Implement Therapeutic Group Activities

The optional unit ‘Implement Therapeutic Group Activities” looks at why group activities are important, how they are organised and evaluated and how the participants can be supported.

Learning Outcome 1: Understand the principles of therapeutic group activities

1.1 Explain how participating in therapeutic group activities can benefit an individual’s identity, self‐esteem and well-being

Supporting Individuals to attend therapeutic groups and facilitating psychosocial groups are key aspect of my role of a senior worker at my service.

I encourage my clients to engage internally and externally to my service in:

• Talking Groups, for which we use the CGL ‘Foundations of Recovery’ model, which are delivered as workshops, focusing on a range of topics designed to develop personal, social and community recovery capital and support the resettlement process. The model integrates three key concepts – a therapeutic community, with structure and therapeutic milieu; a learning programme that draws upon the latest psychosocial and pedagogical technologies and a hub that promotes positive social connection and reinforces the transition from a culture of addiction, dependency and crime to one of recovery and active citizenship. The programme supports enhanced thinking and life skills with a strong emphasis on emotional regulation, social empathy and interpersonal effectiveness skills. The key programme aims for participants are; freedom from dependence & crime (Initiating and sustaining), wellbeing, Active Citizenship (vocation, rights and responsibilities, positive social contribution and prosocial behaviour).
• Arts therapies – music, painting, dance or drama – to express and understand themselves in a therapeutic environment with a trained therapist. Arts therapies can be especially helpful if individuals find it difficult to talk about their problems and how they are feeling. We provide visual journaling, embroidery, creative writing, and craft groups.
• Complementary and alternative therapies, as some individuals find these helpful to manage stress and other common symptoms of well-being and mental health problems. We provide mindfulness, reflexology, acupuncture and yoga groups.
• Peer support Groups – bringing together people who’ve had similar experiences to support each other. This can offer many benefits, such as: feeling accepted for who they are, increase self-confidence, meeting new people and using their experiences to help others, finding out new information and places for support, challenging stigma and discrimination.
• Physical health activities – as taking steps to look after their physical health can help manage well-being & mental health. We provide walking, body conditioning (keep-fit) and allotment groups.

I also advise my clients generally or suggest they attend specifically the weekly health and well-being group supports individuals around how to; get enough sleep, eat healthily, keep physically active and overall look after themselves.

Participating in group activities can benefit an individuals’ identity, self-esteem and well-being because it gives them a safe and comfortable place where they can share or work out problems. It normalises things and puts like-minded people together, and they can identify with each other, gain an insight into how they do things and offer support or suggestions. By being part of a group the individual will feel less isolated and come to a better understanding of their own identity.

Individuals who have a difficult time with interpersonal relationships can benefit from the social interactions that being part of a group provides and therefore will improve their self-esteem.

Reminiscence therapy is seen as a way of increasing levels of well-being and providing pleasure and cognitive stimulation. Sharing memories and stories with the group can be a social experience and help them to remember that they are still a real person further boosting their self-esteem and wellbeing.

The group setting provides a safe and supportive environment for members to take risks by extending their repertoire of interpersonal behaviour and improving their social skills

Participating in a therapeutic group activity also helps the individual to interact with other people and get feedback and reassurance that they are not alone and are surrounded by people who share the same feelings or are wanting the same things as themselves (i.e. recovery from addiction).

Being in a therapeutic group at my service puts together service users with similar issues (i.e. a desire to reduce, cease, or maintain abstinence from substance misuse) and often (instances of personal exceptionalism & terminal uniqueness) they will feel that they are not the only one with their issue and consequently feel less alone and more reassured. Also peers of a group can encourage each other, share different approaches to solving frequently encountered problems (dealing with triggers, lapses, cravings etc.), and may find more empathy & understanding (not found from partners, family, friends etc.) because they have been through the same or similar things. As well as identifying with each other, hopefully the service user may also come to a better understanding of their own identity.

Once they understand more about their own identity they are more likely to be able to work on it, accept it and be proud of it, which directly impacts on their well-being. Therapeutic groups give service users a safe & comfortable place where they can work out problems and emotional issues, gain insight into their own thoughts & behaviour, and can offer suggestions and support to peers. In addition service users who have a difficult time with interpersonal relationships can benefit from the collective communications that are a basic part of the group experience improving their self-esteem and well-being.

