purpose for which this method of group facilitation was designed is
to enable the participation of members in doing a shared task or activity and to
reflect upon its meaning for each of them.
 Every step in the process calls for the group leader’s therapeutic use of self to
enact the principles of client-centered practice.
I STEP : INTRODUCTION
 Leader and group members introduce themselves: simple,
easy, non-stressful
- (includes therapist asking the members to greet the group by saying their names.
This procedure does more than just help the members learn one another’s names; it
acknowledges their membership in the group and invites them to be a part of it)
 Warm-up/ice breaker
( Ot is concerned with the receptivity of the members. How alert are they? How
preoccupied are they? ? A warm-up is an exercise that captures the group’s
attention, relaxes them, and prepares them for the experience to follow)
 Expectations/ground rules for group
( Ot will explain what he will be expecting by the group members in the session
and lay ground rules )
 Explain purpose of group & briefly outline session
(Describing the purpose of the session and gives members a clue to the session’s
focus)
II STEP : ACTIVITY
• It incorporates all we know about clients, health
conditions, and their corresponding dysfunctions,
assessment, intervention planning, activity analysis and
synthesis, and group dynamics. Selecting a therapeutic
activity involves the entire process of clinical reasoning.
 SELETECD ACTIVITIES:-
- Should be do-able within time constraints
- Must relate to client goals
- Must be presented at level appropriate for clients
- Leader must consider their knowledge and skill level
- Must analyze prior to doing the activity and adapt as
necessary
III STEP : SHARING
• After completing the activity, each member is invited
to share his or her own work or experience with the
group. The structure and process for sharing will vary
with each activity.
- Each member shares own experiences in the form of
drawing or writing something individually or
interaction.
- Members can show or explain their experience
- Leader must acknowledge contributions of each
member
- Leader must provide support so all members share
IV STEP : PROCESSING
• Processing how members feel about the whole
experience and about the leader and each other.
• If Done correctly, processing can reveal some
important and relevant information. If members felt
anxious, embarrassed, or belittled while doing an
activity, this will help to explain some of their
responses when sharing and discussing it.
• From the OT perspective, this process helps to identify
issues that encourage or discourage “engagement in
occupation” and emotions that causes “barriers to
participation”
V STEP : GENERALIZING
• This step addresses the cognitive learning
aspects of the group.
-Leader mentally reviews group's responses
to activity
-Leader "sums up" responses to the group.
VI STEP : APPLICATION
• The goal of this step is for each member to
understand how they can apply the results of
this group experience to help make their own life
more functional outside the group.
• Application of principles learned in group apply
to everyday life. This addresses how the group
learning will facilitate “participation in life.”
VII STEP : SUMMARY
• The purpose of the summary is 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 group’s responses.
• The emotional content of the group is most important
to summarize. Especially when the group feels positive,
verbal recognition of the good feelings by the therapist
will help members remember the group as a positive
experience.
Yalom’s 11 Therapeutic factors for
Group Therapy
1. INSTILLATION OF HOPE
- Faith that the treatment can and will be effective
- optimism about positive change.
- Increases confidence.
2. UNIVERSALITY
- Demonstration that members are not alone in their
suffering and the problems.
- Realizing that others are willing to support them, which
helps move group members out of isolation and can be
profoundly healing.
Irvin Yalom in Theory and Practice of Group Psychotherapy (1995) identified
11 primary “therapeutic factors” present in all group therapy, with ongoing
longer-term adult groups (eg, substance abuse, trauma support
groups). They are as follows:-
3. IMPARTING OF INFORMATION
- Educates group members with
knowledge pertaining to their specific
situation/mental illness.
4. ALTRUISM
- Allows group members to help others
in group.
- Recognize they have something of
value to provide their fellow group
members, they gain in self-worth and
confidence
5. CORRECTIVE RECAPITULATION OF PRIMARY FAMILY GROUP
- Sharing of past family and childhood events within the safety of the
group, which in a way acts as a substitute family for each member.
- learning of new ways that can help to weaken unhelpful patterns
learned in one's family of origin.
6. DEVELOPMENT OF SOCIALIZING TECHNIQUES
- Encouraging social skills such as tolerance, boundaries, empathy,
and conflict resolution.
- This helps reduce isolation and promotes connection with others in
more meaningful ways.
7. IMITATIVE BEHAVIOR
- Learning from other group members who are more effective in
confronting problems and managing relationships.
