GROUP LEADERSHIP

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.

Seven-Step Format for Activity Groups

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 necessary to say their names out loud but the presence of each member of the group is acknowledged by a simple greeting.

INCLUDES:
A. Warm-Up The leader should be concerned with the receptivity
of 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.

B. Setting the mood

Factors include the environment, the therapists facial expression 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.

D. Explaining the Purpose Clearly Usually depends on the type of group and the patients level of understanding. A higher level group of patients will want to know why they are being asked to do a particular activity. Lower cognitive patients are unlikely to understand such abstract explanations of purpose. Goals may need to be spelled out in concrete terms.
E. Brief Outline of the Session The timeframe, the media, and the procedures are told. Gives clues to the members about the sessions focus.

STEP 2
THE ACTIVITY

 Many factors should be considered when planning the activity. This is a complex process. Selecting a therapeutic activity involves the entire process of clinical reasoning.

The following issues will be presented for consideration in selecting a therapeutic activity: Timing Therapeutic Goals Physical and Mental Capacities of members Knowledge and skills of the Leader Adaptation of an Activity

TIMING
The activity should be simple and short and should last no longer than one third of the total session.

THERAPEUTIC GOAL Goals and desired outcomes are something a patient and a therapist strive together to accomplish. A therapeutic goal for patient involves assessing their needs and applying the therapists knowledge of the patients abilities and disabilities. The group goal should be chosen to meet the needs of most of the members. Once the goal is defined, an activity is selected or designed to help members 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 by the physical and mental capacities of members.

KNOWLEDGE AND SKILLS OF THE LEADER Student leaders usually choose activities for the group that they themselves are comfortable with or have done before.

ADAPTATION OF AN ACTIVITY Adaptation of the activity requires some knowledge of activity analysis and synthesis. Activity analysis is the breaking down of an activity into its component parts and matching each part with human function required to accomplish it. Modifications can be made in the activity to suit the patients abilities

Step 3: Sharing
Sharing of work or experience with the group The structure and process for sharing may vary with each activity

 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.

 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

 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

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

 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

 Therapist has the opportunity to incorporate them into the subsequent discussion and to help the clients understand the significance of the 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 that may never be verbalized, but will have a powerful influence on the group.

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.

 The general principles discussed in the group should not be preplanned, but should come directly from the response of the members. General principles may be arrived at in several ways: A. Look at the patterns of response among members: 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 issues that seem to energize the group and stimulate spontaneous conversation

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

Step 6: APPLICATION
Knowledge of each patients background is helpful. The therapist discusses with each member how the principles learned in the group relate to the problems or issues each has expressed earlier. Application may sometimes resemble a kind of group problem-solving: members help each other find ways to apply the newly learned information

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

Step 7: SUMMARY
Therapist asks the group members to help summarize by remembering the activity and giving their ideas about what was learned. General principles are included in the summary. Having members explain their 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 acknowledge feelings is to thank the members for their participation in the group. Addressing and thanking individuals for their openness, honesty, and willingness to share or trust in the group is always welcomed.

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 steps have not been completed by the end of the session, the missing parts and the reason s for this can also be discussed within the summary.

Step 7: SUMMARY
Before leaving the how to section, for additional factors of leadership need to be explored: 1. Group motivation 2. Setting limits 3. Leadership styles 4. Co-leadership All are the responsibility of the leader and should occur throughout the seven steps as they are needed.

LEADERSHIP STYLES

 Leadership styles profoundly affect the outcome of the group Different FORs require very different leadership approaches 3 fundamental leadership styles:
Autocratic Democratic Laissez-faire

Directive Leadership
Directors defines a group, selects activities, and structures the group Uses authority sparingly If too much authority, may feel inadequate and can stunt growth and development Absolutely necessary for lower functioning patients Therapists decision should not be based on own preference, but on expert assessment on the need of the group

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 and concern for members Facilitators also are educators Facilitations also has limitations MOHO depends on a facilitative leadership style

 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

Group Leader as Adviser

-The most passive of the leadership styles -Its use in therapy is limited to the highest functioning groups working on goals like problem-solving or attitude change -The adviser offers expertise as needed or requested, but does not provide structure or goals. Motivation comes from the group itself, and change is produced intrinsically as a result of internal processes of each member. -FORs for which adviser leadership is most appropriate are psychoanalytic, humanistic and MOHO

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.

 The ongoing functions of the group are: to help achieve its goals (task function) and help maintain 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