Interventions With Groups
Chapter 14
Definitions of “Group”
• A collection of individuals who identify with
the leader, and other members, but who act
independently (psychoanalytic definition)
• Parts or components that exist to perform
some activity or purpose (systems theory)
• Two or more people who develop interactive
relationships and share at least one common
goal (this text)
Open vs. Closed Groups
• Open group
–
–
–
–
New members may join.
Members may leave at any time.
New members are at a disadvantage.
Advantage of this type is that group can continue.
• Closed group
– Members join at one time.
– There are no replacement members.
– Group is more cohesive.
– Group is more likely to dissolve when members drop out.
Group Size
• Small
• Large
• Eight to 10 people
• > 10 members
• Cohesive
• Can be therapeutic
• Fewer subgroups
• More cost-effective
• Richer IP
• Open-ended,
ongoing
• Led by one
• Avoid intense
transference and
counter
Group Development
• Group development is a process.
• Definition: Group process is the
culmination of the session-to-session
interactions of the members that move
the group toward its goals.
Group Process
• Beginning
• Honeymoon
• Conflict
• Working
• Develop rules, rituals
• Group realizes its purpose.
• Termination
• Members grieve for loss of the group.
• Reestablish themselves as individuals
Roles of Group Members
• Formal group roles
– Leader
– Member
• Informal group roles
– Task
– Maintenance
– Individual
Group Membership:
Roles & Functions
• Task roles: business of the group
– Initiator, information seeker, coordinator, recorder
• Maintenance roles: keeping group together
– Harmonizer, compromiser, gate-keeper, observer
• Individual roles: either detract or enhance
group
– Aggressor, self-confessor, recognition seeker
Group Communication
• Verbal Communication
– Communication network
• Sociometric analysis
• Sit next to each other, talk to each other
– Group themes
– Mood
Group Communication
Non-verbal Communication
• Seating arrangement
• Eye contact
• Posture
• Body gestures
Group Norms & Standards
• Groups develop norms or acceptable
group behaviors.
• Formalized norms
– Example: beginning group on time
• Informal norms
Group Cohesion
• One of the goals is usually fostering group
cohesion.
• Encourages social interaction
• Helps group stay together
• Increases members commitment to group
• Disadvantage:
– In very cohesive groups, members are more likely
to transgress personal boundaries.
– Can become dysfunctional
Groupthink
• Tendency of groups to avoid conflict and
adopt a normative pattern of thinking
• Can lead to poor decision-making because
the group is more concerned about being part
of the group, rather than thinking
independently
• Unclear whether cohesive groups are more
likely to experience groupthink
• Be aware of the possibility in decision-making
groups
Leading a Group
• Obtains and receives information
• Helps in the diagnosis of group goals,
obstacles and consequences of decisions
• Facilitates communication
• Helps integrate the various perspectives and
alternative possibilities
• Tests and evaluates proposals and decisions
• Techniques Table 14-3
Leadership Skills
• Listening
• Tracking verbal and nonverbal interactions
• Maintaining a neutral, nonjudgmental style
• Not showing preference to one member over
another
• Providing everyone with an opportunity to
contribute
Choosing Leadership Styles
• Led within the context of the group leader’s
theoretical background
• Direct-indirect Continuum
– Direct leadership
• Controls the interaction
• Gives direct information
• Allows little discussion
– Indirect leadership
• Uses reflection and offers little guidance
• Does not provide information to the group
Selecting Group Members
• Leader responsible for membership
• Consider the following:
– Does the purpose of group match the need of
patient?
– Does the patient have the skills to participate in
the group?
– Will other group members accept the new
member?
– Will the new member be able to make the
commitment to attend?
Seating Arrangements
• Use circle seating without barriers
(tables).
• Rectangular tables tend to promote
positions of power at the end of the
table.
• Classroom seating prevents effective
interactions.
• No one should sit outside the circle.
Seating Arrangements
• Members who sit closest to the leader
are more likely to have more power.
• Group should be held in a quiet,
pleasant room with adequate space and
privacy.
• Large rooms inhibit communication.
• Avoid eating during group.
Discussion of
Challenging Behaviors
• Monopolizer
• “Yes, but”
• Disliked member
• Group conflict
Types of Groups
• Psychoeducation
– Task groups
– Teaching groups
• Supportive therapy groups
• Psychotherapy groups
• Self-help groups
Nursing Intervention Groups
• Medication groups (Text Box 14.2)
• Symptom management groups
• Anger management groups
• Self-care groups