- By witnessing other members apply new and appropriate
methods that disrupt their old, dysfunctional patterns.
8. INTERPERSONAL LEARNING
- Provides opportunity for group members to can openly share and
communicate; in return, they receive support and respectful
feedback.
- In effect helping them develop supportive, authentic
interpersonal relationships, Within the safety of the group space.
9. GROUP COHESIVENESS
- Gives members a sense of belonging, acceptance, and value,
providing both a nurturing and empowering experience.
10. CATHARSIS
- Bringing a sense of relief by releasing strong
or long-suppressed emotions associated with past
psychological woundings.
11. EXISTENTIAL FACTORS
- Involves the process of understanding and accepting the reality of
their condition, with all its frustrations and limitations.
- With each other's support, group members learn to accept life on
life's terms without seeking escape or denial, without fighting it.
Instead, they learn how to live with them and through them.
EVIDENCE OF OCCUPATIONAL THERAPY
GROUP EFFECTIVENESS
- Mandel & Clark, et al., 2012 conducted study,
- A randomized controlled trial using multiple pre-post measures of
health and well-being. This 9-month occupational therapy program for
community living older adults combined group and individual
interventions.
- The groups met 2 hours per week, following a schedule of pre-
determined modules, which included components of education about
occupation and its importance in maintaining wellness, open discussion
and interaction, and group activity participation.
- - These researchers state, “the decision to execute the Lifestyle
Redesign program mainly in groups was made primarily because
of the therapeutic benefit of group process and only secondarily
because of potential cost benefits”
EFFECTIVENESS OF ONLINE VERSUS LIVE
MULTI-FAMILY PSYCHOEDUCATION
GROUP THERAPY FOR CHILDREN AND
ADOLESCENTS WITH MOOD OR ANXIETY
DISORDERS: A PILOT STUDY
Iman sapru et.al in 2016 conducted a study in which
Participants included families of children (12 years or younger) referred with a mood
or anxiety disorder to the Division of Child and Adolescent Psychiatry at Queen’s
University (n=16) who were on a waitlist to see a psychiatrist. Change was measured
through questionnaires for all parents before and after the program. Using SPSS v22,
comparisons between the online (n=6) and live (n=10) groups were made using the
Mann-Whitney U test and within group comparisons were made using Wilcoxon
signed-rank test.
The online and live education groups showed similar overall improvements in
knowledge acquisition and expressed emotion in participating families. Online
MFPGT may be an effective way to increase knowledge, provide resources and
support and build on skills thus giving individuals more control and confidence when
dealing with a mood or anxiety disorder while on a waitlist. MFPGT showed equal
efficacy in live and online groups, indicating that the online program has the potential
to be a more convenient and accessible program for families. More research is needed
with a greater sample size.
REFERENCES
• Group Dynamics in Occupational Therapy: The
Theoretical Basis and Practice Application of Group
Intervention, Fourth Edition.
• Therapeutic Factors in Occupational Therapy Groups
Janet Falk-Kessler, Christine Momich, Sharla Perel.
• Occupational therapy: Toward health through activities.
Boston: Little, Brown.
• Frames of reference in psychosocial occupational
therapy. Bruce & Borg.
• THANK YOU

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Group therapy

  • 1. GROUP THERAPY By- SIDRA ARSHAD Guided by - Mrs. RASHIDA BEGUM MOT 2ND Year (Pediatrics) Associate professor JAMIA HAMDARD JAMIA HAMDARD
  • 2. INTRODUCTION  Group therapy is a type of psychotherapy in which a group of 8-10 people can be treated at one time.  This approach provides patient a platform to share their problems with others.  The session for group therapy are usually held once or twice a week, lasting 1-2 hours each.  Occupational Therapy Groups are formed to address specific intervention goals - Members usually have similar issues (motor/psychological/cognitive) OR Members may share similar experiences (e.g. mothers, school aged children) – OR Similar age
  • 3. GOALS FOR GROUP THERAPY  To evaluate client's problems with communication, interaction and relationship with others.  To engage clients with similar goals, problems areas or life roles in activities that address common issues.  To develop awareness, self-understanding, self- efficacy and insight through mutual group feedback.  To promote working in groups (social learning ) efficiently and working on their interpersonal skills with social participation.  To promote self Expression and exploration of emotion which are shapers of behavior.