1.2 Analyse reasons why a group activity rather than one‐to‐one work may be recommended in particular circumstance

A group activity may work better for service users who have difficulties with interpersonal relationships and having all the attention solely on themselves so may not feel comfortable or confident with working in a one-to-one session.

A group activity can benefit the service user as they may feel that they can share their thoughts or ideas after they see that their peers are similar to themselves. They may feel more relaxed and comfortable with other service users who they feel they have things in common with (being in active addiction / early recovery) and because they are not being judged as everyone in the group is in the same / similar position. When service users tell their story to a supportive audience, they can obtain relief from chronic feelings of shame and guilt.

A group activity offers a contained and managed space for the service user to practice social behaviours and actions within the safety and security of the group.

A group activity also allows the service user to receive support and encouragement from their peers, are able to see that others are going through the same sort of experience which helps them to feel less alone. They are able to share their strengths and help others in the group which can boost their self-esteem and confidence. Engaging in a group activity is cognitive and social, it can help to change the way the service user thinks about how they do things and develop the confidence to change.

Generally a service user taking part in a group activity rather than an one-to-one may gain a better understanding of themselves because they learn from peers and develop better interpersonal and coping skills.

1.3 Compare theories in relation to group dynamics

Group dynamics is a system of behaviours that occurs between social groups, and considering dynamics of groups at my service is useful in understanding our clients’ decision making behaviour.

• Kurt Lewin (1943, 1948, 1951) first used the term group dynamics to describe the way groups and individuals react in different circumstances and how based on their feelings and emotions; members of a group form a common perception.
• William Schutz (1958, 1966,) looked at group behaviour from the perspective of three dimensions and used the terms Inclusion, control and affection. This became the foundation for the theory of group behaviour that sees groups resolving issues in each of these stages before they move on or to develop to the next stage.
• Bruce Tuckman (1965) however proposed a four staged model for a group which states that the ideal group making process occurs in four stages as follows:
  • Forming – Coming together as a group for the first time, individuals will be nervous and have different kinds of doubts
  • Storming – Group individuals will test the water with each other, confrontations will most likely occur. The politeness barrier will come down and there may be a lack of order.
  • Norming – The aims and objectives at this stage become clearer. Resulting in acceptance of one another, trust, and productivity.
  • Performing – Working together as a group on a common goal. Effective communication, co-operation and a high motivation.
• Bruce Tuckman and Mary Jenson later developed a fifth stage known as:
  • Adjourning/Mourning – The group having completed their goal and going separate ways.

The key points of these theories have been the basis for group therapy and Bruce Tuckmans & William Schutz theories have concluded that to work in a group; members have to move from one stage to another in order to progress and develop.

2.1 Work with individuals and others to agree:

2.1a the nature and purpose of a therapeutic group

Myself and my other keyworking colleagues all carry caseloads of service users who we support one-to-one and co-ordinate the support of, primarily using a person-centred individualised ‘service user plan’ (SUP) which, amongst other things, allows us to plan and provide group activities for individuals based upon their identified needs. On this plan will be the mutually agreed (between the keyworking practitioner, the service user, possibly colleagues & over involved professionals, and sometimes family &/or advocates) combination of structured treatment groups for that service user to attend which will be chosen because they use specific exercises (for example – role playing) to provide a certain activity (we offer psychoeducational, skills development, cognitive–behavioural, and complimentary & ancillary activities).

In practice, the groups use more than one activity. For example, a therapeutic group in the intensive early recovery treatment stage (in CGL this is called the ‘foundations of growth’ tier) I would combine elements of psychoeducation (to show how drugs have ravaged the service users life), skills development (to help the them maintain abstinence), and support (to teach them how to relate to other group members in an honest and open fashion).

The SUP is required to make sure the agreed groups meet the individual’s identified needs, the objectives of attending that course of groups needs to be clear, prioritised, specified clearly how success is to be evaluated, and should be constantly evaluated and reviewed as the service users identified needs can change.

