FW1C Debriefing

Peer-Reviewed Journal Article

The article that I chose to read was titled Population-Centered Life Skills Groups: Perceptions of Satisfaction and Engagement. This study examined the satisfaction with and engagement in population-centered life skills groups of women in a residential facility for substance dependence. In community settings in which group work occurs, intervention planning may focus on representatives from the population as opposed to individualized evaluations (Peloquin & Ciro, 2013). This global approach falls short of ideal client-centered therapy and is population centered in the sense that unique client needs are assumed to align with those identified in the population. The possible risk in targeting common as opposed to unique needs identified through assessments and interviews is the emergence of feelings of dissatisfaction associated with diagnosis-driven interventions (Peloquin, 1993), thus the necessity for this study. Through retrospectively cross-analyzing 561 Likert scale client rating surveys, descriptive statistics were used to examine client satisfaction with their life skills groups based on the Person-Environment-Occupation model. Client engagement by content focus and activity process were also examined by looking at eight life skills development questions. All participants were women age 18 or older with drug dependence, alcohol dependence, or both. Many had dual diagnoses, including depression, bipolar disorder, post-traumatic stress disorder, and schizophrenia. 98.8% of participants who completed the survey were satisfied with their living skills groups, 73.3% agreed strongly, and 23.4% agreed. There were no significant differences found in the median scores of the engagement responses by either content focus or activity process. From this study, it was concluded that these groups that are conceptualized within a holistic Person-Environment-Occupation model appear to be satisfactory and engaging interventions for women in recovery. 

Having read this article, I am now more aware of how powerful the connection is between what clients get out of a group and the model that the group is based on. In this study, the life skills groups were structured using the PEO and addressed the needs identified by the group members that were taking part in the group. By being client-centered in this way and basing the group on a model that encompasses a match between the client, their environment, and the occupations in which they engage, there was greater satisfaction and engagement reported by the clients. Because these group sessions focused on different components of PEO, better outcomes were achieved. For example, sessions that were titled Being an Observant Woman (Person), Capturing ADL Hints (Occupation), and Finding Frugal Leisure Sights (Environment) were all targeting aspects of PEO while also pulling from the needs that were identified by the group, thus eliciting more engagement from the members. This article certainly goes to show how important it is to match the model on which you are building your group sessions to the specific needs of the clients that you are serving. In the future, I will certainly have to remember to remain client-centered by finding out what is important to my group members and matching this with the appropriate model on which I am forming my group sessions. It truly is so important for us as practitioners to honor aims central to client-centered practice within our group sessions, and if we do this while incorporating the proper model, we can achieve great success with our clients. 

Peloquin, S. M. (1993). The patient–therapist relationship: Beliefs that shape care. American Journal of Occupational Therapy, 47, 935–942. http://dx.doi.org/10.5014/ ajot.47.10.935 

Peloquin, S. M., & Ciro, C. A. (2013). Population-Centered Life Skills Groups: Perceptions of Satisfaction and Engagement. American Journal of Occupational Therapy,67(5), 594-600. doi:10.5014/ajot.2013.008425

Peloquin, S. M., & Ciro, C. A. (2013). Self- development groups among women in recovery: Client perceptions of satisfaction and engagement. American Journal of Occupational Therapy, 67, 82–90. http://dx. doi.org/10.5014/ajot.2013.004796
  

Individual Group Facilitation

Overall, I thought that facilitating a group session on my own was a wonderful learning experience. It seemed like a daunting task at first, but co-facilitating a group a few weeks earlier, really helped make this seeem much more manageable. Not having another person to bounce ideas off of was difficult in the beginning stages, but after doing some research on my topic of money management, I was easily able to build a group protocol that I was pleased with. I was much more comfortable with creating an entire group protocol this time around. The most difficult part for me was trying not to be too broad with what it was I was targeting in my group, and finding a way to make sure that all of my activities focused in on the same thing rather just on money management as a whole concept. Running the group on my own was very enjoyable. Because of the questions that I posed to my group members, I was able to learn a lot about how they all think about money. This was interesting to discuss because this is not a topic that is often explicitly discussed. There were many differing opinions that were shared during the group session, which was interesting, but it was also helpful to hear new ideas in some cases. There were other points during our discussion in which we found common themes on how we approach managing our money as students who have loans. I think that I did a good job of asking thought provoking questions that brought about discussion that was pertinent to us as students who have to manage our money. Based on the questions and responses during the group, I felt that EHP and MOHO were good choices for frames of reference fro this group. I also feel I did a decent job of sharing different resources for money management with my group and highlighting how group members though both similarly and differently from one another. I could have done a better job about elaborating on the comments my group members were making, sharing more of my own personal experiences, and transitioning from one part of the group into the next. Initially, I was uncertain if my group members would be willing to share on a topic that some people find to be a more private matter, but I think that by approaching it as a conversation about motivators and barriers to saving our money, rather than talking in amounts, really helped my group to open up during the discussion portions of the session. Having had the opportunity to experience making a protocol and facilitating a group for my peers, I now have a better understanding of how to read a group based on what is occurring during the session in order to determine when it is time to transition from one part of the group to the next. 

