GROUP THERAPY

GROUP THERAPY

OVERVIEW OF GROUP
THERAPHY..

GROUP
-a collection of individuals
whose association is based on
a shared purpose or common
interests. Values and goals.

GROUP DYNAMICS
-underlying forces working to
produce behavior patterns in
groups; these forces include
group roles, stages of group
development and group norms.

GROUP PROCESS
- The combined verbal and
non-verbal interactions
occurring within the group
and the meanings they
convey.

It includes;
a)Communication
content(what is said
verbally)
b)Relationships among
members
c)Seating arrangements

d.) speaking patterns or tones

e.) body languages or
gestures
f.) group themes, which may
be overtly or covertly
expressed

GROUP DYNAMICS

1. groups can be curative.

Working in a group setting allows
clients to develop better insight
through shared information about
common problems
Several factors associated with a
groups interpersonal interactions
may play a role in effecting a cure

2. Group norms are the implicit

or the explicit rules of conduct
defining member behavior
a) Productive norms enhance the
groups function (such as agreeing that
all members opinions are valued or
allowing only one member to speak at a
time)

b) Nonproductive norms inhibit the

groups functions(for example, not
allowing disagreements or accepting
absenteeism and tardiness)

3.) Leadership of a group maybe

shared(by co-leaders or cotherapists), or the group may be
led by one individual; common
leadership includes authoritarian,
democratic, and laissez-faire.

 LEADERSHIP STYLES AND

GROUP FUNCTIONING
- can have a significant effect on
group dynamics and functioning.

TYPES OF LEADERSHIP
STYLES:
AUTHORITARIAN
Characteristics:
o exerts total control
o makes all decisions
o discourages sharing among members
o Task-oriented

EFFECTS ON GROUP MEMBERS

o Can lead to frustration and anger among
members
o May encourage scapegoating
o May foster passive-aggressive
behavior(absenteeism)

DEMOCRATIC
Characteristics

Encourages member
involvement
Fosters
collaboration and
cohesiveness
Promotes open
communication

Effects on group
members

Promotes feeling
that individual
members are valued
Fosters loyalty
Encourages
productivity

LAISSEZ-FAIRE
CHARACTERISTICS

Functions as
resource/consultant
Provides minimal
direction
Promotes minimal
interpersonal
interactions

EFFECT ON GROUP
MEMBERS

Can cause members

to feel lost or
without direction
Promotes
disorganization
May lead to apathy

Group therapy can occur on

inpatient and outpatient
community settings; brief
inpatient stays and care directives
provide a financial incentive for
using group methods of
treatments.

Stages of group
development
1. Groups work through three
typical stages of development
2. In the orientation stage, group
expectations are established and
group norms are specified
a. anxiety level may be high
among members
b. superficial sharing occurs

3. During the working stage,

members work productively on
the established goals and focus
on the purpose of the group.
a. members increase their
level of self-confidence
b. a cohesiveness develops
within the group

4. In the termination
stage, summarization of
the group experience
occurs
a. Members share feelings of
sadness or loss
b. Some may re-experience
anxiety felt during the orientation
stage

GROUP ROLES

1. Each member typically has a role

within the group.
2. These roles can overlap and change
among members, depending on the
situation; they may also be helpful or
impede the group.

3. Typical roles include:

a. Initiator: suggests innovative ideas and
starts interactions
b. Coordinator: organizes and integrates
the progress of the group
c. Evaluator: appraises group performance
d. Information seeker: elicits facts
e. Gatekeeper: screens input and
maintains open communication
f. Encourager: offers praise and
acceptance
g. Harmonizer: maintains peace through
compromise and alternatives

h. Commentator: processes the group

interactions
i. Blocker: inhibits group advancement
j. Recognition seeker: seeks self-praise
k. Monopolizer: controls by endless
talking
l. Self-confessor: discloses personal
information inappropriately.

