The Group Process in Occupational Therapy

When looking for an article to review concerning the group process in OT, I first started searching databases. During my search, I found a few articles that were abstracts only without the full article available. The one article that I found which really peaked my interest is a clinical trial. The title of this study is "Effects of Individual and Group Occupational Therapy on General Self-Efficacy, Psychological Well-Being, Personal Independence and Occupational Therapy in Older Adults". I really found this study to be interesting and read more about it. I followed a link to see the results of the study. Unfortunately, those results have yet to be reported due to this study being relatively recent. However, examining the information I do have, I found the idea behind this study very intriguing and beneficial to expanding the knowledge on utilizing group therapy within the domain of occupational therapy.

The main objective of this study is to determine whether individual and/or group occupational therapy leads to changes in generalized self-efficacy and psychological well-being, and to identify the type of therapy that has the best effects on the population of older adults. The research uses a randomized experimental intervention study with a pre-post design. The trial compares two groups with one being subjects who receive individual therapy and the other being subjects who receive group therapy to improve overall independence. The study also used valid and reliable statistical analysis as well as well-defined inclusion and exclusion criteria for the participants.

I particularly enjoyed reading the information describing the idea behind the clinical trial. I found it interesting that the researches want to determine the effects of group therapy for OT versus an individualized treatment session for OT. I also liked the population the researchers chose for this sample. Using an older adult population provides a great outlook on how useful group therapy can be for OT. Specifically because the older adult population may lack the motivation to participate in therapy alone versus in a group. I am interested in what the results will be once they are reported. However,  I suspect that the researchers will find that OT intervention for independence and self-efficacy in older adults is more beneficial when implemented within a group versus one-on-one.

Attending a 12-step meeting: My experience

On February 28,  2018 at 7 pm, I attended an open group meeting for individuals participating in the A.A. program. This experience was somewhat different but still very effective. To begin, the meeting was held in a church on a rainy Wednesday night. The group started with only 3 other people but 2 more showed up within 10 minutes to the meeting starting. The role of the facilitator was voluntary. The facilitator was also an individual participating in the program. He is a recovering alcoholic and was very familiar with the protocol and dynamic of the group. He opened up the meeting by mainly reading from a scripted protocol and then shared his story. He then encouraged the other 4 men in the room to share their stories as well. He was not as much of a directive leader as he was a relatable leader for the other group members. The leader demonstrated active listening and provided commentary when appropriate during the sharing portion of the other members. The environment of the session was chaotic to say the least. Originally and typically, this group meets in a more private room within the church. However, the door was locked and they were unable to meet there. Therefore, the group moved the meeting to an area beside the gym in the church which was only sectioned off by a very thin and retractable wall. In the gym, there was a youth group sermon going on. The teachers of this group had microphones and the speakers were overpowering several times during the A.A. meeting. The youth group would also do activities such as playing basketball which definitely caused some distraction as well as frustration in the A.A. meeting. I believe the session was therapeutic overall despite the external factors creating distractions. The group did not necessarily follow every step we have learned to follow in our OCP Groups course. However, I believe the group was a very meaningful and personal experience. The members shared their stories and opened up to others allowing people to see their weaknesses as they struggle to accept them for themselves. The session did not have any activities or processing steps. It was primarily a forum to share their experience and how they overcame what they have. I do believe the group could be better developed if led by someone who was educated in how to lead a group therapy session. Considering, the member leading was not and he was just volunteering to more or less open the group. It did strike me at times as being closer to a business meeting when reading directly from the pieces of paper about what an A.A. meeting is and what A.A. stands for. That process seemed as if it was too much and the time could have been used better in a different way. I believe this group was a self-help and self-management group because the members and the leader had close to the same amount of speaking in the group and the topics discussed were how and why they have the addiction they do as well as a recognition of why even taking one sip of alcohol is not good for them. A reoccurring theme I heard from each group member was "We don't drink like others." and I found that to be a common way to admitting their own personal weakness which they have turned into a strength.

Leadership Summit

During my meeting with others who were also facilitating a life skills group around the same time I was, we discussed our different topics as well as what activities we were going to do during our group session. This was a nice way to see the various methods and techniques others were doing. Some were basing their activities off of other labs we have done in our OCP adulthood class, so I found that interesting to see how they incorporated what we learned from one class into another class. We did not rehearse our group session or activities. We just more or less talked about what we were going to do and why we each found that activity to be relevant to learning about the life skill we chose. I enjoyed explaining how and what I was going to do and receiving positive feedback on my ideas. I also enjoyed seeing how creative my other classmates were able to be. 