Some of the service users identified needs that certain groups (that may be chosen to be on the SUP to) address could be (depending where they are on their recovery journey):

• To provide positive peer support and pressure to abstain from substances of abuse.
• To reduce the sense of isolation that most who have substance abuse disorders experience.
• To witness the recovery of others.
• To help learn to cope with substance abuse and other problems by allowing them to see how others deal with similar problems.
• To provide useful information those who are new to recovery (for example, learn how to avoid certain triggers for use, the importance of abstinence as a priority, and how to self‐identify as a person recovering from substance abuse.
• To provide feedback concerning the values and abilities of other group members (to improve their conceptions of self or modify faulty, distorted conceptions).
• To offer family‐like experiences (can provide the support and nurture that may have been lacking in their families of origin / also gives members the opportunity to practice healthy ways of interacting with their families).
• To encourage, coach, support, and reinforce as undertake difficult or anxiety‐provoking tasks.
• To offer the opportunity to learn or relearn the social skills needed to cope with everyday life instead of resorting to substance abuse (learning by observing peers, being coached by peers, and practicing skills in a safe and supportive environment).
• To effectively confront them about substance abuse and other harmful behaviours (because the group speaks with the combined authority of those who have shared common experiences and common problems).
• To add needed structure and discipline to the lives of service users who can often enter treatment with their lives in chaos (establishing limitations & consequences, which helps clarify what is their responsibility and what is not).
• To instil hope, a sense that “If he can make it, so can I.”

The groups we provide are revolving membership groups which are ongoing groups that service users join until they accomplish their goals.

2.1b specific activities to fit the purpose of the group

Our activities / exercises in a therapeutic group setting are initiated by the facilitator to intentionally affect the processes and learning of the group. They may be used, for example, to clarify understanding, redirect energy, or stop a damaging sequence of interactions. One type of activity, a confrontation exercise, deftly points out inconsistencies in clients’ thinking.

All specific activities / exercises (node mapping – either handouts or flipchart, role playing, group problem solving, or structured experiences) are designed to fit the purposes of the group, be it:

• Psychoeducational, which teach about substance abuse.
• Skills development, which hone the skills necessary to break free of addictions.
• Cognitive–behavioural, which rearrange patterns of thinking and action that lead to addiction.
• Complimentary & ancillary, to improve health and well-being.

In practice, the activities in groups usually meet more than one purpose, for example, a therapeutic group in the intensive early recovery treatment stage (in CGL this is called the ‘foundations of growth’ tier – FoG) I would combine elements of ‘psychoeducation’ – to show how drugs have ravaged the service users life, and ‘skills development’ – to help the them maintain abstinence and support them how to relate to other group members in an honest and open fashion.

To fit the purpose/s of the group the prepared activities will:

• Address directly the factors contributing to the individual’s problematic behaviour.
• Be consistent with the assessment of the individual’s abilities, learning styles and needs, and with the recommendations of the team.
• Be skills based, address problem solving, and build upon the individual’s strengths and interests.
• Be appropriate to the individual’s age, sensory and general abilities.
• Be of a form that can specify clearly how success is to be evaluated, in terms of addressing the individual’s identified needs.

Please see attachment ‘FoG Combined Group Work Programme’ demonstrating the activities, exercises & format which are appropriate for the purpose, core aims and objectives of the ‘foundations of growth’ tier – FoG (the intensive early recovery treatment stage).

2.1c the monitoring or observations required as part of the group activity

At my setting, it is current practice that in all groups delivered, there is always a facilitator and a staff or manager observer, thus allowing feedback as to how the latter experienced the delivery, what works and what can be improved or removed. This is usually discussed straight after the group session.

Observed practice and feedback on my delivery as well as how the content is received from an objective view enables us to effectively plan and prepare for future therapeutic group activities so as to better:

• Encourage group members to participate at a level appropriate to their abilities.
• Encourage group members to participate in the planned activities at a sufficient intensity and duration for the activity to achieve its aims.
• Communicate in a manner, level and pace, appropriate to the participants.
• Minimise avoidable distractions and disturbances.

It is also our current practice to have daily morning briefings, weekly multi discipline team meetings, monthly group clinical supervision and ad-hoc professional discussions as needed (with my manager, colleagues and/or other professionals) where we talk about a planned group activities which allow the staff team to prepare & plan groups and the activities therein, encouraging dissemination of good practice & shared learning as well new knowledge &/or identification of learning & development needs.

