Development of a tool to measure therapeutic factors in group process

Measuring Group Process in Nurse-Facilitated Support Groups for Psychosocial Club Members

Nearly half of patients with serious mental illness (SMI) lack friends and social connectedness-building blocks of recovery. While support groups have been found to promote friendship-building, there is little information about the process. This study examined the use of nurse-facilitated support groups by Psychosocial club members with SMI. Participation, core members, therapeutic factors, content discussed, and satisfaction with the intervention were measured. Perception of unmet need for a friend and membership in a group was measured before and after the intervention. Participation increased over time. Core members emerged. Yalom's therapeutic factors evolved. Discussion included sexually transmitted diseases, safety, making friends, health problems, problems with landlords, and adverse events such as victimization. The unmet need for a friend decreased. Two-thirds were satisfied with the groups. Support groups are low-cost psychosocial interventions that can be used to help patients with SMI move toward recovery.

Exploration of experiences in therapeutic groups for patients with severe mental illness: development of the Ferrara group experiences scale (FE- GES)

BACKGROUND

Group therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context.

METHODS

An initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension.

RESULTS

The resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency.

CONCLUSIONS

The Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.

Fatores terapêuticos em grupo de suporte na perspectiva da coordenação e dos membros do grupo

OBJETIVO: Identificar os fatores terapêuticos presentes nas sessões de um Grupo de Apoio a Pais e Familiares de crianças hospitalizadas, na perspectiva dos participantes e da coordenação do grupo. MÉTODOS: Pesquisa descritiva, exploratória. Os dados foram obtidos por intermédio de um check list preenchido pelos familiares e pela identificação de fatores terapêuticos das coordenadoras do grupo. RESULTADOS: Os familiares indicaram a presença dos seguintes fatores terapêuticos no grupo: coesão, compartilhamento de informações, universalidade, fatores existenciais, desenvolvimento de técnicas de socialização, instilação de esperança, altruísmo, aprendizagem interpessoal e comportamento imitativo; as coordenadoras identificaram: coesão, compartilhamento de informações, universalidade e fatores existenciais. CONCLUSÃO: A identificação dos fatores terapêuticos é uma importante ferramenta que pode ser usada para avaliar se os membros estão se beneficiando de sua participação no grupo.

Child-oriented family nursing intervention process in a single-encounter setting

The purpose of this study was to develop nursing intervention skills emerging from the process of single-encounter child-oriented family nursing. This study was a part of a long-term research project by Shiau, conducted from 1990. The participants chosen for this study were patients with schizophrenia or mood disorders from an acute psychiatric ward of a medical center in Taipei. They lived with their spouses (or primary caregiver) and children after being discharged from that medical center. Each nursing intervention program for each family was arranged beforehand. The data of the family nursing intervention process with interview were tape-recorded and transcribed into narrative form and analyzed by content analysis. Results showed that family nursing intervention skills could be categorized into three stages: construction, problem oriented, and hope bridge. The unique point of the family nursing intervention in this study was its child orientation in the context of a single encounter. Providing such an affordable and accessible service for clients is necessary in modern society typified by busy lifestyles, nuclear family structures, and the dominance of cost-effectiveness in medical care delivery.

Some benefits experienced by hospice nurses from group clinical supervision

A small clinical supervision group consisting of five hospice nurses met together in their workplace 1 h weekly for 12 weeks. Issues concerning professional practice were examined with the help of a researcher (A.J.) who acted as facilitator. At the end of the group's life A.J. asked all nurses to complete a questionnaire related to the workplace and 12 identified helpful factors. Two weeks later the hospice nurses were interviewed in group format and asked to consider the reasons for their choice of answers. The data revealed that collectively--interpersonal learning (output), identification, catharsis, family re-enactment, group cohesiveness and self-understanding were experienced by the hospice nurses as the most helpful factors to the group. Existential factors, guidance, universality, interpersonal learning (input), instillation of hope and altruism were identified as less important. Variations in individual responses showed different ways in which a group might meet the needs of its members. The study concludes with the suggestion that work discussion groups can offer nurses the means to calm, regulate and plan their interactions with themselves and others. Clinical supervision is an effective format for exploring issues concerning professional practice, allowing nurses to: learn from each other, offer support, recognize how others see and esteem them as fellow workers, and moderate concerns and anxiety related to their work. Group work is likely to raise anxiety in all participants, however, and preparation and support are required for the group facilitator. Carefully chosen membership is also considered important to the safety of members and successes of the group.