Refelction on Facilitating a Life Skills Group session: Play Participation

On February 28, 2018, I led a group session on the life skill which I chose. The life skill that I chose to focus on was play participation. I more specifically focused on the iADL of child care with the iADL of play participation. Within this group, I wanted to more or less dissect the various components of play activities and enlighten the group members on what to consider when trying to engage others in play. I honestly enjoyed facilitating this group more than I expected. I was actually incredibly nervous and worried beforehand. There were several worries that the group was not going to flow or my points were not going to be conveyed clearly for understanding. During the group, we did a few activities and had several opportunities to share thoughts and express concerns when it comes to the activity of playing. We played games as well as modified common games seen. From this experience of leading a group independently, I developed a better understanding of how overwhelming it can be to attempt to lead a group. At points, it felt more difficult than others simply because the topic was play. So my biggest dilemma was when to step in and end an activity. Essentially, mastering having control to make the group respectable but not too much control where the group was no longer fun was a hard process. I am still not confident I was successful with this in every instance during the session. Leading a group alone versus leading a group with others was a completely different experience. Honestly, I felt more concern when it was just me leading it than when I had others leading it with me. I know I felt this way because having others lead a group with you provided a better sense of security during the session. I knew if the group went astray or off topic, I would have help with the redirection. Being the only facilitator, I did not have as much confidence with this. Being the only facilitator, I was forced to step out of my comfort zone more which I found to be a wonderful learning experience. One of my personal PDE goals was to become more of a leader in a group. I definitely felt as if yesterday's session assisted in developing my leadership skills. Another aspect I took from leading this group was appreciation for the other one's who have led a group before me. I have thought about it since then and wished I had led sooner so I could have a better understanding of all the hard work these group leaders put into planning a protocol and carrying it out. Overall, the experience was a very educational one and I felt as if I developed more leadership skills because of it.

Self-assessment of co-facilitating a group session

Name: Alicia Rinks                                Date: 2/7/2018                              Time: 11:00 am- 11:40 am

Group Title: "Seven Heads Are Better Than One"

Based on my contribution to the written group plan, I feel like I sufficiently took part in constructing and editing the document for submission. I enjoyed learning my other co-facilitator's ideas throughout the process. As a team, we were able to be creative, and ironically enough, learn to collaborate ourselves in order to create a group protocol centered on collaboration.

My main job as a co-facilitor when leading the group was the introduction and the ice breaker activity for the group. I felt as if I did explain the purpose clearly as well as communicated our expectations for the group in the beginning. I also allowed for introduction of the leaders as well as the members. I did not, however, outline a definite time frame for the group. During the first activity, I explained the instructions and allowed for the members to gather the materials needed for participation. After partnering up, I told the members when to begin and answered questions as needed.

After my role in facilitation, I continued to encourage the members in the following activity as well as throughout the sharing and processing parts of the session. I attempted to stay positive and not create a stressful environment from my own personal attitude. Instead, I chose to take steps back from the activities and allowed for the members to work out and accomplish goals on their own. The idea was collaboration among the members, and I wanted the members to work together and through conflict resolution. The group did get off topic at times and while I could or maybe should have stepped in, I honestly enjoyed watching it play out. I was better to able observe natural personalities come out within the group if I wasn't exerting too much control. I wanted to see how the collaborated more naturalisticaly.

As far as my strengths and weaknesses are concerned, I believe that my personality type can be both a strength and weakness when leading a group. I can be too relaxed and not always take control when others may. Given if the group derailed completely, I would definitely regain control and focus the group's attention back to the task at hand. However, I will tend to let the group deviate slightly just because it builds relationships and trust within the group. The group has a more relaxed feel allowing for better observation. This could also serve as a weakness because the group is more likely to get off task without enough control from my end.

