Nurs 343 Ch. 34 – Flashcards
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Conflict
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a disagreement between two or more people or groups
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Closed group
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a group in which membership is restricted: no new members are added when others leave.
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Catharsis
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intense feelings, as judged by the member, are shared.
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Feedback
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letting group members know how they affect each other.
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Group
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two or more people who come together for the purpose of pursuing common goals and/or interests.
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Group Content
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all that is said in the group.
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Group Norms
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expectations for behavior in the group that develop overtime and provide structure for members (e.g. starting on time, not interrupting)
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Group Process
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the dynamics of interaction among the members (e.g. who talks to whom, facial expressions and body language)
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Group Psychotherapy
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a specialized treatment intervention in which a trained leader establishes a group for the purpose of treating patients with psychiatric disorders.
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Group Themes
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members' expressed ideas or feelings that recur and have a common thread.
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Group Work
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a method whereby individuals with a common purpose come together and benefit by both giving a receiving feedback with the dynamic and unique context of group life.
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Open Groups
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a group in which new members are added as others leave.
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Psycho-educational Groups
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groups set up to increase knowledge or skills about a specific somatic or psychological subject and allow members to communicate emotional concerns.
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Support Groups/Self-help groups
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structured for the purpose of providing patients with the opportunity to maintain or enhance personal and social functioning through cooperation and shared understanding of life's changes.
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Therapeutic factor
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aspects of the group experience that leaders and members have identified as facilitating therapeutic change.
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Characteristics of groups
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Size Defined purpose Degree of similarity of members Rules Boundaries Climate Apparent content
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Advantages of group therapy
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Cost effective for more clients Members feel less isolated Members receive peer feedback Groups teach more problem solving approaches Members learn about functional roles in groups
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Disadvantages to groups
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Privacy can be compromised Some clients cannot share intimate feelings or thoughts in a group Some members may not feel that they are receiving attention if another member is more active
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Exclusion from groups
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Acutely psychotic or manic Those who are cognitively impaired with dementia or intoxicated.
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Phases of group development
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1. Initial 2. Working 3. Mature 4. Termination
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3 styles of group leadership
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Autocratic Democratic Laissez-faire
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Therapeutic factors common to all groups
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Universality-one is not alone in one's situation Instillation of hope Imparting information Altruism Corrective recapitulation Developing social skills Imitative behavior Interpersonal learning Group cohesiveness Catharsis Existential factors
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Interpersonal learning after trust is established
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Group cohesiveness Catharsis Existential resolution-learn to accept painful aspects of life
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Challenging client behaviors
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The monopolizer The complainer who refuses help The demoralizer The silent client
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The nurse is caring for four patients. Which patient would not be appropriate to consider for group therapy? The patient who: 1. has limited financial resources. 2. is acutely manic. 3. has few friends on the unit. 4. does not speak up often, yet listens to others.
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is acutely manic.
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The nurse tells group members that they will be working on expressing conflicts during the current group session. Which phase of group development is represented? 1. Formation phase 2. Orientation phase 3. Working phase 4. Termination phase
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Working phase
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Group members are having difficulty deciding what topic to cover in today's session. Which nurse leader response reflects autocratic leadership? 1. "We are talking about fear of rejection today." 2. "Let's go around the room and make suggestions for today's topic." 3. "I will let you come to a conclusion together about what to talk about." 4. "I'll work with you to find a suitable topic for today."
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"We are talking about fear of rejection today."
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The nurse is planning care which will include a dual-diagnosis group. Which patient would be appropriate for this group? The patient with: 1. depression and suicidal tendencies. 2. anxiety and frequent migraine headaches. 3. bipolar disorder and anorexia nervosa. 4. schizophrenia and alcohol abuse.
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schizophrenia and alcohol abuse.
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A patient continues to dominate the group conversation despite having been asked to allow others to speak. What is the most appropriate nursing response? 1. "You are monopolizing the conversation." 2. "When you talk constantly, it makes everyone feel angry." 3. "You are supposed to allow others to talk also." 4. "When you speak out of turn, I feel concerned that others cannot participate equally."
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"When you speak out of turn, I feel concerned that others cannot participate equally."
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The phase of group therapy in which the group deals with feelings associated with separation and loss is A. orientation. B. working. C. termination. D. post-termination.
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termination.
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When a group member supports and encourages another group member and thus feels 'good' about doing so, the group phenomenon at work is A. altruism. B. ventilation. C. universality. D. group acceptance.
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altruism.
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A client has recently been treated for prostate cancer. The nurse suggests that talking with others who have had similar problems might be helpful. The type of group most useful to the client would be A. a cognitive-behavioral group. B. a time-limited group. C. a support group. D. a milieu group.
