522 OCTH


Step 1: Introduction

-this includes the therapist name, title, and the name of the group that is about the begin. Explain the purpose clearly, use the warm-up if needed to relax or prepare the group. Communicate expectations outline timeframe, structure of group, and any rule

Step 2: Activity

Must ab adequately prepared, utilizing time effectively. Directions should be clearly give and prepared to down grade if needed for those client that might require extra attention. Have appropriate materials ready and available and make sure the environme

Step 3: Sharing

in this step invite members to share their finished projects or assignments, use appropriate verbal and nonverbal communication and empathize and acknowledge feelings or group members. Make sure time is shared equally amongst all group members

Step 4: Processing

-in this step of "processing", leader are encouraged to elicit members feelings about the experience. Ask if they were able to relate to one another or asking the group to provide suggestions. If part of intervention is to assess leadership. Ask members h

step 5: generalizing

-during this point group leaders should point similar responses, contrasts or differences. If possible, identify principles learned during the group

step 6: Application

-the leader verabalizes the meaning of this experience, shows how the experience can relate to everyday life. If appropriate identifies the experience of group to everyday problems or issues.
-A questions to ask the group is "how would you apply what you

step 7: summary

-during this last step, identify important points that were emphasized, reinforce group learning acknowledge contributions of group members and thank them for attending. Try your best to end group on time

what is group?

an aggregated of people who share a common purpose which can be attained only by group members interacting and working together

primary group

face to face relationships

secondary group

more formal

benefits of groups

-non-textbook reasons
-instill hope
-gain/give information
-recapture family dynamics
-develop socializing strategies
-imitative behavior
-existential factors
-interpersonal learning

Group Norms

-seen as rules/attitudes/behaviors that are accepted
-can be verbalized and specified by group leaders

Group non-verbalized norms

-unspoken rules, norms that develop over time, which can be implied by behaviors and interaction of group members
-eg. avoidance of conflict:
-eg, taboo topics (unspoken topics)

Group Verbalized Norms

-confidentiality, respecting others, no cross talking/ disrupting

Group Desirable Norms

-Active involvement in the group
-Extensive self disclosure (leader might share his or her feelings/experience)
-desire for self-understanding (push for them to explore themselves)
-eagerness of change

Role as the OT/Leader

-discourage norms that are defeating the goals of the group
-you the leader should serve as the role model to share feelings/experience

changing norms as OT/Leader

-don't want them to always focus on group leader for all the answers
-reinforce positive behaviors
-encourage to change undesirable behaviors


-what happened or was said in the group
-pay attention to the demeanor during verbal interaction


-what is happening beyond what is said or done?
-What is implied by the content?

Process vs. Content: Therapist role

-need to identify the area of content that must be processed. If processed properly, this will help clients move forward and as a result through processing their needs will be addressed

Process vs Content: Group Development

Over time a group develops, relationships change and you (the OT) will see processing more often as time goes on

Schultz's Stage of Group Development: Stage 1

Inclusion stage- Beginning stage, general thought process of members "where do I fit in?" "Am I respected?

Schultz's Stage of Group Development: Stage 1 behaviors

-over talking
-individual self-centeredness
-listen but do not hear
-look at leader but not at others
-turn to leader for answers
-look for similarities, downplay difference
-depend on leader for structure
-only say what will be accepted

Schultz's Stage of Group Development: Stage 2

Control stage- Group members may think..."how do I stand in relationship to power?" "How much influence do I have?

Schultz's Stage of Group Development: Stage 2 behaviors

-leader is viewed with skepticism
-leadership struggle
-members disagree about leadership
-challenge leader
-disenchantment with the group

Schultz's Stage of Group Development: Stage 2: choice for leader

-back down
-subdue the rebellion
-encourage sharing the leadership

Schultz's Stage of Group Development: Stage 3

Affection Stage-Members thoughts..."how do others feel about me?" "How do we feel about each other?" (In this stage there is an observable group mentality)

Schultz's Stage of Group Development: Stage 3 behaviors

-now group is able to listen
-feel safe
-altruistic desire to help others
-can often regress from this stage

Why do we need Schultz's stages? How groups can reach maturity?