We discuss our own views and those views of the service users with regard to group activities, including its anticipated effectiveness in meeting the agreed goals. We can suggest and discuss the hoped for progress that service users will make towards the goals set, and any problems foreseen. We can identify appropriate members of the team to seek advise from if there are continuing problems with the implementation of the activities, and consider whom to inform upon the activities having been effective.

2.1d own role in relation to planning and preparing for the group activity

In addition to 2.1c above, my responsibilities for planning would be to ensure that all policies and protocols are up to date and adhered to, that all risk assessments and service user plans have been carried out and are up-to-date, that the participants are part of the planning & that they understand what the activity is about, and what is expected of them during the activity. I will also support them to identify their aims and goals of the activity.

I know, agree with and practice the codes of practice & conduct, standards & guidance relevant to my own practice, and the roles, responsibilities, accountability and duties of others, when preparing agreed therapeutic group activities

I use ongoing reflective practice, monthly supervisions and annual appraisals with my line manager to update if needed my planning of facilitating groups.

There is training available to me which takes place in my service, at the local training centre or e-learning on the intranet. I also attend Local Authority learning programmes. This all helps me plan my own role in facilitating groups and the activities used.

2.2 Address any risks that may be associated with the planned activities

In this context a risk refers to any risk to the effective facilitation of the group. Risks may be to individual participants, to the group as a whole or to those facilitating. This includes health & safety risks and emotional well-being but may also include, for example, the risk of delivery methods not being appropriate.

As the facilitator, before a new service user starts group – I would communicate effectively with colleagues to ensure that there is an up-to-date risk assessment for all participants and that all policies and procedures are adhered to with all care plans.

To be considered before starting the group by the keyworking practitioner, their manager and the facilitator and addressed if needed through pre-group keyworking are the following:

• The service users level of interpersonal functioning, including impulse control.
• Does the service user pose a threat to others? If so, in what way.
• Does others in the group pose a threat to the service user? If so, in what way.
• Is the service user prepared to engage in the give and take of group dynamics?
• The service users’ current level of psychological functioning and integration.
• Is the service user prepared for what they can expect from a group (not only the topics & activities, but for situations that could offend, upset or repel them).
• Does the service user understand and prepared to comply with the anticipated group agreement that will be required in order for them to effectively participate (see 3.1 below).

2.3 Prepare the environment for a therapeutic group activity

Before group, I ensure that the environment is safe and comfortable and that no distractions are present to disrupt the activity and that all health and safety policies and risk assessments are adhered to.

The physical and emotional environment in which group sessions take place has a significant impact on the effectiveness of the interventions / activities delivered. An environment that is aesthetically pleasant, comfortable, quiet, confidential, and allows for a variety of learning styles to be catered for will create some of the conditions for an individual and group to flourish. Images, ideas and impressions taken in from the environment can have an effect on the psyche of the individual and can either reinforce an identity enmeshed in addiction or conversely an identity embedded in recovery. Up to 95% of decision making is driven by unconscious processes and the built and social environment can impact these processes and increase the probability of “quantum change” occurring

In so far as is practical I arrange the environment in a way which is appropriate for, and encourages the full participation of all involved, the characteristics of the environment foster learning and development – including:

• Using the same room from session to session to bring about a sense of continuity and consistency.
• I check the lighting is suitable – Lights can be too harsh or too soft, having access to daylight is preferable.
• Minimising intrusions – Is the room located in a busy part of the building where intrusions are likely, I put a sign on the door and place the co-facilitator or a peer mentor by the door to monitor / filter entrants.
• Consider ambience – Is the room clean and quiet (both visually and in terms of sound).
• Check the chairs the same as each other, all functioning & are they relatively comfortable.
• Declutter the room of any unneeded furniture or items, make sure there is nothing in the middle of the room.
• Make sure the space is safe and address any hazards promptly and correctly.
•  Ensure there adequate break out space for work in small groups if needed.
• Ensure there is access to multimedia equipment for music, internet access, power point displays and video if needed.

