Groups- Peer Reviewed Journal Article

The Directive Group: Short-Term Treatment for Psychiatric Patients With a Minimal Level of Functioning
Kathy L. Kaplan 

Although this was an article that was published in 1986, I found it incredibly relevant and applicable to all that we have been learning and experiencing in our class, Occupation-Centered Group Practice. I know that the concepts mentioned and studied within this paper have only been built upon and further strengthened. A developmental approach was used, along with the model of human occupation (MOHO) as the theoretical framework. The author established the importance of using a framework to organize knowledge, observe, and predict client outcomes. The model was used to show a continuum of occupational behavior through exploration, competence, and achievement. The groups were organized in this way. The model helped to assess behavior and create treatment goals. The model helped to create an environment that would facilitate change.  The exploration group is the most basic level, for patients with severe dysfunction, where OT would co-lead the Directive Group program with Psychiatry. I loved that this paper broke down the group process from orientation to wrap up. Examples were given of strategies and activities to maneuver through the session and the four parts that make up the group time: orientation and introductions, warm up, main activities, and wrap up. Using this group program with a rating scale for achievement (1-5), 88% of clients improved their ratings by 1 or 2 points on the scale. Clinical observation also indicated that clients' behavior was significantly different when in group verses elsewhere in the facility.


I think it only resonates that the group process works. It makes a difference. And, OT has a skill set to share in group therapy in coordination with other disciplines. The same kind of group process tested in this paper is the same kind of outline that we have been following in our group sessions. And even the smallest activity, from identifying the day and time on a calendar, can bring together the skills that will add to a person's habits, social abilities, awareness, and success in daily occupations that will lead to a healthier, more meaningful life. 





Kaplan, K. L. (1986). The Directive Group: Short-Term Treatment for Psychiatric Patients With a Minimal Level of Functioning. American Journal of Occupational Therapy, 40(7), 474-481. doi:10.5014/ajot.40.7.474