-have a focus
-pay attention to feelings
-be an active participant
-give feedback
-be open to feedback
-take responsibility for what you accomplish

Group roles: initiator-contributor

suggests ways or ideas for addressing

group roles: information seeker

asks for clarification or facts relating to problems

group roles: opinion seeker

not facts, but clarification of values and attitudes

group roles: information giver

offer facts or info or generalization w/out being asked. They do it automatically

group roles: opinion giver

states beliefs or opinions, maybe w/out being asked

group roles: elaborator

spells out suggestions and gives examples

group roles: coodinator

clarifies relationships among various ideas

group roles: orienteer

defines position of group with respect to its goals

group roles: energizer

prods group into actions

group roles: procedural technician

gets group going by doing things

group roles: recorder

group memory, writes everything down or remembers everything

group roles: evaluator/critic

asses accomplishments in-group

group building & maintenance roles: encourager

praises members and exudes warmth toward members

group building & maintenance roles: harmonizer

someone that helps keep the peace smooth out differences between group members

group building & maintenance roles: compromiser

person that will change opinion or compromise in order to keep group in harmony

group building & maintenance roles: gatekeeper & expediter

tries to keep communication going by encouraging participation, equally sharing

group building & maintenance roles: standard setter

-presents standard that will help group move forward

group building & maintenance roles: group observer commentator

someone that pays attention to group process & gives info & interpretation/ good evaluation of process

group building & maintenance roles: follower

acts more passively, goes along with the flow, builds group cohesiveness

individual roles: aggressor

someone that expresses disagreement (in unpositive way), of the way group is going. May attack feelings of others, or group as a whole. Might joke aggressively, right see them taking credit for what they'v done

individual role: blocker

-someone negative/stubborn trying to prevent progress, bring up old issues which prevents moving forward

individual roles: recognition seeker

someone that calls attention to themselves, by boasting, being over talkative

individual roles: self-confessor

expresses non-group feelings or only slightly related. takes opportunity to dump

individual roles: play boy

-cynical, lack of interest in group, may do horseplay, flirting, and little emotional investments

individual roles: dominator

person that tries to be authority, this type of person moves into leadership role. However; not really listening, talks over others and interrupts

individual roles: help seeker

always looking for sympathy, might be insecure, self-depreciative, can be teary eye in sessions

individual roles: special interest pleader

will always be trying to stand up for a political/special interests

Group roles

-information seeker
-opinion seeker
-information giver
-opinion giver
-procedural technician

group building and maintenance roles

-gatekeeper and expediter
-standard setter
-group observer commentator

individual roles:

-recognition seeker
-help seeker
-special interest pleader

What is communication?

a sensory modality: visual, auditory, and kinesthetic/body language

non-verbal communication: eye contact

none= passive
stare= aggression

non-verbal communication: body posture

good stance= assertive
slumped= passive
forward= aggressive

non-verbal communication: hand movements

natural= assertive
tentative= passive

non-verbal communication: facial expression

downcast= passive
contorted= aggressive

OT as a communicator

your right are to speak up, you're allowed to have problems, to be confronted, to work, to make mistakes, to be rewarded, to be independent, to find solutions, to confront others, to correct mistakes, to reward others, to be dependent on colleagues

non-therapeutic use of questions

-don't make judgments
-don't use multiple questions
-"why" questions can become offensive
-be careful of self-disclosure

common communication problems & strategies

-break eye contact
-redirect questions to other members of the group & encourage interactions
-don't give advice/ suggestions right away
-validate client's perceptions/ beliefs
-think about your body language as a role model
-encourage patient to share th

communication response to avoid

-don't probe too much
-do not be too socialized with patient
-avoid giving false reassurance
-don't be too giving (could equal dependency)
-no "why" questions
-avoid interrupting patient
-don't summarize right away
-do not belittle the patient