2.4 Prepare equipment or resources needed for the activity

Available and appropriate equipment and resources are important factors to consider when selecting and using learning & development tools to facilitate learning and development in groups

Resources cover any physical or human resource that supports the learning and development process and could include technical equipment, Information Technology-based learning, handouts, workbooks, and people such as support peer mentors, co-facilitators, outside speakers etc. – all pre-briefed in what to expect and what is required of them.

I prepare equipment and materials that are sufficient, safe, ready for use, and place them where participants can access them easily, prior to the start of the group as I want to enable individuals to participate in the group / activity at a sufficient intensity and duration for the activity to achieve its aims

I would ensure that all equipment I needed for the activity is safe and complete for use and is compliant with legislative and regulatory requirements, otherwise this could result in an accident, and also interrupt the activity causing participants to become anxious and not wanting to take part.

Learning outcome 3: Be able to support individuals during therapeutic group activities

3.1 Support group members to understand the purpose and proposed activity of the group

As mentioned in 2.1a & 2.1b above the groups identified in the SUP to be attended all have a specific purposes (made up of planned activity exercises and interventions) for the service user; be it to learn about substance abuse (psychoeducational activities), hone the skills necessary to break free of addiction (skills development activities), to rearrange patterns of thinking and action (cognitive–behavioural activities) or to improve health and well-being (complimentary & ancillary activities).

In one-to-one sessions, when mutually agreeing and contracting which groups the service user will attend; I would discuss which of the specific / combined purposes the group would serve – the aims and objectives of the group are explained, and a hand-out on giving and receiving feedback is reviewed and confirmed as understood by the service user.

For groups I facilitate; from the beginning and throughout; I need to provide sufficient information and guidance, at an appropriate level and pace, enabling all group members to exercise their skills – so as to treat them in a manner that is likely to promote their well-being, dignity and self-esteem and maximise their learning & development.
At the beginning of the group session, I would explain to the group what the session was going to aim to achieve, what activities / interventions I planned, and highlight the benefits from participating in the activities.

I then ask for a group agreement to establish the expectations that group members have of each other, me, and the group itself. A group member’s acceptance of the contract before entering a group has been described as the single most important factor contributing to the success of outpatient therapy groups (Flores 1997). Consequently, it is important that I present the contract in a way that causes service users to view it as a true commitment and not a mere formality. Particularly with service users referred to treatment through the criminal justice system, it is important to make therapeutic contracts that are explicit and clear, and that carry a firm expectation that the agreement is to be honoured by all members of the group.

3.2 Support group members during the activity in ways that encourage effective communication, active participation and co‐operation

Participation has an intrinsic value for those in a therapeutic group; it is a catalyst for further development; encourages a sense of responsibility; guarantees that a felt need is involved; ensures things are done the right way; uses valuable indigenous knowledge; frees people from dependence on others’ skills; and makes people more conscious of the causes of their issues and what they can do about it.

In groups I facilitate I encourage effective communication within the group to foster an environment that supports active participation in the group and discourages passive note taking. I make participants aware of the outcomes they are expected to achieve and how the planned activities I ask them to engage in will support these. I monitor participants’ verbal and non-verbal responses and use appropriate strategies to motivate them individually and collectively.

Using motivational interviewing I provide participants with sufficient information and guidance, at an appropriate level and pace, to enable them to exercise their skills and encourage and assist individuals to comment constructively on their experiences.

I am aware of the importance of my own communication skills and different ways to communicate effectively with groups, and individual service users within groups.

I balance and adjust my delivery to meet individual needs while achieving planned group outcomes and agreements.

As mentioned in 3.1 above I encourage accountability in that the participants are required to mutually agree upon group agreements (rules of participation have been agreed in advance, and appropriate sanctions made clear) such as punctuality, respecting all members of the group & challenging discrimination, commitment to the group, and confidentiality of group members, etc.

I provide active support and place the preferences and best interests of the group and its members at the centre of everything I do, whilst enabling group members to take responsibility (as far as they are able and within any restrictions placed upon them) and make and communicate their own decisions about their involvement in therapeutic group activities.

3.3 Support group members according to their own level of ability and need

During group activities; I encourage the individuals to interact and communicate with others in the group For example if one of the participants appears to not be getting on as well as the others, I would ask one of the others who is getting on well if they would like to assist, I would actively encourage members to participate even if it was just a small input.

