Group therapy--process and practice.
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Family Practice↗
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Results for “GROUP PROCESSES”
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Varieties of learning in an experiential group.
Variously described as enhancing sentence, supporting professional identity, providing insight and introducing the resident to covert group processes, the experiential group has been a part of residency education for over 25 years. This article specifically focuses on and identifies the potential areas for learning about group process in such an experience. These areas are organized around the contribution of individual psychological, social-psychological, and group-as-a-whole issues in the group. Actualization of the learning depends on the psychological state and level of emotional preparedness of the individual member, the consultant's orientation and style, the composition and development of the group, and its relationship to the organization in which it takes place. An example is provided to highlight the areas of potential learning, and there is a discussion of some applications to the patient role and the practice of group psychotherapy.
Female↗
Nursing students' experiences of the effects of continual process-oriented group supervision.
AIM: To describe and analyse the nursing students' experiences of the effects of process-orientated group supervision. BACKGROUND: There is a need to promote the development of the nursing student's professional identity and preparedness to act as well as to provide the opportunity for reflection and setting up a group supervision programme. METHOD: This paper is an in-depth study using both quantitative and qualitative methodologies. An open-ended interview form including 24 items and four open-ended questions was used and 80 nursing students answered a questionnaire. The data were analysed by a factor analysis with varimax rotation and by open coding. FINDINGS: The three analysis factors were labelled: 'Increased patient attentiveness', Increased empathy ability', and 'Increased insight and security'. From the findings of the qualitative analysis two main categories emerged: 'Increased ability to communicate' and 'Personal growth'. CONCLUSIONS: The findings of this study suggest that there is an association between the effects of group supervision and the nursing students' development of a nurse identity.
Attitude of Health Personnel↗
Problems in doing nursing research: maximizing the group research process.
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Arizona↗
Release of 14-kDa group-II phospholipase A2 from activated mast cells and its possible involvement in the regulation of the degranulation process.
Group II phospholipase A2 was detected in appreciable amounts in rat peritoneal mast cells. The effect of several inhibitors specific to 14-kDa group-II phospholipase A2, including two proteinaceous inhibitors and a product of microorganisms with a low molecular mass, on mast-cell activation was examined. When rat peritoneal mast cells were sensitized with IgE and then challenged with antigen, the specific phospholipase-A2 inhibitors suppressed histamine release in a concentration-dependent manner. By contrast, these inhibitors showed no effect on prostaglandin generation under the same conditions. Histamine release from rat peritoneal mast cells subjected to non-immunochemical stimuli, such as concanavalin A, the Ca2+ ionophore A23187, compound 48/80 and substance P was also suppressed. When rat peritoneal mast cells were treated with 14-kDa-group-II-phospholipase-A2-specific inhibitors, washed and stimulated, histamine release was not affected appreciably. Similar suppressive effects of the inhibitors on histamine release were observed with mouse cultured bone-marrow-derived mast cells. When bone-marrow-derived mast cells were activated, they secreted both a soluble and an ecto-enzyme form of 14-kDa group-II phospholipase A2, although appearance of the enzyme associated with the external surface of cells was observed transiently. An appreciable amount of membrane phospholipids was degraded during activation of mast cells, which was decreased by treatment with 14-kDa-group-II-phospholipase-A2 inhibitor. These observations suggest that degranulation and eicosanoid generation in mast cells are regulated independently by discrete phospholipases A2 and that the 14-kDa group-II phospholipase A2 released from mast cells during activation may play an essential role in the progression of the degranulation process.
Animals↗
The contribution of group cohesion and group alliance to the outcome of group psychotherapy.
The contribution to outcome of two group-process factors, group cohesion and group therapeutic alliance, was tested in the context of a randomized, controlled treatment trial for borderline personality disorder. Group members from four time-limited groups of an experimental model of group psychotherapy completed measures of group cohesion and group alliance at prespecified intervals across the 30-session therapy. Outcome was measured in terms of psychiatric symptoms, social adaptation, and indicators of behavioral dysfunction. The results showed that cohesion and alliance were correlated significantly and separately contributed to outcome on most of the dependent measures. Stepwise regression analyses showed, however, that when compared with cohesion, alliance accounted for more outcome variance on the dependent measures. The clinical implications of the findings and the limitations of the study are discussed.
Adult↗
Enhancing physician adoption of practice guidelines. Dissemination of influenza vaccination guideline using a small-group consensus process.
