Fieldwork Debrief

Reflection #2: Leading a Life Skills Group

Home Management and Establishment
"There's No Place Like Home"

To summarize the session, we discussed how "home" is a commonly referenced and shared experience of every human being, while also being very personal. We discussed what home means to us, and we searched for and shared something we want to establish in our home, now or in the future. We talked about how home can and will evolve through our life, and we applied it to the here-and-now by looking at resources to start a Home Management Binder. 

I feel that I explained the purpose of the group meeting, but the expectations for participation and respect were implied. I did not outline all of the activities at the beginning of the session, but I did explain each activity as I went through them. I did an introduction and warm up by allowing members to share how they left their house this morning with the following descriptors to help: rushed, excited, tired, dreadful, anxious, happy, determined.

The activities went smoothly. I prepared the members before the group began to bring a computer for the Pinterest activity. I did forget to have them bring a writing utensil, but everyone was able to get one quickly. I gave everyone time to share and tried to encourage them in their thoughts and ideas, without overstepping. We stayed in a pretty good time frame, maybe a little long. I believe the session went about 45-50 minutes before debriefing.

When asking for response, I tried to give personal examples to help members understand my thought process and begin to understand the direction of the session.

I made a point to pick out the similarities between group members' responses, but also wanted to highlight differences. I mentioned how a different population could have a completely different dynamic and group process based on personal history, age, and/or gender. At the end, I summarized what we had done that day and mentioned what we would be doing in future sessions, building off of the first meeting.

The session established the role and function of home in our past, our future, and how we can manage it now. We discussed how, like us, home has changed over time, and will continue to change in different ways in each member's life. I ended by thanking the member's for their reflections and for sharing.

I have loved the experience of being in a group. It has been encouraging and inspiring. I hope to implement some of the tools that have been given to me in these different life skill sessions. I would enjoy having a group session every week!

Narcotics Anonymous

I attended a Narcotics Anonymous meeting on Monday, March 5th in Olive Branch, MS. I went alone and I have to say, I was a little nervous to walk into that door. I imagined the anxiety and uncertainty someone coming with an addiction must feel when entering a room full of people for a meeting for the first time. But, once I had found where I was supposed to be and found a seat, I felt better. The facilitator sat at a desk at the front of a small room and we sat in a circle. As more people came in, he ended up giving up his chair and sat on the desk, and then eventually moved to the floor during the group discussion. He read the outlined script to start the meeting, welcomed newcomers, and ended the meeting. Because there were new members, he also told his story of recovering from addiction. Once he had finished his readings and gave his short testimony, he said, "Okay, it's y'alls group!", and took a seat in the floor. From that point, the members led the meeting until his readings to close. Being in a small room in a circle made it impossible to "hide" but it also encouraged participation and the feeling of being involved and belonging. I would say the session was therapeutic in that it was encouraging. After different members took turns reading the 12 steps and philosophy and explaining what NA was, discussion took place. During the beginning readings, it was obvious that it is done every meeting. People chimed in in unison with different sayings as people were reading. (The best way I can describe it is like when people chime in during Rudolph the Red Nose Reindeer because they know it and have heard it so many times..."Rudolph the Red Nose Reindeer" "Reindeer!" "Had a Very Shiny Nose" "Like a lightbulb!", etc.) At first I couldn't tell if they were making light of it, joking, even disrespecting. Some were playing games on their phones or tablet, some didn't seem engaged or like they were even listening. But, as the session continued, it was clear that the members believed in the program and had seen the change in their lives. They spoke in a common language of drug use and recovery, and I found that really interesting! The language used by the leader and the members was sometimes pretty crude, but in the same breath as an "f*%$*  this sh*%$*" came the words "this is my surrender" and "I have to wake up and choose to live or choose to die" and "forgiveness" and "trust". I thought there was something really beautiful about the pairing of a powerful language with the harsh reality. I think that that communication in itself is therapeutic. Being honest, and empowering. This group opened and closed in formality, but the in-between was very informal, sometimes light, sometimes heavy. People joked and laughed, and they ended with celebrating those that had met milestones of sobriety. I really enjoyed this experience and have so much respect for the people I saw in my group who are showing the courage of taking steps to come together with other people, find support, encourage one another, work everyday to make the right choice, and to be honest, with themselves and with others. 

OT 532 Leadership Summit

I met with the other group leaders who are leading a group on Wednesday, March 7th: Maggie, Haleigh, and Virginia. We discussed our planned protocols by talking through the group process for each one. We shared some of the feedback given to us from our first draft. We suggested some ideas based on previous groups where we had experienced a similar topic as a participant. We also shared the goals for our clients. I think each of us are going to have a great group session tomorrow! It was helpful to be able to collaborate and talk through our ideas with other leaders. I think the affirmation in our good ideas and the support where we were unsure was incredibly helpful. The meeting gave us a chance to have more confidence and preparation for tomorrow! I don't think collaboration and support can ever be anything but helpful!