I give constructive feedback to individuals in a manner, and at a level and pace, appropriate to them and in a way which encourages their development and participation, accounting for aspects of equality, diversity and, where relevant, bilingualism, that need to be addressed.

I utilise different ways of adapting my delivery according to participant response whilst still focused achieving planned outcomes and agreements. I am mindful of the abilities and needs of group members and provide them with sufficient information and guidance, at an appropriate level and pace, to enable them to exercise their skills.

An example might be – regarding specific communication needs – problems with speech and language can have many causes, including learning disabilities, physical disabilities like cerebral palsy, strokes, brain injury, neurological diseases and cancers of the head and neck. It is important to identify individual’s communication needs to communicate effectively with them. It will help to find the best solutions for someone who has a problem with communicating. Different styles and methods of communication may include:

• Language differences – I may use a simpler vocabulary (mindful to not be condescending) or interpreter
• Hearing difficulties – I may place myself in front of the person (or vice versa) and use a lower or higher tone
• Visual impairment – I may need to place myself at the appropriate distance (or vice versa)
• Learning difficulties – I may need to use more basic/easier vocabulary (mindful to not be condescending)

3.4 Give direction, praise, reassurance and constructive feedback during the activity

When facilitating, as well as minimising the effects of any disruptive influence on the group, I endeavour to manage the group environment so individuals feel valued, supported, confident and able to learn and develop. I reassure and give appropriate support where I can, but if appropriate will also seek advice from a specialist colleague, manager or an involved professional (e.g. their ADHD counsellor – with consent) if the service user experiences difficulty or reacts negatively to the activity.

I encourage and affirm group members’ behaviour and values that foster mutual respect and support the learning and development process and I, myself, behave in a manner which provides a role model likely to promote the individual’s development. I do not underestimate the importance of acting as a role model for the individual. As a general rule, it seems that service users value feedback more when it is given by someone they respect as a role model. Appropriate feedback contributes significantly in developing service user competence and confidence. I give constructive feedback to group members in a manner, and at a level and pace, appropriate to them and in a way which encourages their development and participation.

The difference between positive and constructive feedback is that the latter is news or input to a participant about an effort well done; whereas the former is information-specific, issue-focused, and based on observations.

3.5 Support the group to bring the activity to a safe and timely end

At the beginning of the group I would explain the structure and purposes of the activities I plan to be done and how long they will be, and near to the end of each activity I would start giving times as to when we will be finishing. For example 10 minutes I would tell them and then again at 5 minutes, so as not to rush them, and meaning that they were prepared for the end of the activity.

I keep accurate, legible and complete records of the activity, so that I can fine tune it if needed, and know the timings of each exercise and section.

I will often use different group dynamics management and containing techniques to maintain the health, safety and emotional well-being of participants, myself and other colleagues present.  All participants will ‘check-out’ to the group before the session closes, and myself and any colleagues (peer mentor, co-facilitator) present will debrief straight after the session once all service users have departed.

Another common provision of group agreements (see 3.1 & 3.2 above) stipulates that group sessions will start and end at specific times. I, as facilitator, make sure that these time boundaries are observed, both by service users, myself and any support staff (usually peer mentors) – service users cannot be expected to abide by the group agreement if the staff do not. The standard group agreement in my therapeutic groups is usually that if a service user is five minutes late they cannot come in; and likewise participants commit to not leave until the session is complete and all members have completed their ‘check- out’. If they have to leave early due to an important appointment then it is contracted they will tell me (the facilitator) before the group and I will mention it to the group when I invite them to check-in near the start of the session.

Learning outcome 4: Be able to contribute to the evaluation of therapeutic group activities

4.1 Encourage and support individuals to give feedback during and after group activities

Feedback from participants on their views and concerns about the group activities is a good way to assess both learning and the incorporation of skills, and ensure we/I am providing them with sufficient information and guidance, at an appropriate level and pace, to enable them to exercise their skills.

Feedback helps to highlight any areas of the activity that may need to be revised / improved if evaluated as being inappropriate, or where the resources are unsuitable or inadequate, so upon consultation with colleagues / managers it can be modified.