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a support group.
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The group goals are to learn to express feelings comfortably rather than keep them covert. S, a group member, let's the group know how expressing these feelings makes her feel. This dynamic is called A. group content. B. confrontation. C. subgrouping. D. feedback.
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feedback.
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A democratic group leadership style is most appropriate for a group: A. that meets for 30 minutes to discuss unit rules B. focused on creating meaningful trauma-related artwork C. psychotherapy group directed towards anger management D. that is responsible for organizing the unit holiday celebration
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psychotherapy group directed towards anger management
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The nurse reading a group protocol notes that it is a closed group and understands that A. discussion topics will be restricted. B. membership is limited to one sex. C. no new members are added. D. the group is cohesive.
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no new members are added.
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The phase most influenced and managed by the group leader is: A. orientation B. working C. termination D. post termination
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orientation
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Self-help and support groups are least influenced by the premise that A. professional leadership is inappropriately expensive for treatment of minor problems. B. people who have had a particular problem can help others with the same problem. C. promotion of dialogue, self-disclosure, and encouragement can produce change in members. D. Self-help and support groups are designed to serve people with a common problem.
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professional leadership is inappropriately expensive for treatment of minor problems.
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At what point in the life of a group lasting 12 sessions should confidentiality be explained and discussed? A. At the first session B. During session 4, as the working phase begins C. During session 12, as the group terminates D. At the time each client is interviewed so as not to waste group time
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At the first session
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A treatment group that a novice psychiatric nurse is likely to be assigned to lead is: A. group psychotherapy B. medication education C. dialextical behavior treatment D. art therapy group
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medication education
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At what phase of group development would the nurse hear the following interchange? Client 1: "I do not feel comfortable here." Client 2: "I wonder what we are supposed to talk about." Client 3: "Let's ask the leader to explain things again." A. Preorientation B. Orientation C. Working D. Termination
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Orientation
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K tells the group "I think the committee saw how unsure of myself I am. I felt all shaky inside during the promotion interview, just like I am feeling and acting right now." To present reality the leader should A. remain silent and nod slightly to signal that K should continue. B. say "K, tell us more about how you are feeling." C. ask "Does this shaky feeling occur often?" D. ask the group to give K feedback about how he appears to them.
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ask the group to give K feedback about how he appears to them.
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M tells the group "I have so many problems in my life that it is hard to know where to begin." The leader suggests "Choose the problem that is troubling you most at this time and tell us about it." The leader is promoting A. insight. B. focusing. C. reframing. D. feedback.
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focusing
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C had planned to bring up the topic of his angry feelings toward his brother at the group meeting. However, M seemed distraught and on the verge of tears. C noticed M's distress and said "It looks as though you need the floor to tell us what is so upsetting to you." C's action can be assessed as showing A. reality testing. B. universality. C. ventilation. D. altruism.
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altruism.
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A, B, and C always sit together during the group meetings. They are seen to look at one another and nod or smirk as others are talking. Whenever one of them expresses an opinion the others are quick to support the opinion. The leader can assess this behavior as A. altruistic. B. universality. C. subgrouping. D. contingency seeking.
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subgrouping.
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During group, D tells of the pain she experienced when her child was killed in an automobile accident. F mentions that she, too, experienced the pain of losing a child in an accidental drowning. F comments on the fact that the pain lessens over time, even though in the beginning one cannot believe it will. Sharing similar experiences is a curative factor identified by Yalom as A. universality. B. ventilation. C. reenactment. D. recapitulation.
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universality.
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A nurse is the leader for a medication group for bipolar clients. The group is 5 weeks in length. No new clients will be added as the group progresses. The group is A. open. B. homogeneous. C. heterogeneous D. closed.
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closed.
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A key quality indicator that might be identified for successful outcome in a medication education group could be clients will A. state they liked the leader. B. demonstrate a bond between members of the group. C. describe modes of transmission of sexually transmitted diseases. D. confer with health care provider before changing medication regimen.
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confer with health care provider before changing medication regimen.
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The nurse leader of a cognitive therapy group for persons with dysphasia would use the technique of A. negative reinforcement. B. conflict suppression. C. clarification. D. flooding to desensitize a client to anxiety.
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clarification.
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P has been a member of the therapy group for 4 weeks and has said nothing during the sessions. A strategy the leader may use to encourage him to speak during a session is A. "P, you are letting the group down when you fail to contribute." B. "P, what do you have to say about what just happened?" C. "By now, P, you must be feeling safe enough to enter the discussion." D. "What are you thinking, P?"
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"What are you thinking, P?"
