CEW 

Group Treatment Plan

1. Group Topic: coping with anxiety and stress/controlled breathing

2. Purpose of the Group: Controlled breathing exercise/develop coping strategies

3. Frame of Reference (MOHO, Humanistic, Behavioral) Humanistic

4.Group Size: 2+ members

5. Group Goals for the individual members (What measurable skills do you want the

members to demonstrate, identify, do, etc.): 

1.  Members will follow directions with minimal distraction during the activity given by
group leader 80% of the time during the one-hour session.

2. Members will develop at least one new coping strategy to respond to stress by the end
of activity.

3. Members will paint a measured breath cycle on a piece of paper, demonstrating their
understanding of controlled breathing and breath awareness by end of activity.

4. Members will accurately steady their own breathing pattern three out of four times
during activity while utilizing the 5 second inhale, 7 second exhale. 
6. Methods: 
1. Supplies needed (What do you need to gather before group): 
-paper
-paint
-brushes
-cups
-water
-paper plate for paint 

2. Introduction/ Icebreaker activity (Be specific with the steps involved with your
introduction and icebreaker. This should relate to your main activity and
purpose):  

Ask group members to identify a time they get overwhelmed and one coping
strategy they might utilize during that time. 

1. State that often when people become overwhelmed they have a way of
dealing with that feeling, ask group members to identify a time that they
felt overwhelmed and ask what they did to cope with that feeling
2. Allow each group member to respond utilizing active listening techniques
and summarizing what they said to make sure it was understood correctly
3. Add that there are many ways to cope with a stressor and that today we will
have an activity that addresses controlled breathing (one coping strategy)
and using art to visualize this 

3. Main Activity (Provide specific steps involved in your main activity): 

1. As a warm up activity, teach group members how to practice controlled breathing

→ breathe in through mouth slowly, let lungs and stomach expand, count to 5 on
the inhale, and then slowly release breath through mouth and count to 7
2. Explain activity: group members will paint their breaths into waves (brush stroke
up on inhale, down on exhale)
3. Have group members pick paint color(s) that they think of as calming
4. Demonstrate activity as needed
5. Work on activity for 15-20 minutes with calming music playing in the
background (ask first if members are comfortable with music playing)
 6. Ask members to analyze their waves to look for patterns and/or outliers in their
breathing

4. Wrap-Up Discussion (How will you pull it all together and relate activity to skills 

Ask group members how they feel after activity and if they feel like controlled breathing
helps them to feel more calm. Discuss why controlled breathing can help de-stress a person
and why they feel it might be helpful/not be helpful. Discuss the colors each group member
chose and why they chose that paint color. Talk about coping/calming strategies in
situations where they may feel stressed or overwhelmed and discuss other strategies that
they can utilize in these situations. 

7. References (What scientific literature supports your activity/ies): 

1. https://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-
control-helps-quell-errant-stress-response 
2. Bernardi, L., Wdowczyk-Szulc, J., Valenti, C., Castoldi, S., Passino, C.,
Spadacini, G., & Sleight, P. (2000). Effects of controlled breathing, mental
activity and mental stress with or without verbalization on heart rate variability.
Journal of the American College of Cardiology, 35(6), 1462-1469.
3. Yu, B., Funk, M., Hu, J., Wang, Q., & Feijs, L. (2018). Biofeedback for everyday
stress management: A systematic review. Frontiers in ICT, 5, 23.

Grade up:
1. Allow more choices in terms of paint colors, brush size, paper size etc.
2. Require members to discuss their artwork and thoughts on the activity with one another
as they had not done that in the previous group therapy session
Grade down:
1. Only provide 3 paint color choices, 1 brush size, 1 paper size so the choices are less
overwhelming
2. Group leader provides verbal cues step by step during the activity and can provide hand
over hand assistance if needed