BACKGROUND: A dissemination intervention to facilitate adoption of a preventive practice guideline (influenza vaccination for older adults) in group practices was developed and evaluated. The intervention, small-group consensus process, started with a physician expert presenting the guideline and followed with the group participating in a structured discussion of ways to implement the guideline that culminated in a public commitment (ie, "buy in") to adopt the guideline. METHODS: Thirteen group practices and their primary care physicians (mean size, 5) were assigned randomly to intervention or control arms. In each group practice, physicians in the intervention arm met for 1 hour. Control physicians participated in an unrelated discussion (non-steroidal drug use). Guideline adoption was determined by changes in physicians' vaccination rates that were obtained through prechart and postchart reviews of 51 physicians. Prequestionnaires and postquestionnaires measured influenza knowledge and prevention attitudes. RESULTS: Using analysis of covariance, the small-group consensus process was found to increase physician vaccination rates by 34% compared with the control arm (F (1,48) = 19.49). All intervention arm physicians increased vaccination rates from before to after compared with 54% of control arm physicians. Attitudes and knowledge did not change and were unrelated to increased vaccination rates. CONCLUSIONS: A case is made for the small-group consensus process as an effective utilization-focused dissemination method. Interventions based on group dynamics and sensitive to local practice contexts can be useful in facilitating adoption of guidelines by physicians in group practices.
Decision Making↗
Sustaining leaders of cancer support groups: the role, needs, and difficulties of leaders.
Cancer support groups are an important source of support for cancer patients, yet little is known about the characteristics of, and barriers to, effective leadership, and the training needs of both professionally trained and untrained leaders. This study explored the views of 179 leaders of 184 cancer support groups in NSW, Australia, regarding these issues. Four hundred and sixteen members of 50 groups selected from the larger cohort completed questionnaires eliciting the importance of group processes, including leader qualities, and satisfaction with group leadership. Finally, members of nine groups participated in focus groups regarding effective group processes. The importance of the leader(s) was emphasized in all stages of the research. Fifty-nine percent of group leaders were currently experiencing a difficulty, primarily related to infrastructure or group process. Three characteristics of effective leaders were identified: educational qualities, facilitation skills, and personal qualities. There is clearly a need to develop and evaluate effective interventions to maintain leaders in these roles, if the proven benefits for cancer patients are to be protected.
Focus Groups↗
Envy in the group-therapy process.
The origins and vicissitudes of envy are discussed from the viewpoints of Boris and the Kleinians. Their ideas, coupled with a relational perspective of the therapeutic process, enrich our understanding and inform our work concerning the emergence, processing, and working through of envy in the therapy group. A variable in the negative therapeutic reaction, envy can be destructive to the therapy process. It is proposed that envy, accompanied by shame and guilt, is likely to enter the group via enactments. They are fueled by projective identification, which, if ignored, impede the continuation of the group process. Four clinical vignettes illustrate how envy enters the group and how the group functions as a container and transformational object as it processes the projective identifications and works through the enactments.
Adult↗
IDENTITY MAINTENANCE OPERATIONS AND GROUP THERAPY PROCESS.
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Defense Mechanisms↗
[Group psychotherapeutic factors in a self-assertive group].
The technique of group psychotherapy has recently been introduced to the practice in self-assertiveness training group. This study aims to assess various group factors that are hypothesized to be effective in the group process in a self-assertive group. Subjects of the study were participants in a 13-member self-assertiveness training group, with 4 female nurses and 8 male employees and 1 male student. The average age of this group was 35.2 years. Assessment of the group was based on Yalom's concept of twelve therapeutic factors in the group process. The results showed that 'identification', 'The existential factor' and 'interpersonal learning-input' were the three most important factors demonstrated during the group process. There were no significant age and gender differences in the above 'identification' and 'existential' factors. However, different beneficial factors were found for each group: for subjects aged 40 and above and males, it was 'interpersonal learning-output'; while in those with aged under 40 and females, 'universality' was more important than 'interpersonal learning-input'. Comparison of therapeutic factors among different groups was attempted. The above results were found different from patient groups, or the groups of university students. The discrepancy is due to different composition and tasks of each group.
Adult↗
[Interpersonal exposure to danger and risk-taking in the group therapy process].
The writer singles out from the complexities of the group psychotherapeutic process the dynamic pair: inter-personal exposure to danger and the taking of risk. According to his empirical experience and tests the degree of risk-taking is a good parameter for assessing the psychotherapeutic process. For this purpose the inter-action matrix devised by Hill proves itself most useful.
