Antonio, Iris Marie Avenido, Elaine Jo Chan, Jacqueline Marie Cisneros, Cindy Jane

Colina, Ryan Benedict Lim, Elizabeth Janine Mejiliano, Christine Ygay, Goebel Anwin

BSOT 4 OT7 Psychosocial Dysfunction Mr. Louie Ygot, OTRP

FRAMES OF REFERENCE FOR GROUP TREATMENT

Object Relations
group that gives emphasis to the process of the activity, with the end product being secondary the therapist helps in improving each patient's social and task behavior, interpersonal relations and their approach to activities based around inciting change through the different interactions of the group The therapist should observe the following: method of activity choice the skills which the patient demonstrates attitudes of members towards each other the satisfaction with the group outcome the feelings expressed about the group the communication system

The therapist discusses his observation with the patient within the boundaries of their understanding and intended therapeutic benefit to bring about change

Cognitive-Behavioural Frame of Reference

The predominant approach identified with this theory is the psychoeducation group. It is an instructional model which utilizes contemporary educational activities such as short lectures, audiovisual materials, worksheets and handouts, simulated exercises and homework. These activities are graded learning experiences to develop new knowledge and skills to achieve mastery. Multiple patient levels of function in the group allow the patients to help each other, give feedback and provide support for risk-taking. They are encouraged to learn from each other and to work together during problem-solving. Programmes which exemplify psychoeducational OT are the life skills groups by Lilli and Armstrong and the SCORE: Solving Community Obstacles and Restoring Employment programmes by Kramer in 1984. Theories related: a) Allen cognitive theory b) Sensori-motor integrative theory (Ayers, King, Ross and Burdick) c) Recapitulation of ontogenesis (Mosey) d) Developmental theory (Llorens) Only recapitulation of ontogenesis by Mosey and sensori-motor integrative theory by Ayers stage specific, sequential developmental principles Bruce and Borg operant concepts related to adult development and emphasized use of life development intervention (LDI) strategies during adult years

Developmental Frame of Reference

Therapeutic Factors Imitative behavior Learning from other patients in the groups and from staff role modeling Learning to express feelings effectively in the group Working through concerns regarding death, freedom, isolation and meaninglessness, and their relationship to the anxiety and pathology which they are experiencing Developing a sense of belonging to a group and feel valued by the m embership Behaving similarly to the way they do in the everyday environment Change in the group = change the patients interpersonal style and success in the community Catharsis Existential Factors

Cohesiveness Interpersonal Learning

Instillation of hope Patients at various functional levels have renewed optimism as they hear similar problems and see others take risks and change Universality Patients meet persons with similar problems and experiences and realize that they are not unique. Impairing of information Patients gain implicit or explicit information regarding the meaning and management of their symptom and feedback about their interpersonal style Altruism From group interactions the patients learn that they can contribute and thus increase their selfvalue and what they have to offer. Corrective recapitulation of the primary family group In the group patients can re-experience family conflicts and learn new responses rather than use the maladaptive patterns which may be established Development of socializing techniques During the group patients have the opportunity to listen, express empathy, respond to others and learn general social skills

The Group Leader 3 types: 1. Autocratic Planning, implementing and determining the outcome of the group Presents the activity, assigns tasks, and sets and controls the boundaries of group interaction 2. Democratic Values capabilities of group members and encourages them to share in: o Setting group goals o Determining group activities o Assuming responsibility for the group task and process o Determining problem solving strategies 3. Laissez-faire Observer Patients are given full responsibility

Contingency Style Leadership: Flexible Adapt to the group situation and its needs Adjust the leader strategy

Within one group or week to week the group leader may need to adjust the leader strategy and be autocratic, democratic or laissez faire. The criteria to determine leader style are: a) the quality of group interaction and the response desired (output) b) the time available and necessary to accomplish the task c) the capabilities and satisfaction of the group members d) the group attendance and cohesion e) the dependence - independence of group members Plus, the effectiveness of group function, group history and the expectations which the group members have of the treatment experience can influence the leadership required and the group outcome.

Group Development Group development is the specific or sequential pattern of events over time (Fisher, 1974) as well as within each individual group meeting. Four Phases Applied to OT Groups (Tuckman, 1965) 1. Forming People get to know each other and know the purpose of their meeting Can be facilitated by a group warm up People interact; individual needs, interests and value differences emerge and conflict may exist 2. Storming OT listens for themes and tries to get the group to acknowledge similarities and differences and focus on common concerns to being problem solving. Therapist may use the differences of each member to look for alternative solutions, develop new standards and assume various roles in the group 3. Norming Effect of storming Help members work together as a group (cohesiveness) 4. Performing Happens once norms are established Group focus on its task and reach maximum productivity to achieve group goals As each of these 4 phases occurs, the thx may choose to bring the development process to that attention of group members in order to recognize their growth or to promote learning. The therapist may acknowledge individual or group accomplishments at some point bring closure to the group. Patients: gain awareness of group development principles and learn from communication process which occurs during OT group.