GROUP DYNAMICS in Occupational Therapy: The Theoretical Basis and Practice Application of Group Intervention

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Introduction to the Fifth Edition

The literature reports occupational therapy group interventions much more frequently today than 2 decades ago when this book was first published. Furthermore, occupational therapy groups now target not only mental health adult clients, but also children, youth, and older adults with a variety of physical, neurological, and developmental health conditions. We can speculate that part of the reason is the availability of more f lexible sources of funding for occupational therapy services, allowing reimbursement for group interventions by medical insurance or from public sources. But more impor-tantly, we now have an abundance of evidence that group interventions work, especially when the occupational therapy group leaders skillfully facilitate the development of social and emotional support so vital to the client’s sustained effort in facing health challenges (Bandura, 2001). Also, groups are cost effective, because they support self-management and self-efficacy, both important factors for preventing illness and keeping people well, away from hospitals or costly institutions, and living in their communities (e.g., the Well Elderly Study, Clark et al., 2011).

In this Fifth Edition, some things have changed, while others have stayed the same. The basic method for conducting occupational therapy groups remains unchanged because Cole’s seven steps are widely taught and used, both nationally and internationally, and they still work as well as they did in the beginning. The seven steps are mainly a teaching tool, to prepare professional students for leading the highest level therapy groups without missing any learning opportunities for the members. These steps were always intended to be adapted in consideration of different clients, cultures, populations, treatment settings, and frames of reference. Their f lexibility has made the steps a lasting tool for practice. The basics roots of group dynamics likewise remain constant, with, of course, many evolving areas of new research to add to our knowledge about how different types of group work and what qualities make groups therapeutic. The broader theories that underlie group intervention in occupational therapy are reviewed in Chapter 3, such as client-centered practice, complexity theory, and nonlinear science. The entire book is updated in consideration of the Occupational Therapy Practice Framework: Domain and Process, Third Edition (American Occupational Therapy Association), which was updated in 2014.

In Section II, the first five frames of reference remain as broad categories, keeping the basics and adding new devel-opments and evidence. All of the theory chapters contain examples of the many new group interventions reported in the literature. Special attention was paid to the addition of group interventions for children and youth, as requested by the reviewers. The brief overview of occupation-based models in Chapter 10 includes updates for all five: the Model of Human Occupation, Occupational Adaptation, Person-Environment-Occupation/
Person-Environment-Occupation-Performance, Ecology of Human Performance, and the Kawa models, also with newly published group examples.

The main change was in Section III, with the addition of an additional chapter on wellness, recovery, and trauma-informed care, as requested by reviewers. The group protocol is updated to ref lect current practice, including new work-sheets that are classroom tested (with acknowledgment to Professors Tufano and DeFrancesco of Quinnipiac University). The student laboratory experiences on professional development and cultural competence remain as before (because they are still widely used), and the community service learning project has been updated to include current examples.

So, the book is updated, many things added, but little has been removed this time around. Activity examples and learning activities remain where they were so instructors will have them available when needed for long-standing lessons and coursework. The most critical update for groups is the newly validated goals of supporting self-management and self-efficacy. These are based on Bandura’s social cognitive theory, and soundly embedded in the models of wellness, recovery, and trauma-informed care. These could be critical to the future of our profession, and it is hoped that more occupational therapists will build their group interventions around them.

Also, revised instructor’s materials are available for the Fifth Edition. Please visit at www.efacultylounge.com to obtain access.

Contents

About the Author .......................................................................................................................vii
Introduction to the Fifth Edition ..............................................................................................ix
Introduction to the Fourth Edition .......................................................................................... xi

Section I  Acquiring Group Skills ........................................................................................... 1
Chapter 1 Group Leadership: Cole’s Seven Steps ..................................................................... 3
Chapter 2 Understanding Group Dynamics ................................................................................. 29
Chapter 3 Client-Centered Groups ............................................................................................... 59
Chapter 4 Groups and the Occupational Therapy Practice Framework: Domain and
        Process, Third Edition ................................................................................................ 101

Section II Group Guidelines From Selected Frames of Reference and Models ................. 123
Chapter 5 Psychodynamic Approaches ...................................................................................... 127
Chapter 6 The Behavioral Cognitive Continuum ...................................................................... 155
Chapter 7 Allen’s Cognitive Disabilities Groups .................................................................... 195
Chapter 8 Developmental Approaches ....................................................................................... 221
Chapter 9 Sensorimotor Approaches ......................................................................................... 253
Chapter 10 A Model of Human Occupation and Other Occupation-Based Models................... 285

Section III Planning an Occupational Therapy Group ........................................................ 321

Chapter 11 Writing a Group Protocol ........................................................................................ 323
Chapter 12 A Group Laboratory Experience ............................................................................. 347
Chapter 13 A Group Experience: Developing Cultural Competence......................................... 367
Chapter 14 Community Intervention: A Service Learning Experience for Students ................ 397
Chapter 15 Wellness, Recovery, and Trauma-Informed Care ................................................... 405

Appendix A The Task-Oriented Group as a Context for Treatment .................................. 427
           Gail S. Fidler, OTR
Appendix B The Concept and Use of Developmental Groups ............................................ 433
           Anne Cronin Mosey, PhD, OTR
Appendix C Summary of Mosey’s Adaptive Skills ........................................................... 437
Appendix D Excerpts From the Occupational Therapy Practice Framework:
           Domain and Process, Third Edition ................................................................ 439
Appendix E Theory-Based Group Leadership Guidelines.................................................. 441
Appendix F Overview of the International Classification of Function, Disability and
           Health, Second Edition ......................................................................................443
Index ..........................................................................................................................................445