  • 4. TYPES OF GROUPS ACC. TO DIAGNOSIS OF THE MEMBERS HOMOGENEOUS GROUPS (members of the group have similar diagnosis) HETROGENEOUS GROUPS (members of the group have different diagnosis)
  • 5. Mosey's Taxonomy of Activity Groups - The levels, types, and functions of groups are organized based on Mosey's taxonomy, which is a structural system that helps an occupational therapist understand the different work each kind of group can do.
  • 7. (18 months to 2 years) (2 to 4 years) 6 6.i. 6.ii.
  • 8. (5 to 7 years) (9 to 12 years) (15 to 18 years) 6.iii. 6.iv. 6.v.
  • 9.  Group dynamicsare the processes that occur between group members.These are the forces that influence the interrelationships of members and ultimately affect group outcome. • Group dynamics helps to understand how each person's actions make sense in the context of the group.  Group development refers to the stages that groups go through as they progress from initiation to termination. - Groups have predictable stages of development and will respond best to different activities at different stages. As leaders, our recognition of our group’s stage of development should influence our selection of activities. • These influence group outcomes and thus planning and implementing group interventions. As an OT We need to understand stages of group development as this will impact on activity choices and Group dynamics that impact how we may lead groups.
  • 11.  This format reflects a client-centered approach that facilitates client participation at every level of the process.The format is easily adapted to meet the goals of any group.  The primary purpose for which this method of group facilitation was designed is to enable the participation of members in doing a shared task or activity and to reflect upon its meaning for each of them.  Every step in the process calls for the group leader’s therapeutic use of self to enact the principles of client-centered practice.
  • 12. I STEP : INTRODUCTION  Leader and group members introduce themselves: simple, easy, non-stressful - (includes therapist asking the members to greet the group by saying their names. This procedure does more than just help the members learn one another’s names; it acknowledges their membership in the group and invites them to be a part of it)  Warm-up/ice breaker ( Ot is concerned with the receptivity of the members. How alert are they? How preoccupied are they? ? A warm-up is an exercise that captures the group’s attention, relaxes them, and prepares them for the experience to follow)  Expectations/ground rules for group ( Ot will explain what he will be expecting by the group members in the session and lay ground rules )  Explain purpose of group & briefly outline session (Describing the purpose of the session and gives members a clue to the session’s focus)
  • 13. II STEP : ACTIVITY • It incorporates all we know about clients, health conditions, and their corresponding dysfunctions, assessment, intervention planning, activity analysis and synthesis, and group dynamics. Selecting a therapeutic activity involves the entire process of clinical reasoning.  SELETECD ACTIVITIES:- - Should be do-able within time constraints - Must relate to client goals - Must be presented at level appropriate for clients - Leader must consider their knowledge and skill level - Must analyze prior to doing the activity and adapt as necessary
  • 14. III STEP : SHARING • After completing the activity, each member is invited to share his or her own work or experience with the group. The structure and process for sharing will vary with each activity. - Each member shares own experiences in the form of drawing or writing something individually or interaction. - Members can show or explain their experience - Leader must acknowledge contributions of each member - Leader must provide support so all members share
  • 15. IV STEP : PROCESSING • Processing how members feel about the whole experience and about the leader and each other. • If Done correctly, processing can reveal some important and relevant information. If members felt anxious, embarrassed, or belittled while doing an activity, this will help to explain some of their responses when sharing and discussing it. • From the OT perspective, this process helps to identify issues that encourage or discourage “engagement in occupation” and emotions that causes “barriers to participation”
  • 16. V STEP : GENERALIZING • This step addresses the cognitive learning aspects of the group. -Leader mentally reviews group's responses to activity -Leader "sums up" responses to the group.
  • 17. VI STEP : APPLICATION • The goal of this step is for each member to understand how they can apply the results of this group experience to help make their own life more functional outside the group. • Application of principles learned in group apply to everyday life. This addresses how the group learning will facilitate “participation in life.”
  • 18. VII STEP : SUMMARY • The purpose of the summary is 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 group’s responses. • The emotional content of the group is most important to summarize. Especially when the group feels positive, verbal recognition of the good feelings by the therapist will help members remember the group as a positive experience.