ROLE OF THE NURSE

1. In the group therapy, the nurses role
depends on her educational level and
experience, as outlined by the ANA
standards of psychiatric-mental health
clinical nursing practice
2. The psychiatric-mental health
generalist or registered nurse works
with groups on issues that pose
immediate problems with clients health
or well-being

3. the psychiatric-mental health clinical

specialist or nurse practitioner works
as a group therapist, using her knowledge
of behavior at the interpersonal and
group levels

3 TYPES OF GROUPS:
PSYCHOTHERAPY GROUPS

1) Psychotherapy focuses on
encouraging members to analyze and
improve interpersonal functioning.
2) Groups are designed around a
specific theoretical framework.
3) The most common types of
psychotherapy groups include;
a. psychoanalytic group therapy
b. interpersonal group therapy
c. cognitive-behavioral group therapy

o Therapeutic group

 Therapeutic groups focus on group

relations, interactions among
members, and immediate issues of
living and behaving.
Several types of groups are available
to clients on both an inpatient and
outpatient basis
a. support groups provide acceptance
and empathy for members, reinforce
existing strengths and reduce anxiety

b. Activity groups(arts, dance and music)

facilitate communication and interaction
by encouraging expression of feelings in
non-verbal ways; they also enhance selfesteem.

c. Educational groups(medication
management, stress management)
provide information on topics of interest;
they empower clients through selfmanagement of behaviors.

d. Socialization groups(clubs, hobby groups)

help members to improve interaction skills
and plan activities for mutual enjoyment.

e. Reality-orientation groups(current events

groups) assist clients with cognitive
impairments by using a variety of
environment reminders( such as clocks,
television, radio, newspapers, magazines).

f. Community meeting groups(inpatient

groups on a particular psychiatric unit)
explore common concerns and focus on
problems in group-living situations.
-they discuss and clarify rules, request
and privileges
-they also encourage clients to be selfdirected

o Self-help group

o Members(rather than mental health

professional leadership) run the group.

o Members share the same problem

which is the main focus of the groups
work, and offer strategies for coping.

NURSING PROCESS

A. ASSESSMENT
1. Assess the individual client
behaviors within the group
2. Assess the group processes,
noting such factors are
a. seating preferences
b. communication patterns

c. Non verbal-patterns of
communication
d. Response to group norms
e. Roles assumed by individual
members

B. nursing diagnoses

1. Recognize how the groups behavior

and your own behavior affect
individual group members

2. Analyze group dynamics and group

processes.

3. Establish individualized nursing

diagnoses for clients within the
group, as needed:
.Anxiety
.Decisional conflict
.Deficient knowledge
.Impaired social interaction
.Impaired verbal communication
.Ineffective coping

 ineffective health maintenance

Post trauma syndrome
Readiness for enhanced management
of therapeutic regiment
Situational low self-esteem

PLANNING AND OUTCOME

IDENTIFICATION
1.Work with group in setting realistic goals
2.Establish desired outcome criteria
Members will participate in group activities
Members will demonstrate concern for individual
members of the group
Members will focus on the identified purpose
related to the specific group type and task
Members will improve communication and
socialization skills
Members will learn effective ways to manage
therapeutic regimens
Members will demonstrate improved individual
coping behaviors

IMPLEMENTATION

1During the orientation phase, take the following

measures
Provide directives and establish the contract for
meeting schedules, purpose, and goals for the
group
Encourage open communication and feedback from
all members
Discuss and establish norms of behavior

IMPLEMENTATION
2. During the working phase, take the following
measures
Assume the appropriate role as leader, depending on
the type of group
Listen, observe and provide therapeutic feedback
Comment on behavior that enhances or hinders
group progress
Recognize conflicts and discuss them in open
manner
Foster self-esteem among members
Focus in immediate issues and problems of members
Provide appropriate information in an educational
group setting
Ensure the participation of all members

IMPLEMENTATION

3. During termination phase, take the following

measures
Assume a supportive role in assisting members to
identify and discuss termination feelings
Encourage evaluation of group and individual
members progress
Refers those whose needs were not met by the
group for further evaluation and treatment

OUTCOME EVALUATION

The group exhibits shared allegiance and

responsibility
The group demonstrates active participation by all
members
The group accomplishes its goals or purpose
The group communicates among all members, not
just between leaders and members

OUTCOME EVALUATION

Individual members demonstrate use of

communication skills
Individual members apply problem solving skills to
their own life
Individual members report improved coping and
behavior
Individual members state effective ways to
manage their therapeutic regimen