It provides the opinions of the people who are experiencing the activities and interventions first hand, giving valuable information from an ‘expert by experience’ perspective. Feedback is most useful when it is constructive but even when it is not – it is still valid.

Service user’s feedback is gained through discussion with the facilitator during or after the group, discussion in session with the keyworker, feedback forms, monthly service user forums, suggestions box in reception or a session with a service user representative in a separate confidential appointment.

Providing encouragement to feedback empowers service users by asking them their opinion and allows them to take responsibility and ownership of their success, and gives me (and colleagues) a chance to affirm to them how well they are doing.

4.2 Agree with others’ processes and criteria for evaluating the therapeutic benefits of the group and its activities

As mentioned above in 2.1c it is our current practice that in all groups delivered, there is always a facilitator and a staff or manager observer, thus allowing feedback as to how the latter experienced the delivery, what works and what can be improved or removed. This is usually discussed straight after the group session.

Observed practice and feedback on my delivery as well as how the content is received from an objective view enables me to grow and develop as a facilitator, to improve my style and competency as well as be affirmed in areas of proficiency.

It is also current practice to have daily morning briefings, weekly multi discipline team meetings, monthly group clinical supervision and ad-hoc professional discussions as needed (with my manager, colleagues &/or other professionals) where we can talk about delivered group activities which allow the staff team to evaluate & revise these if needed, encouraging dissemination of good practice and shared learning as well new knowledge and/or identification of learning & development needs.

We discuss our own views and those views of the service users with regard to carried out group activities, including its effectiveness in meeting the agreed goals. We can identify and discuss the progress that service users have made towards the goals set and any problems encountered. We can seek advice from the appropriate members of the team as soon as possible where there are continuing problems with the implementation of the activities, and inform relevant parties where the activities have been effective.

The agreed evaluation criteria might include:

• If I encouraged group members to participate at a level appropriate to their abilities.
• If I encouraged group members to participate in the planned activities at a sufficient intensity and duration for the activity to achieve its aims.
• If I communicated in a manner, level and pace, appropriate to the participants.
• Did I minimise avoidable distractions and disturbances.

4.3 Carry out own responsibilities for supporting the evaluation and agreeing any revisions

In addition to 4.2 above, my responsibilities for supporting the individuals would be to ensure that all policies and protocols are up to date and adhered to, that risk assessments and service user plan reviews are regularly carried out and updated if necessary, and that the individuals is part of the evaluation and that they understood what the activity was about and that what was expected of them during the activity. I will also support them to identify their aims and goals and if the activity was appropriate &/or successful I that regard.

I know, agree with and practice the codes of practice and conduct, standards & guidance relevant to my own practice, and the roles, responsibilities, accountability and duties of others, when evaluating & revising agreed therapeutic group activities

I use ongoing reflective practice and monthly supervisions and annual appraisals with my line manager to evaluate and revise if needed my practice of facilitating groups (see completed Unit 301).

There is training available to me which takes place in my service, at the local training centre or e-learning on the intranet. I also attend Local Authority learning programmes. This all helps me evaluate and support the evaluation of groups and the activities used.

4.4 Record and report on outcomes and any revisions in line with agreed ways of working

In addition to the methods/actions in 4.2 & 4.3 above all being minuted and recorded, whenever I finish facilitating a group session in line with agreed ways of working I make notes of the service users who attended, how they presented and participated and anything else of importance that needs to be documented. This means that colleagues involved with the service users are kept up-to-date, enabling team effectiveness.

As part of best practice, ensuring quality and striving to meet the needs of service users, we not only accurately record and monitor what we do, but also evaluate the efficacy of group activity &/or an intervention – measuring hard and soft outcomes / qualitative and quantitative. This help us understand impact as well as look at areas of improvement, helping us understand the role that a group activity &/or an intervention has played in someone’s journey.

Taken into account in all the above are current local & UK legislation and regulatory requirements, procedures and practices for:

• Data protection, including recording, reporting, storage, security and sharing of information.
• Health and safety.
• Risk assessment and management.
• Protecting individuals from danger, harm and abuse
• Preparing, implementing and evaluating agreed therapeutic group activities.
• Working with others to provide integrated services