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

Reflection #1: Co-Leading a Group Session on Active Listening

Active Listening: Learning to Listen Better

To summarize the session, we heard from each member on on how they were feeling given some descriptors and got some practice with recall from listening, learning that our emotions can affect our listening. We talked about what active listening is and ways to express it. We did a role-playing activity to help facilitate awareness for both the “sharer” and the “listener”, active and non-active. We also did an activity to help facilitate awareness on the importance of asking questions to better understand those we are listening to. (The therapist will say, “draw a triangle intersected by a line on top of a circle next to a square.” The instructions will not be repeated, and no clarifying questions can be asked. Everyone will draw their own picture based off their interpretation of the instructions.) Without clarification, we can walk away with very different perspectives. We also spent time discussing how listening applies to our everyday life, its relevance and importance. Listening Skills Handouts were given to each member and we encouraged them to choose at least one active listening skill to use in conversations this week.

I feel that we explained the purpose of the group and expectations. I can't remember if we outlined all of the activities at the beginning of the session, but we did explain each activity as we went through them. We did a warm up by allowing members to share how they were feeling given seven descriptive words, and then asked members to recall what the person before them had shared.

Our activities were prepared and we gave directions clearly. We began with a role-playing activity and then moved on to a drawing activity that showed how lack of active listening can lead to people walking away from a conversation with very different interpretations. I think I really saw some lightbulbs coming on with that activity. It seemed to make people really think, even to the point of seeing the perspective of someone who doesn't have the ability to ask questions and give feedback. We discussed in the debrief that the role-playing activity was much "stiffer". Audrey and I had to really pull out input from the group members by coming up with questions on the spot. After the drawing activity, there seemed to be more discussion and input given freely and comfortably. The flow improved. Maybe the drawing activity could have been first to help the role-playing be more comfortable for the participants? Each member was given a chance to share, and every member shared at least once. I feel that we gave appropriate verbal and non-verbal communication. I sometimes wasn't sure if I should jump in and help connect dots and give input and encouragement for participating or give the members more time and let there be breaks of silence. We received positive feedback from participants on the experience. I feel that we lead with a facilitative approach. We had a plan and an outline, but we wanted to facilitate awareness, understanding, and discussion. We spent time at the end sharing why active listening is important and should be applied in our everyday life. Group members were given time to reflect on experiences that they have had that involved listening. We summarized our group in the way that I began this blog. We reviewed all that we had done in the group and thanked our participants for their engagement and participation. I feel like we were prepared and allowed our members opportunities to share and discuss. We also made a point to emphasize the life application of our topic, active listening. We wanted the members to leave knowing that the activities and tools of group were meant to make a difference in important ways in their every day life.

As mentioned, we could have switched our activities to help with some of the dynamics, starting with something a little more relaxed and moving to something more structured. We were starting to worry midway through the session about time, but I think we realized that every second doesn't have to be and can't be planned and structured, and there needs to be time for the members to have their effects on the group process by sharing and facilitating.

I loved this experience. Audrey was a wonderful partner and our group is so great! They were encouraging, enthusiastic, and engaged. I would enjoy having a group session every week!

NeuroNote #5: Wear A Helmet!!

Kim Gorgens TedxTalk, Protecting the brain against concussion, was spirited, informative, and left me with further curiosity, and thankfully, resources, to find more information on the topic. 
My house, other than my Dad, was an all girl house. So, other than the occasional bicycling and four-wheelers, we didn't have a lot of concussion risk as far as playing goes. We weren't in rough contact sports like football (thank goodness). I always appreciated the guys out there playing because football season is so much fun, but I am so thankful I never had to be a part of the constant tackling and banging and "bell-ringing". 
Although a concussion can occur in a number of ways, I have been really interested in how they can occur through sports, the long-term effects, and what can be done to fully protect players. One day, I might have a little boy who wants to play football, and I want to be sure that I am caught up on my research and the best protective gear! Our minds are a priceless treasure, and we only get one. So, we must be vigilant in protecting them. 
Dr. Gorgens emphasized the importance of wearing a helmet....many times. She also emphasized: study up, speak up, and suit up. She gave resources in order to study up on new information and research. She encouraged the audience to speak up to legislators and coaches about restrictions, protection, and funding. Lastly, she demanded that we suit up our kids. She used her son as an example several times. Dr. Gorgens knows how drastically a person's life can be changed due to a head injury, and how protection can make such a difference. She also knows that our brains are resilient and strong, however, they are not invincible. 
Unfortunately, there are still questions without answers, and much research to be done. However, if we can put all of our brains together, we will continue to learn and adapt to new knowledge, and protect our beautiful brains. 

Gorgens, Kim. (2010). Protecting the brain against concussion. Retrieved from: https://www.ted.com/talks/kim_gorgens_protecting_the_brain_against_concussion/transcript?language=en