Generally speaking, I thought I could have been more clear about what expectations I had for the group as their leader. I failed to mention that their comments were welcomed, but not required. My activities were adequately prepared, but I do feel that I could have asked some of my questions in a more direct and straight forward manner. I could have better supported my group members in the processing portion of group by helping them to probe deeper when trying to elicit their feelings about the session. Many times I would just comment on their thoughts as being good, but I could have asked more about what they shared. Additionally, my summary portion of the group could have been a bit more articulate. I could have done a better job at summarizing what all was covered during the group session. I think I did a good job during the sharing, generalizing, group motivation, limiting of the setting, and application components of our session. Overall, I really enjoyed this learning opportunity and feel that though I had some areas that were stronger than others, I can certainly grow in all arears of facilitating an occupational therapy group.

Leadership Summit

I met with 2 other students for my leadership summit. I found it to be a rather encouraging experience. The people that I met with thought that the activities that I had planned were insightful and helpful for learning strategies on how to better manage one’s money. It was nice to hear that other people thought that they would find my activities helpful if they were participants in my group. I also enjoyed hearing about their activities. I felt that they all had great ideas. This was a good experience for helping me feel more encouraged about leading my group, but as far as the protocol goes, it might have been more helpful to meet with people that were running groups on topics that were more similar to my own.  

12-Step Meeting

I attended an AA Meeting that was an open book club meeting. During this meeting, the role of the facilitator was a bit unconventional. It would have been more of an advisory type of role. He let the members of the group have most of the control when it came to discussions, and this was a very informal type of meeting. This was very apparent when the group would turn to more of an open discussion style during the meeting where there was little to no direction from the leader other than offering up a question and occasionally sharing insight on what was being said. We even spoke to the leader after the meeting about his role, and he mentioned that he approached this meeting very different than he would a closed meeting. In a closed meeting, he is acting as more of a structured facilitative leader. He will try to steer frequent talkers away from over-sharing during a meeting, and play a more active role in taking charge of the group. In the closed groups, the members are meant to learn something from the experience through discussions and they play an active role in making choices related to the group. During this meeting, the facilitator encouraged participation by sharing his own insight. It was brought up during the meeting, that it is easier to share and help other people who have been in a similar situation. For him, he pulls on and shares his experiences with alcohol and going through AA to relate members in the group. The environment was a room in a church with about 30 chairs. There were around 10 members present, and because of the abundance of chairs, people were randomly spread about with some people choosing to sit alone and others sitting in groups of up to 3 people next to each other. Because of this, there really was a more sporadic and random sharing order. I think that the session was therapeutic for the participants. I believe that the group was a mature group because the leader was able to be flexible in the roles that he took on even to the point where leadership was shared a bit with people who acted as the group treasurer and secretary. This was more of a social support group because the participants were peers that shared  similar stories. They did not necessarily provide solutions to the problems that were being shared, but more so supported each other and spoke to their shared experiences. There was also a good balance between the task of asking questions based on the content from the book that was being covered and the leader addressing the various needs of the group members present.

Co-Facilitation of an Occupational Therapy Group

I really enjoyed the experience of co-facilitating a group focused on cultivating a positive attitude. Going through the process from top to bottom by creating a complete group protocol, revising that protocol, and implementing it with our peers was a wonderful learning opportunity. For me, there were several experiences during this process that I found to be quite revealing and useful. For one, creating the protocol and basing our activities on a particular theory was very helpful. After discussing several theoretical bases, we finally chose Behavioral-cognitive, which most effectively allowed us to target our goals that dealt with identifying positive attributes about oneself and others, and identifying positive approaches one can implement when feeling negative thoughts encroaching. Being able to work through the pros and cons of basing our session on various theories was very helpful. During the group session, one of the more significant aspects of this experience was working with a co-facilitator. I lead a small group of high schoolers at my church alongside another advisor, so based on my experience doing this, I was able to transfer my skills of co-leading to this setting. I felt that we did a nice job of being able to seamlessly communicate and interact with the group. I also found it very helpful to be able to put our protocol into action. I liked that this mimicked a real-world scenario in that you do not know how your participants will react to the group meeting, and how you must rely on your therapeutic use of self and other "OT skills" in order to most effectively lead the group. Initially, I was unsure of how the group would respond to the activities we had chosen, but I no longer felt this way after everyone provided thoughtful answers during the ice breaker activity. Having had the opportunity to experience making a protocol and co-facilitating a group for my peers, I now have a better understanding of the more practical elements that go into facilitating an occupational therapy group.

Generally speaking, I thought we could have been more comprehensive when doing the group introductions. We should have been clearer about what expectations we had for the group as their leaders. Our activities were adequately prepared, but I do feel that our directions could have been a bit clearer, and given when the group members were fully attentive. We could have better supported our group members in the processing portion of group by helping them to probe deeper when trying to elicit their feeling about the session. Additionally, our summary portion of the group could have been a bit more articulate. I think we did a good job during the sharing, generalizing, group motivation, limiting of the setting, and application components of our session. Overall, I really enjoyed this learning opportunity and feel that though we had some areas that were stronger than others, we can certainly grow in all arears of facilitating an occupational therapy group.