Group process and therapy

• Occupational therapy group treatment is a

combination of structured, adapted group
process and tasks or activities aimed at
fostering change and adaptation in people
with acute, chronic illness, impairment and
disability.
 Therapeutic use of group properties

• Leadership involvement
• Purposeful activity
• Structure and format
• Practice
• Teaching and learning
• Socialization and outside action
• There and then
• Here and now
Eras of group work in Occupational therapy

• Project era 1922-36- project completion

• Socialization era 1937- 53- social activity
• Group dynamics proces era, 1954-61-
interpersonal dynamics
• Ego building- psychodynamic era- 1962- 1969
ego reconstitution
• Adaptation era- 1970- present- social
adaptation
 10 types of groups
• Exercise
• Cooking
• Tasks
• Adl
• Arts and craft
• Self- expression
• Feelings- oriented discussion
• Reality –oriented discussion
• Sensorimotor or sensory integration
• Educational
 OT group variables
• Setting
• Therapeutic factors
• Short term and long term goals
• Duration of group
• Composition of group
• Time frame and format
• Population
• Group size
• Frame of reference
• Open vs closed group membership
• Member selection and preparation
• contraindications
 Functional group model by Howe and
Schwartzberg, 1986
4 key concepts:
• Purposeful activity
• Self- initiated actions
• Spontaneous action
• Group- centered action
Group orientation and Inpatient goals and Outpatient goals and
format techniques techniques

Interpersonal and Support, containment Social change, insight

dynamically oriented New skills and attitudes,
structure, here and now
Behaviourally and (immediate experience)
educationally oriented

Support groups acceptance Legitimization, information

and decreased isolation

Maintenance and Safety, reevaluation, Adaptation, resources,

rehabilitation groups discharge planning minimization of stess
 Selected OT group approaches and
theoretical consideration
• Group approaches:
1. task- oriented group
2. Functional group model
3. Directive group therapy
4. Activity group
5. Developmental group
6. Psychoeducational group
7. Integrative group therapy
8. Peer support group
 Developmental groups
• Parallel group- provide safe place, feels accepted, and valued. Each patient would work on his
own chosen task while sharing space with other patient. E.g., craft group. OT is a leader here

• Project group- come together to interact, casual conversation to complete a short term task .
Work together cooperatively, share space, material, tools, and able to cope with LIMITED
COMPETITION. Ot is the leader here, present short term tasks, support, assist guide. Provide
opportunity to trial and error learning, for group interaction and a task, and for a balance
between cooperative and competitive experience. E.G.,Team sports or games, planning or
preparing a party

• Egocentric cooperative group: one hour per session, in one or two work session, completion of
task. Learn to express needs, acknowledge other’s needs, ask for feedback, and give feedaback.
Ot is democratic leader here, makes suggestion, allows to choose and patient plan and carry
out task. Facilitate task completion, acceptance and safety. 1. identify group norms and goals 2.
use their own knowledge and skill, 3. experience various group roles, 4. identify himself as
group members with rights, 5. respect rights of others, 6. respond empathetically to group
members’ needs, 7. gain satisfaction. Eg., structured learning experience- assertiveness,
communication skills, stress management
• Cooperative group: cohesive group, express and share
needs, thoughts and feelings. Promote sharing, listening,
don’t seek end product. OT role is as advisor rather than
a leader, becomes a participant. Behaviour change is not
the focus of this group. E.g., music , poetry, discussion

• Mature group: patient independently select, plan and

complete a group task, time limited and produces a
specific end product. OT works as a group member. Learn
socio- emotional and task roles of group. Goal is to keep
aside individual needs and work for the betterment of
the group and help to accomplish the goal e.g.,
community transition group
 Activity group
• Evaluation group
• Task oriented group
• Developmental groups
• Thematic groups
• Topical groups
 Sample roles and phases of group
development
Roles Formation Development Termination

Leader Set climate Grade actions Aid separation

Provide structure Facilitate Reinforce gains
Offer support

Member Identify purpose Collaborate Evaluate

Initiate Express reactions

Activity Form goals Purposeful action Review

Establish trust