Group Observation

Introduction:

Groups talk about goals in different ways, using different words. Some groups have major and minor goals or meta- and micro-goals; others divide goals into mission, purpose or goal, and objectives, while other groups talk about aims and expectations. A group is strengthened to the extent it has clear goals and all members know what their roles are in helping to achieve them (Dimock and Kass, 2008, p.62-63).

My placement is currently in the Mental Health field and as mental health workers we have groups that are organized to promote to mental health of all and to support the resilience and recovery of people experiencing mental illness.

The first group observed for this assignment is an interdisciplinary group within my clinical setting comprising of a psychiatrist, social worker, mental health case manager and a patient. This interdisciplinary team works together to enhance relationships with the patient and improve collaboration among health care providers.

The plan for recovery of patients is coordinated by all members of the team as each member can bring a level of expertise the other member cannot. This team was chosen because many people living with mental illness require the aid from more than one professional. Many of these patients require housing, employment, social assistance, counselling and support. Psychiatrists, social workers, case managers, occupational therapists and more come together as a formal team to combine skills and resources to provide guidance and information for the recovery of these patients.

The second group observed was a relaxation therapy group. This informal therapy group is conducted for patients suffering from anxiety, depression, panic attacks, etc. Therapy is conducted with a group of people, rather than in a one-on-one session which is the biggest advantage in helping patients realize that he or she is not alone which can be a huge relief to the person. It is important to remember that this session is guided by a professional therapist but the therapist only acts as a moderator who may suggest a “theme” or topic for the group’s discussion. Critical Examination of Groups:

There is a growing consensus that interdisciplinary mental health collaboration will contribute to improving patient care and outcomes, improve access to health care, improve communications among health providers and improve satisfaction and recovery among mental health patients (Kuarnstrom and Cedersund, 2006, p.245). While observing this group it was recognizable that each member of this team took into account the expertise, preferences and skill set of each provider.

The group’s culture is a way of working together, including their shared habits, traditions and beliefs which is in the best interest of their patient. This group shows cooperation, peer learning and mutual respect for each other which allows for them to communicate with each other and the patient as effectively as possible.

The culture of this group is affected by a combination of behaviours, values and attitudes which in turn affects “the way they do things” (Dimock and Kass, 2008, p.20-21). Because this group is comprised of a psychiatrist, social worker, case manager and patient, each individual’s skills and mission are different. At the same time their goal is similar in providing patient care and recovery. This group is able to demonstrate enthusiasm, optimism, collaboration, thoughtfulness, teamwork and competency by building on group culture.

The group process, role functions, decision making, problem solving and leadership are all responsibilities of the interdisciplinary team members. The group interacts with each other using verbal and nonverbal communication, seating in a circular manner and equal participation. Because this group is formed of different specialties, establishing role functions is key to their success.

According to research one of the challenges of interdisciplinary work is ensuring clear definitions of the providers’ roles and expectations with regard to shared care. Clearly defining practitioner roles and responsibilities will enhance the positive elements and reduce ambiguity and misunderstandings (Paquette-Warren et al., 2004).

Each member of the team is a coordinator/questioner, evaluator, elaborator, energizer, initiator and problem solver for different reasons. The roles of these team members vary and will briefly be discussed to give an overview of how important each member is to the team. The psychiatrist’s primary function is diagnosis of mental disorders and prescription of medical treatments. The social worker works with families, community support and referral and the case manager is involved in clinical skills, relationship skills, and liaison and advocacy skills.

Decision making and problem solving for this group is determined by focusing on the patient and what’s in the best interest for that patient. Once the group has brainstormed various ideas regarding a solution to a problem, the group determines what the highest priority is for the patient. The interdisciplinary team arrives at a consensus through discussion and debate.

The team which is the core of interdisciplinary practice is characterized by mutual respect among disciplines and involves sharing of leadership (Paquette-Warren et al., 2004). This structure encourages collaborative problem solving and to accomplish this they share leadership that is appropriate to the presenting problem and promote the use of differences in their professions.

The second group observed was the relaxation therapy group. This informal group is conducted with a group of co-patients rather than a one-on-one session with interdisciplinary professional team. Group sessions vary but the basic format is a small group of patients meeting to discuss their feelings and problems and provide mutual support. The dynamics of this group often mirror those of society in general and learning how to interact with other members of the group can help them in relationships outside the group (Sheldon and Bettencourt, 2002. p.34).

This group’s culture is evidenced by the similar problems experienced by its group members. These members who share similar experiences can support each other and may offer suggestions to dealing with a particular problem that the other may not have thought of. This structure is unorganized but the members have common interests and attitudes. Joining forces in a small group for these individuals makes the members feel stronger, less anxious and less insecure.

Because this group is an informal team, the roles of the team members focus on giving advice or sharing opinions. The members of the group will then interpret ideas, define terms in their own words become encouragers in a friendly, warm and responsive way to other group members.

