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Group Ideas

Psych Rehab OT

Psych Rehab OT
This group serves as a haven; a source of inspiration and information for OT practitioners working in psychiatric rehabilitation.

Group Ideas

  • Hi I work in an acute psych community based mental health facility...I am looking for good group ideas for my patients...any suggestions would be greatly appreciated

    Anne

  • I am assuming that 'acute' means that people are in crisis or trying to recover from one and that community based means that it's not a locked faciltiy.  I'm also assuming that your clients are adults.  If all of those assumptions are correct, I suggest the following groups:  not longer than 30-40 minutes, focused on a maximum of 2 key points and  involving an activity that applies to their circumstances of recovery. General topics might be "managing medication side effects", balanced meals on food stamps, talking to the Dr, keeping appointments, 'distress tolerance', etc---by asking them what they have trouble with (or reading their pre-admission status reports) you can get a pretty clear idea of what sort of things to build into your treatment program.

    Karla Gray, OTR/L, LICSW

  • Hi,

    I work with adults (18+ years old) on an inpatient behaviorial health unit at a local community hospital. 

    I lead a morning community meeting/ goal setting group (which is paired with a nursing evening wrap up group). 

    In the afternoons, I lead a coping skills group (Mon), an expressive media group (Tues), a work or productivity skillsd group (Wed), a life skills group (Thurs), and a self expression group and a leisure skills group (Fri).  In the coping skills, the work or productivity skills, the life skills, and part of the leisure skills group, I introduce the patients who are present to a host of potential relevant topics.  We, then, go around the group to choose a few topics to quickly highlight in that meeting.  If appropriate, I see the interested person 1:1, after the gathering, sharing an educational handout and further guidance.

    In special unit activities (crafts, collages, unit decorations, mind challenges, etc.), I assess and monitor task skills.

    Good luck!

    RICK

  • Anne,

    Rick presents a good schedule for community practice. I work in an acute, inpatient setting and we do similar groups. Starting the day with goal setting/community meeting, and then a mix of process/therapeutic activities and task assessment group. Providing a forum to "learn" skills and then doing a craft/cooking/exercise group to practice the concepts learned allows you to theme a day and incorporates occupation based activities. You can also use the practice framework to guide your day. Thinking about activities that will prepare clients to focus on topics (starting the day with stretching) and then building up to occupations can guide your treatment planning. Wellness Reproduction's Life Skills books are a great resource for therapeutic activities. I also like 104 Activites that Build: by Alanna Jones.  We also work to provide patients with an opportunity to talk about their illness. Recently one of our staff began doing a group on psychosis on our intensive treatment unit which the patients find very valuable. It only runs about 30 minutes and they identify their symptoms and discuss management. This helps decrease the stigma and isolation of chronic illness. Another well received group is Sensory Modulation Education. We have a cart with activities from all sensory areas. We discuss what people are doing to calm themselves from each area and then pass around items from that area (aromatherapy scents, sweet/sour candy, vibration, etc.) Everyone is calmer afterwards and identifies something they can begin to do more of in their daily routine to help themselves "stay on an even keel". (check out Tina Champagne's work)

    Best of luck, commmunity psych is a great place to be working!

    Barb

  • Hi,
     I work in an acute care psych unit.-15 beds. I run a short Community Meeting to orient grp to the day. We do intro's of grp members, good byes to those that are leaving, review grps running for the day & ask members to ID a coping skill to focus on/practice for the day. Stress Mgt grp is based on Benson's Relaxation Response & we walk, do light aerobics, yoga stretches, meditate. Life Skills Grp focus is on balance of daily activities, countering negative thinking, managing emotions/feelings, esteem building, communication, boundaries,recovery, crisis planning. sensory techniques. Therapeutic Activities a task grp with goals such as creating relaxation response (coloring, crocheting, eg) self esteem, distraction, self soothing, improving concentration, enhancing social skills, balance of daily activities.
    All these grps run daily.  RN's cover some groups (less grps on weekend) when I am not on Unit. I also do some 1:1 work when asked by the team on coping skills & occasional functional evals (KELS), if there is concern about Pt being able to function in the community.
     
    I also have used workbooks mentioned in earlier post. In addition, I have used The New Diary, by Trainer (I think);  The Artist's Way, Cameron;  Benson's books/workbook;  Language of Letting Go, Beattie;  DBT work books by Linehan, McKay, Sprandlin, Marra; .The Blooming of the Lotus & The Miracle of Mindfulness , Nhat Hanh.  You can also check SAMSHA website for group ideas & worksheets eg http://download.ncadi.samhsa.gov/ken/pdf/toolkits/illness/IMR_PractitionerGuide.pdf 
    and DBT website below
     
    Good luck & have fun with your new program,
    Jane

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    Group Ideas
    By anne in Psych Rehab OT

     

    Hi I work in an acute psych community based mental health facility...I am looking for good group ideas for my patients...any suggestions would be greatly appreciated

    Anne

     

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  • Anne,

     

    I should add to my last comments that I use art media to examine a theme of choice in the expressive media group (e.g. love and appreciation, self worth and dignity, hope and healing, positive and negative judgments, healthy and responsible relations, where to go for beauty/ passion, fun activities, good friends, combating cravings or a return of symptoms, strengths and limitations, change, etc.)

     

    In addition, I introduce the topic in the self expression group.  It usually is related to anger management, assertiveness, healthy relationships, cognitive distortions, mental health and addiction recovery, self awareness, development, and esteem.  It may be clear from what is going on in the therapeutic milieu, what direction to take.

