OT 640 Debrief

Here is my debrief video!  Looking forward to hearing about everyone's experiences. 

Peer Reviewed Journal Article

   According to the article by Patterson, Fleming, Doig, and Griffin (2017),  there are several benefits of using group-based interventions in health care.  One benefit is the cost effectiveness.  It is also helpful to maximize intensity of rehabilitation for populations such as individuals with a traumatic brain injury.  The purpose of this article is to examine the use of group-based occupational therapy interventions in brain injury rehabilitation at Princess Alexandra Hospital in Queensland, Australia.  There are four different group offered at The Brain Injury Rehabilitation Unit (BIRU): meal preparation, community access, upper limb group, and cognitive rehabilitation group.  The groups can typically accommodate 3-4 participants, and the therapist to client ratio is 1:4.  The hospital set four principles that are used to create groups for individuals in brain injury rehabilitation.  To sum up these principles, the program should focus on peer support, adaptations for cognitive and behavioral changes, individualized goals, and a structured process.  I find that these principles are congruent with group process in other areas of occupational therapy.  

     To evaluate the efficacy of the group program, a questionnaire was given to eligible clients (n = 35) who participated in the group sessions.  The majority of participants responded positively about the group sessions.  While most of the participants enjoy the group programs, some reported negative experiences.  Some said the sessions were not specific to their needs.  This could be due to the group session not being appropriate for all clients.  Thus, it seems to be a challenge to find a group that fits well with the client's needs and goals.  

      I chose this article because it focused on a population that I have little experience with and those clients' perspectives.  The article brings up several considerations when facilitating a group program during inpatient rehabilitation.  Understanding the clients' perspectives is imperative to the efficacy of the program.  It is also important to include family members in group sessions to increase the generalizability of the tasks that are focused on in the session.  While cost-effectiveness and intensifying rehabilitation are evidence-based benefits to group programs, the clients' perceptions should be strongly considered when designing a group program.  

Reference: 

Patterson, F., Fleming, J., Doig, E., & Griffin, J. (2017). Participant evaluation of an inpatient occupational therapy groups programme in brain injury rehabilitation. Australian Occupational Therapy Journal,64(5), 408-418. doi:10.1111/1440-1630.12392

Attending a 12-step Meeting

Al-anon Meeting 2/25/18

     I went to an Adult Children of Alcoholics (ACOA) Al-anon meeting on 2/25/18.  I entered the room feeling intimidated and awkward.  The group provided banana pudding so that eased some of my anxiety.  I think having food at the meeting created a more relaxed environment.  The members welcomed us but were not too pushy.  There were round tables set up which gave members a chance to talk comfortably.  I planned on participating in the group and not telling them I am there for a school assignment; therefore, I was anxious about having to speak up.  Fortunately, I was not required to share and a guest speaker shared her story.  Before the speaker shared, the group facilitator ran through the rules and expectations of the group.  The leader made it clear that political or outside issues should not be discussed in order to maintain cohesion.  She acknowledged there were new members and shared a quick testimony about her experience in ACOA.  She had two regular group members read the 12 steps of Al-Anon and the principles of the program.  
     The guest speaker shared her experiences and how Al-anon has facilitated her recovery.  Some of her final comments resonated with me.  She said, "You're never too old to learn how to play."  I immediately related this to OT and the importance of incorporating play into our engagement with clients throughout the lifespan.  From her perspective, engaging in leisure activities as an older adult was beneficial for her growth in Al-anon and AA and for her mental health.  
     I had expectations that this group session would be more therapeutic than it was.  I think this is why they encourage new members to attend at least 6 sessions before deciding if it is helpful. Since my father is a recovered alcohol, I thought the meeting would be something that would benefit me personally.  I think the meeting would have been more therapeutic if I attended a weekday meeting.  The weekend meetings are designated for guest speakers, while the weekday meetings are for exploring the 12 steps of Al-anon.  
     This meeting was a form of a social support group.  As stated in the meeting, all of us with alcoholic parents have some type of feelings in common.  A benefit of going to these meetings is the realization that we are not alone in our past and current struggles.  Being able to apply what I have learned in Groups class to a real-life group process was insightful.  In the past, I have been curious about the structure of Al-anon meetings, but I was too nervous to attend.  This assignment enabled me to experience Al-anon as a student and as a potential member. 

Group Session Reflection #2

Worksheet 1-3 (Cole, 2018)
Leadership Assessment (Self-assessment)

Introduction: 8 out of 10
I should have given a time frame and outline of the group session.
Activity: 9 out of 10
I think the activity of putting on the cloth diapers using the rolling technique went well and the group learned from this. 
Sharing: 10 out of 10
I had each person to share about what they already know about cloth diapers.
Processing: 8 out of 10
The members elaborated on their hesitations about cloth diapers and what they have learned from this group.
Generalizing: 8 out of 10
I thought it was beneficial to go over the pros and cons of cloth and disposable diapers and have the group members think through these to decide what method is best for them.
Group Motivation: 10 out of 10
Having the baby dolls and cloth diapers for them to learn from made the group session highly motivating.
Limit Setting: 9 out of 10
I did my best to control how long the group spent on the two activities without taking away from their learning experience. 
Application: 10 out of 10
I asked the group about other ways we can potentially child-rear naturally.
Summary: 7 out of 10
I would have liked to do better at reiterating what was covered in the group and giving a more concise final summary.  