Neuro Note #5: OT 537

For my final neuro note, I chose another Ted Talk to listen to and write about. I actually chose this Ted Talk to listen to because another student recommended it to me. It sounded interesting because the subject was on Alzheimer's Disease and the speaker is also the author of the book Still Alice. The speaker of this talk is named Lisa Genova and the title of the speech is "What can you do to prevent Alzheimer's". During her speech, Lisa provided a solid background to how and why some people develop this disease over others. She explained how the build up of amyloid plaques is what essentially causes the downward spiral into forgetfulness and dementia. Lisa pointed out how common the disease is amongst Americans and even the nation as a whole. Listening to Lisa speak, I learned a great deal about how the science behind the treatment of Alzheimer's isn't necessarily incorrect but is just being administered at the wrong time for the individual. Lisa mentioned how the drugs need to be used as a preventative way to developing the disease. I found this interesting in that I always assumed that the drug was used as a preventative measure, but in fact it is not. In order for the treatment to be effective, the individual should take it before the actual development of Alzheimer's and before the build up of amyloid plaques reaches a "tipping point" as she describes it. Lisa also went on to discuss other ways to prevent the disease by the diet one consumes and exercising regularly. She really emphasizes how important it is to consume a healthy diet and maintain cardiovascular health. This is, of course, important for every individual but especially important for those who are at risk for developing AD. She talks about how this lifestyle change as a huge impact in what one's older years of living may be like. Overall, I learned a lot from this talk. Lisa went on to paint colorful images and provide great comparisons and examples of what Alzheimer's disease is like. I find it interesting in how doctors will be able to know when to administer treatment early enough to certain individuals, and I also wonder that since so much more has been discovered about the mechanism of Alzheimer's disease if the amount of people to develop it will decrease significantly. I absolutely enjoyed this Ted Talk and since she was such a wonderful speaker, I want even more to read Still Alice!

Retrieved from: Genova, L. (2017, April). What you can do to prevent Alzheimer's [Video File]. Retrieved from https://www.ted.com/talks/lisa_genova_what_you_can_do_to_prevent_alzheimer_s#t-820240

From a Margarine Tub to a Sock Aid: Being creative with household items to assist in ADLs

In my Neurological Aspects of Occupation Centered Practice course, we had the opportunity to show our innovative side as future occupational therapy practitioners. The project was completely randomized with us as a class drawing different household items or other materials from a bag and then being assigned to a client with a specific diagnosis and detailed description of the person's interests, roles, barriers, and level of function in various areas of life. While some people may have been assigned the same client no one had the same material to use, so everyone's project will be unique. For me specifically, I drew from the bag a "margarine tub or something similar" and then was assigned to a client named Paula. Paula is a 76 year-old Caucasian female with a primary diagnosis of Parkinson's Disease and then secondary diagnosis of cataracts and hypertension. Paula experienced several challenges and barriers with this diagnosis. Paula had several interests that included communication with colleagues and her husband. She also wanted to be able to use her computer and review manuscripts for a publishing company. However, it was stated that Paula had a couple priorities for OT Intervention which include independence in daily bathing and dressing. Therefore, that is what I focused on when creating my intervention for her. She was completely dependent in putting on her shoes and socks so I thought that it would be nice for her to be able to put on her socks independently with the help of a sock aid created from what was once a margarine tub. Crazy, I know. I wasn't exactly sure how I was going to make this work. I did my research and stood in the grocery store playing around with different butter tubs attempting to see which one would serve the best for putting a sock on a foot. Not typically why one stands in the butter section, but hey I am going to be an OT so I guess I should get used to being creative in some very unusual ways. The day I was constructing the sock aid from a butter tub my family was having a cookout at the house, and I was the overly excited future OT running around with one sock on and asking others to try out my new product. I definitely got some weird looks at first, but it also gave me the chance to explain why, how and show people an example of how occupational therapists can help people in all kinds of ways with just about anything. Once I showed them how my sock aid worked, they were definitely impressed and found it cool that I thought to make it out of a butter tub. I did my little hair flip and proceeded to the next person to show out on. Putting my silliness aside in making this project, I used this item to make a sock aid to help Paula be able to put her socks on her feet, so that she isn't necessarily depending on others for everything in her life. Although putting your socks on is typically viewed as being a small and simple task, it definitely takes a toll on you when you are not even able to do something that was once so simple. I wanted Paula to feel more independent, so I took a margarine tub and gave her a way to put her socks on her feet without asking someone else to do it for her. I also thought that by teaching Paula how to use this sock aid she would be able to strengthen those muscles in her feet and work on her coordination in her lower extremities. Paula will also work on grip strength and fine motor coordination in her hands by gripping the straps and pulling on them in order to move the sock aid across the bottom of her foot. Overall, I had so much fun making this product and I feel like it will be very beneficial in my client's OT intervention process. Below I have included a picture summing up my client and why I chose to make a sock aid for her. I also have provided pictures of the different steps in using the sock aid as well as a before and after of making the sock aid.
Summary of Media Project:


A little Before and After Photos:
                                
Using the Sock Aid:
Step 1: Putting the sock on on the end where straps will still have the freedom to fall in order to grab these straps

Step 2: Pulling the sock over the sock aid to ensure it stays on when the foot is initially placed into the other end

Step 3: Placing your foot into the sock aid and holding on to the straps with your hands so you can pull the sock aid up


Step 4: Pulling up on the straps pulls the sock aid across the foot resulting in the sock going onto the foot
             
Step 5: Mission Success! The sock is now on the foot with the help of the sock aid!