Traits of a good leader

-in control

good leaders born or made?

both: depends on your strengths and weaknesses

primary functions of the leader

develop group goals/objectives
-how to meet goals
-group building and maintaining: facilitates processing and goes beyond the group activity

roles of OT group leader

-select members to join group
-write group protocol
-choose the best leadership style for the group
-support positive efforts of group members
-maintain therapeutic norms
-evaluate progress and determine group outcomes

group leadership styles


group leadership styles: directive leadership

-feedback is give by the leader.
-determine structure, activity, and processing
-takes active role in shaping member participation
-group goals achieve through active leadership
-this type of leadership is appropriate when there is cognitive impairment, p

group leadership styles: facilitative leadership

-is a democratic system where leader gathers support from members by communication and through showing concern for the group's best interest and allows choices
-a level of ability and rational thought is presumed
-the group can experience advanced levels

advisory leadership

-a passive type of leadership, which assumes a higher level of functioning
-members are more motivated and activities tend to be more informal (such as community and professional activities)
-the leader acts as a resource, provides information on more spe

co-leadership disadvantages:

-take sides against each other
-power struggles
-unequal contribution
-takes more time meeting
-each individual has a different pace

co-leadership tips

-choose good partner for you (compatible)
-interview clients together
-plan to be organized together
-time to process afterwards
-remember co-therapy has both positive and negative effects

sharing group leadership with a COTA:

-OTR needs to understand the skill level of a COTA
-There's no need for a power struggle, COTAs can work with all groups at all levels
-As co-leader, COTAs may have more knowledge of the client than the OTR because of prior contact

COTA Group leaders

-collaborative relationship must be established first
-COTA and OTR share or alternate responsibility
-COTA can lead groups alone
-OTR has education with regard to theory, but the COTA may have more experience

problem behavior types

-the silent one
-the monopolizer
-the hostile and aggressive one
-the abusive language and swearing one
-the late one
-"I want to leave group"
-the skeptic
-the narcissistic member "attention seeker"

problem behavior: the silent one

-makes frequent eye contact, break the ice, speak to person outside of the group
-ask "you seem quiet today"
-encourage don't force to participate
-recognize and appreciate small efforts
-ask for their opinion

problem behaviors: the monopolizer

-takes over the group
-OT should redirect the topic to others, summarize/ re-focus group goals
-ask other members to give feedback of how they feel when group conversation is taken over

problem behaviors: the hostile & aggressive one

-provide person with cool-off time

problem behaviors: the abusive language and swearing one

-as long as no one is being offended, know how group members feel

problem behavior: the late one

-figure out why they are late, depending on setting, ask them to listen and sit quietly when they arrive, and talk with them after group

problem behaviors: "I want to leave group

-ask yourself why
-ask them why
-show you care
-let them know it's their choice

problem behaviors: breakdown/crying

-as long as not disruptive of an act of attention-seeking, it's okay
-be supportive, discourage other group members from overreacting

problem solving: dishonesty

-ask why
-discuss privately with person
-be conscious to decrease embarrassment
-have group confront the individual depending on the situation

problem behaviors: the skeptic

-ask why
-what are they really saying
-leader should not become defensive
-remember group process
-let group members respond
-meet with the patient individually

problem behaviors: self-deprecator

-ask why
-ask group to identify behaviors
-encourage the patient to accept group support and encouragement

problem behaviors: the narcissistic member: "attention seeker

-demands attention and has a fragile sense of self worth
-can be very disruptive
-in a caring manner have members tell how the individual's actions make them feel

problem behaviors: psychotic behavior

-pay attention to it
-if destructive in group, ask the individual to leave.
-action is better versus discussion in this case