Sometimes in informal groups we have negative activities that affect the group. Often in mental health relaxation therapy groups we have members verbally attacking other group members and members distracting the group with trivial information or unnecessary humour. This can prove difficult, but with a professional therapist on hand to moderate if necessary, this behaviour is usually avoided.

Decision making, problem solving and leadership proved to be different in this group because the relaxation therapy group didn’t require decision making for these patients. These patients also didn’t require problem solving as it was a time for patients to express feelings and provide support to other patients.

The informal structure of this group allowed for a unique leadership style. There was a professional therapist to lead this group but his role in the group meeting was little to none. The therapist’s role was to help provide “themes” for group discussion if needed and as moderator if needed.

This observed group was self directed by its members and thus leadership was shown by all members involved. At times there may not always be a designated leader; when there is not, like the case of this group; you can learn to provide informal leadership, helping the group function more effectively by becoming a situational leader (Vecchio, 2007, p.451). Comparison of groups demonstrating critical thinking:

When comparing the similarities and differences of the selected groups, similarities and differences were found. First, I will speak of the various differences. The first group observation was that of a formal one where the second observed group was informal. The interdisciplinary team combined the efforts of different disciplines trying to solve patient problems whereas the therapy group was formed by patients themselves whom expressed feelings to each other and supported one another without much help of a professional leader.

According to Dimock & Kass (2008), there are many situations where groups work well without a designated leader, but with a facilitator. They also mention that the facilitator acts as a neutral group helper, paying attention only to assisting the group work efficiently and effectively. This is true in the case of our therapy group.

Working together as a team, members must balance responsibilities, values, knowledge, skills and even goals in shared decision making. Communication, effort and balance of contributions are also used by both groups. Both groups have to communicate with each other for group processes to work and this requires effort by all individuals that are part of that team. Both groups also functioned well together, moving naturally and smoothly which made an enormous difference in their efficiency and effectiveness.

Both groups were also small in size, with four members in the first group and 7 members in the second group and according to Dimock & Kass (2008), maintaining an optimal group size is criterion for forming a strong group as interactions are more likely to be satisfying. This allowed the group to stay focused and ensured good communication between all members. The above illustrate some of the commonalities within the two groups. Synthesis: Discussion of Findings related to implications and theoretical perspectives

I have learned from the examination and discussion of these groups that both formal groups and informal groups work much of the same way but can have different outcomes. The formal group included a psychiatrist, social worker, case manager and the patient.

The patient was very much a participant in making decisions with the interdisciplinary team which I found made the patient more strongly motivated to accept and carry out the process to their recovery. This formal group was able to make quality decisions, used effective problem-solving tools, each group member had a variety of experience in their field and brought greater information to the group. Groups that use group process techniques are more satisfied with their decisions and more committed to their implementation (Barnes and Schwartzberg, 2000, p.29).

I enjoyed observing the informal therapy group because individual group members were stimulated, encouraging individual development. All members participated in discussion and you could tell that having other people in similar situations as them increased their general level of arousal and awareness.

This group also encouraged social facilitation because the presence of others stimulated them to express feelings and support others stories. This group was non-judgemental and made members feel that they had an honest opportunity to state their views and be heard.

It is also important to note that patients suffering from mental illness benefit from formal groups as they often need guidance from a leader or leaders. These individuals often only feel comfortable talking with professionals rather than expressing their feelings in an informal group surrounded by other co patients.

The observation of these groups is very relevant and beneficial to my practice because I hope to work in Mental Health. I could have observed many more groups in this area and recorded the importance of group processes however these two groups were very influential.

Group Theory suggests that one of the differentiations is that a teams often involve people who recognize a similar goal and the need to work together in order to achieve this goal (Dimock and Kass, 2008, p.21). In practice, this means that mostly the individual members of teams have different skills from one another and each uniquely skilled person can contribute effectively towards this goal as we saw with the interdisciplinary team.

Research suggests that although groups are formally established and planned, informal groups will also occur and are important to organizational structure (Marquis and Hutson, 2008, p.46). Formal groups are created in order to achieve specific goals and they are primarily concerned with coordination (Marquis and Hutson, p.60). Informal groups are more based upon personal relationships or common beliefs than on defined role relationships (Marquis and Hutson, p.60). This is extremely evident with the therapy group as it served to satisfy social and psychological need than organizational goals. Conclusion:

The role of groups and teams in mental health delivery are very important to patient recovery. Both the formal and informal group has its purpose along with its advantages, disadvantages, similarities and differences. By observing the two groups I have realized that both types of groups can be used efficiently and effectively.

The most important thing I will take with me into practice is that it is important that members of groups work well together, as well as various groups must be able to interact proactively to benefit from the group. In mental health, groups and teams can encourage patient recovery and improve patient motivation and commitment. These groups and teams also take advantage of opportunities to build friendships as well as increase leader satisfaction.