Humans↗
Experimentally induced psyche- and socio-process in small groups.
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Group Processes↗
Setting targets: a three-stage model for determining priorities for health promotion.
This paper describes a three-stage model for setting targets for health promotion. The model was developed in 1992 in response to the need to identify priority areas for health promotion for women in the Hunter Region of New South Wales. The approach enabled epidemiological data and views from the community to be synthesised and integrated with those of experts from health and social services (key informants), using a nominal group process. The reliability of the method was investigated by replicating the process with two groups of key informants. There was considerable commonality in the targets generated by the two groups. The process resulted in the identification of seven targets that reflected the concerns of the community and local experts as well as the health priorities suggested by local epidemiological data. The model used could be adapted for determining priorities in a wide range of health and health care settings, where available resources restrict the range of services or activities which can be offered.
Consumer Organizations↗
Vulnerability, tenderness, and the experience of selfobject relationship: a self psychological view of deepening curative process in group psychotherapy.
A focus on patients' self-experiences and narcissistic vulnerability can enhance the deepening of curative process. From a self psychological view, deepening the therapeutic process means that, through the analyst's empathic immersion in the patient's subjective view, earlier and earlier forms of the patterns and beliefs that organize this view, including selfobject yearnings and fears of retraumatization, are experienced and become available for interpretation. Vulnerability is viewed as one end of a dimension of self-state. The other end is a state of self-protectiveness. Tenderness and emotional availability as aspects of a selfobject relationship are seen as crucial to the encouraging of vulnerable moments that are key to the deepening of curative process. A group session is presented to illustrate the attitudes that facilitate this process.
Humans↗
Digital processing in cardiac imaging.
In recent years, imaging modalities have realized the potential for digitizing images of the heart. These modalities include nuclear cardiology, echocardiography, digital subtraction angiography, computed tomography, positron emission tomography, and magnetic resonance imaging. Once the cardiac images have been digitized by the computer and formatted in a pixel array of data, the computer can perform mathematical operations on the input (original) images for the purpose of providing improved output (processed) images. The computer can also analyze the original (or processed) images for the purpose of extracting global, regional, or temporal measurements of cardiac perfusion and function. These processes include the restoration, enhancement, analysis, manipulation, and coding of images. These basic processes are implemented by a combination of image processing operations. These operations include pixel point processing, pixel group processing, frame processing, geometric processing, and information extraction. This article describes how these operations are used to perform processes, and how these processes are applied to cardiac imaging, currently and in the future.
Algorithms↗
'CO-CO' in nursing care planning: an innovative approach to student learning.
This qualitative study evaluated the application of a new real-time, synchronous computer conferencing technology (CO-CO) to assist student nurses develop effective nursing care planning skills. Using CO-CO, first-year undergraduate nurses collaborated across a local area network to produce nursing care plans based on given patient profiles. A convenience sample involved a total of eight students, working in pairs at different work stations. An initial training session introduced the students to the Unisys Icon microcomputer system and the CO-CO software application. In the second session the researcher displayed a patient case study in one of the CO-CO screen windows along with specific instructions. The students' objective was to co-operate and collaborate as a group in order to produce an appropriate nursing care plan. For the most part they worked independently of the teacher who was able to engage in other activities while remaining available to the group for occasional essential feedback. Later, a questionnaire was completed by the students. The students cited the ease with which they could use the software CO-CO to reach decisions about care. The sessions reportedly improved group process and group interaction. This computer conferencing system offers an alternative approach to the teaching of nursing care planning.
Adult↗
The waiting-list group.
This report describes a pilot study of a waiting-list group (preliminary process group [PPG]) that provided treatment for applicants to a university affiliated, urban mental health center. All individuals on the treatment waiting list were informed of the PPG. This semistructured group, meeting weekly, began with members presenting their problems, followed by free discussion, and ending with goal setting for the next week. Approximately one seventh (35 out of 262) of the clinic's applicants during a 4 1/2-month period chose to enter the PPG. They differed from those who chose not to participate (wait list) by being older and less educated. Approximately 80% of both wait-list and PPG participants subsequently entered therapy. Significantly more PPG patients than those on the wait list entered group treatment. The PPG served clinic needs by providing prompt service for self selected individuals and by supporting the group therapy program.
Adult↗