Reflection
I have been looking forward to my group facilitation on the use of cloth diapers.  I knew it was not a typical interest of my group, but it would be beneficial knowledge as future pediatric occupational therapists and future parents.  When the group session began, I was struck with timidness.  I realized I was the only one in charge, while last time I had a partner to feed off of and ensure I was on track.  Once again, I forgot to give an outline or time frame of the session.  I think the nerves took over, and I lost my train of thought for my introduction. After a few minutes, I felt comfortable to lead the session.  I was pleased to see how fascinated the group members were about the use of cloth diapers.  I was not sure how intriguing this topic would be to them.  I found the discussion about the pros and cons of cloth and disposable diapers to be an exceptionally beneficial aspect of this group.  It allowed the members to briefly analyze the different characteristics of the diapers and what they think would fit their lifestyle best when/if they become parents.   When the group session ended, two group members told me they will now consider using cloth diapers when they have children.  I felt accomplished knowing I have provided them with a small bit of knowledge that they may carry with them after OT school.  I anticipate that this confidence and excitement will carry on in my potential group facilitations as a future OT. 

Leadership Summit

Participating in the Leadership Summit was a very useful tool in preparation for my group facilitation.  My group included Katelyn, Chelsea, and Makayla.  It was helpful to hear from individuals who I'm not typically in groups with to get different perspectives.  Everyone shared their plan for group facilitation, and we provided feedback and suggestions.  I am facilitating my group on child rearing specifically cloth diapers.  The group gave me several new ideas for how to facilitate my small group.  They advised me to add another activity to my warm-up and bring disposable diapers to compare with cloth diapers.  They also added that this group could be geared towards young mothers and/or underserved mothers which is a great idea!  I enjoyed receiving feedback from my classmates before I lead my group session.  

Group Session Reflection #1 - Relating to Others

Worksheet 1-3 (Cole, 2018)
Leadership Assessment (Self-assessment)

Introduction: 9 out of 10
We should have discussed the structure of how the group session will take place. 
Activity: 10 out of 10
Emily and I worked well together to provide the appropriate materials and were prepared for this group. 
Sharing: 10 out of 10
Each member felt comfortable enough to share their quilt piece.  I made sure to use active listening skills and empathy when each member spoke. 
Processing: 8 out of 10
We could have tried to elicit more feelings about the quilt pieces or asked them to find more ways to relate to each other.  I decided to let this part flow naturally since the group members are fairly comfortable with each other. 
Generalizing: 8 out of 10
I wish we would have verbalized clear, distinct principles. 
Group Motivation: 10 out of 10
I made sure to let the group know that they had freedom when designing their quilt piece.  We encouraged the members to comment on each others similarities. 
Limit Setting: 10 out of 10
We provided enough time for members to complete each activity and respond to our questions with out being overly controlling. 
Application: 10 out of 10
I asked the group what they took away from the session or what they found meaningful.  Emily asked them how they can apply this to real-life situations. 
Summary: 8 out of 10
I would have liked to do better at acknowledging the group's work as a whole at the end of the session. 

Reflection
Being the first pair to lead a group session was at first intimidating.  I started the session feeling slightly unsure of how the next half hour would go.  Our introduction game was not only a good warm-up for the members, but it was also a way for me get acclimated to co-facilitate a group session.  Assuming authority was a difficult role for me, but I think Emily and I both managed this role well without seeming too controlling.  I noticed when we asked probing questions, it took the members a moment to gather their thoughts and respond.  That awkward silence is not always a bad thing!  This was an important observation that I will remember when facilitating groups in the future.  The most meaningful aspect of co-facilitating this group was during the sharing phase.  Each member put effort and thought to their quilt piece and was willing to share their pieces with the group.  I found it interesting that the members shared feelings on different emotional levels.  Some were about concrete, tangible ideas such as wanting to ride a horse while others were about abstract, emotional ideas such as having a fear of abandonment.  I think the mix of ideas made this group session a beneficial learning experience for everyone.  I would have liked to have given more specific takeaway messages at the end of the session.  Although, when we asked them to debrief at the end I was relieved to hear that they found it meaningful in varying ways.  Overall, co-facilitating this group session was an amazing learning experience that has allowed me to feel confident to lead a group on my own in the near future. 

Missed Group Session Feb. 9: Providing Constructive Feedback

In the education setting, constructive feedback should be to improve an individual’s knowledge and learning.  It is the driving force for professional growth.  Constructive feedback often requires us to say something negative or unpleasant to a peer, which can be challenging for most of us.  According to an article by Robert Pozen (2014) in Harvard Business Review, people respond more strongly to negative events than they do positive ones.  In other words, a negative event typically makes a person more upset than a positive event makes a person happy.  Therefore, hearing negative feedback from a peer may impact an individual more than hearing positive feedback.  We should understand this idea when giving effective constructive feedback.

There are several strategies that can help when giving feedback.  When suggesting changes to a project, it is important to add that the changes are merely suggestions and to acknowledge the peer’s effort and the positive aspects of the project.  There will often be times when negative feedback is necessary.  During these instances, it is important to focus on improving a peer’s learning experience and avoid focusing on criticizing them or their work.  An individual would be more receptive to feedback if it is given in a private setting.  Applying these and other strategies named in the article will be a beneficial tool for refining this skill.

            Reading this article reminded me of the Professional Development Evaluation that is facilitated in the OT program.  The process for providing constructive feedback follows the guidelines explained on this article.  While this was previously a daunting event, the faculty creates a positive environment where negative feedback is given when necessary to enhance the student’s growth.  In conclusion, learning to successfully provide constructive feedback to peers and students is vital to professional, personal, and team growth.  

References: 

Pozen, R. C. (2014, August 07). The Delicate Art of Giving Feedback. Retrieved February 01, 2018, from https://hbr.org/2013/03/the-delicate-art-of-giving-fee