  • 19. Yalom’s 11 Therapeutic factors for Group Therapy
  • 20. 1. INSTILLATION OF HOPE - Faith that the treatment can and will be effective - optimism about positive change. - Increases confidence. 2. UNIVERSALITY - Demonstration that members are not alone in their suffering and the problems. - Realizing that others are willing to support them, which helps move group members out of isolation and can be profoundly healing. Irvin Yalom in Theory and Practice of Group Psychotherapy (1995) identified 11 primary “therapeutic factors” present in all group therapy, with ongoing longer-term adult groups (eg, substance abuse, trauma support groups). They are as follows:-
  • 21. 3. IMPARTING OF INFORMATION - Educates group members with knowledge pertaining to their specific situation/mental illness. 4. ALTRUISM - Allows group members to help others in group. - Recognize they have something of value to provide their fellow group members, they gain in self-worth and confidence
  • 22. 5. CORRECTIVE RECAPITULATION OF PRIMARY FAMILY GROUP - Sharing of past family and childhood events within the safety of the group, which in a way acts as a substitute family for each member. - learning of new ways that can help to weaken unhelpful patterns learned in one's family of origin. 6. DEVELOPMENT OF SOCIALIZING TECHNIQUES - Encouraging social skills such as tolerance, boundaries, empathy, and conflict resolution. - This helps reduce isolation and promotes connection with others in more meaningful ways.
  • 23. 7. IMITATIVE BEHAVIOR - Learning from other group members who are more effective in confronting problems and managing relationships. - By witnessing other members apply new and appropriate methods that disrupt their old, dysfunctional patterns. 8. INTERPERSONAL LEARNING - Provides opportunity for group members to can openly share and communicate; in return, they receive support and respectful feedback. - In effect helping them develop supportive, authentic interpersonal relationships, Within the safety of the group space.
  • 24. 9. GROUP COHESIVENESS - Gives members a sense of belonging, acceptance, and value, providing both a nurturing and empowering experience. 10. CATHARSIS - Bringing a sense of relief by releasing strong or long-suppressed emotions associated with past psychological woundings. 11. EXISTENTIAL FACTORS - Involves the process of understanding and accepting the reality of their condition, with all its frustrations and limitations. - With each other's support, group members learn to accept life on life's terms without seeking escape or denial, without fighting it. Instead, they learn how to live with them and through them.
  • 25. EVIDENCE OF OCCUPATIONAL THERAPY GROUP EFFECTIVENESS - Mandel & Clark, et al., 2012 conducted study, - A randomized controlled trial using multiple pre-post measures of health and well-being. This 9-month occupational therapy program for community living older adults combined group and individual interventions. - The groups met 2 hours per week, following a schedule of pre- determined modules, which included components of education about occupation and its importance in maintaining wellness, open discussion and interaction, and group activity participation. - - These researchers state, “the decision to execute the Lifestyle Redesign program mainly in groups was made primarily because of the therapeutic benefit of group process and only secondarily because of potential cost benefits”
  • 26. EFFECTIVENESS OF ONLINE VERSUS LIVE MULTI-FAMILY PSYCHOEDUCATION GROUP THERAPY FOR CHILDREN AND ADOLESCENTS WITH MOOD OR ANXIETY DISORDERS: A PILOT STUDY Iman sapru et.al in 2016 conducted a study in which Participants included families of children (12 years or younger) referred with a mood or anxiety disorder to the Division of Child and Adolescent Psychiatry at Queen’s University (n=16) who were on a waitlist to see a psychiatrist. Change was measured through questionnaires for all parents before and after the program. Using SPSS v22, comparisons between the online (n=6) and live (n=10) groups were made using the Mann-Whitney U test and within group comparisons were made using Wilcoxon signed-rank test. The online and live education groups showed similar overall improvements in knowledge acquisition and expressed emotion in participating families. Online MFPGT may be an effective way to increase knowledge, provide resources and support and build on skills thus giving individuals more control and confidence when dealing with a mood or anxiety disorder while on a waitlist. MFPGT showed equal efficacy in live and online groups, indicating that the online program has the potential to be a more convenient and accessible program for families. More research is needed with a greater sample size.
  • 27. REFERENCES • Group Dynamics in Occupational Therapy: The Theoretical Basis and Practice Application of Group Intervention, Fourth Edition. • Therapeutic Factors in Occupational Therapy Groups Janet Falk-Kessler, Christine Momich, Sharla Perel. • Occupational therapy: Toward health through activities. Boston: Little, Brown. • Frames of reference in psychosocial occupational therapy. Bruce & Borg.