     

    Finally, in the first part of the leisure skills group, we do stretching exercise, deep breathing, bio-energetic moves, ball games, sensori-motor and more cognitive warm up activities.

     

     

    In the real world (not the typical OT school classroom), space, equipment, and supplies may influence what you may or may not be able to offer 1:1, in groups, or in special unit activities.  For example, we no longer have the facilities that Barb’s community program must have to offer the option of cooking.  (The unit director also is quite concerned about health and safety issues with cooking and some crafts.)  And I lack the room to store and the expense account to be able to purchase and replace sensory modulation equipment and supplies.

     

    Also, staffing and turf battles strongly determine what you may accomplish.  I probably would not have such a varied behavioral health OT program, if we had a creative arts or recreation therapist, addictions counselor, vocational specialist, or psychologist on board. As it is, with some of my direction, psych techs do a weekly recreation group that may include physical exercise or games, like pictionary, trivia pursuit, etc.  A COTA could have lead this and other therapeutic activities as well as help me with data gathering, etc.

     

    Hope this is helpful!

    RICK 

     

     

     

     

  • Anne,

    I too would recommend publications for group ideas:

    The Relaxation and Stress Reduction Workbook by Davis, Eshelman, and McKay (coping skills)

    The Recovery Book by Mooney, Eisenberg, and Eisenberg (coping skills, expressive media, self expression)

    Pathways to Recovery:  A Strengths Recovery Self-Help Workbook by Ridgway, McDiarmid, Davidson, Baynes, and others (coping skills, expressive media, self expression, leisure skills)

    What Color is Your Parachute by Bolles (work or productivity skills)

    ADL:  A Manual of Group Activities and Written Exercises by McCarthy (life skills, leisure skills)

    The Life Presentation Guide by Grand (life skills)

    100 Interactive Activities for Mental Health and Substance Abuse Recovery by Butler (self expression, expressive media)

    Your Perfect Right:  A Guide to Assertive Living by Alberti and Emmons (self expression)

    Scriptographic pamphlets (all)

    I agree with Jane that the exercises at the conclusion of each chapter in The Artists Way by Cameron might be used in expressive media or a similar group.

    Be careful you gain some extra expertise with DBT training techniques, before working with people who have borderline personality traits, characteristics, or a full-blown disorder.

    Being Peace is another popular book by the Vietnamese Buddhist Monk Thich Nhat Hanh.  I also like Going Home:  Jesus and Buddha as Brothers.

    Linehan and other DBT practioners borrow mindfullness training from Buddhism.  Others borrow Yoga from Hinduism.  You may be curious to explore these cultural/ religious traditions more in depth on your own or to try contemplative or centering prayer or 12 step philosophy and practice for a more Western Christian perspective.

    I too recommend the free Illness Management and Recovery Workbook from the SAMSHA website.

    I have mixed feelings about many of the exercises in the Life Skills Management books.  They often need to be modified, combined, and/or adapted up some.   I suspect many were developed at state hospitals, a long time ago.  They tend to be scattered, dated and simplistic.

    I am not familiar with 104 Activities that Build by Alanna Jones.

    I wish OT schools used these practical texts in their behavioral health classes, rather than texts that deal with the up-and-coming latest frames or reference.  (How many frames of reference are we up to now?!)   In England and other lands, I heard OT's get introduced to MOHO and relatively little else...

    In the Spirit,
    RICK

     

     

     

  • Anne,

    One last point about establishing a behavioral health OT program in an acute psych community based mental health facility.  You will have to decide, whether you will evaluate all that are seen in your program, even if it is to offere a simple screening based primarily on chart review and observation.

    I attempt to see all for an evaluation, OT POC, and OT MTP Problem Area.  Ideally, the person completes a self assessment and, then, I review it with them, during an interview.  The form is not standardized.  But it is modified somewhat for young adults (18-25) and for older adults (65+).

    In addition, an OT Intern or I may do a Life Wheel Assessment or a OCAIRS, if we have the time and it seems warranted.

    We may do a Leisure Interest Inventory, individually or in a group.  Moreover, we may try to determine, if we can help with a particular education, training, or work skill or with a particular parenting skill, if we have time and it seems warranted.

    In theory, we could do the MMSE or a more in depth living skills or educational assessment, but we really don't have the time.

    This may sound sacriligeous, but I have mixed feelings about the ACL.  It too seems simplistic and dated.  It was standardized, after-all, before several new generations of psychiatric meds--some of which are supposed to be effective on negative as well as positive schizophrenic symptoms.

    I must admit that screenings and assessments aren't my forte.  But it is something that you should consider...

    Good luck!

    RICK

  • treekamp and others added to this list...

    RICK

    Recommended Publications for Obtaining Ideas for Behavioral Health OTGroups

    by Davis, Eshelman, and McKay (coping skills) 

     

    The Relaxation and Stress Reduction Workbook

     

     

     

     

     

     

     

     

     

     

     

    The Relaxation Response

    & The Wellness Book by Benson (coping skills, leisure skills)

    The Recovery Book

    by Mooney, Eisenberg, and Eisenberg (coping skills, expressive media, self expression)

    The Self-Esteem Program: Inventories, Activities, & Educational Handouts by Liptak, Khalsa, and Leutenberg

    (expressive media, self expression)

    Group Exercises for Enhancing Social Skills & Self-Esteem

    by Khalsa (self expression)

    Strategies for Anger Management

    by Moles (coping skills, self expression)

    Pathways to Recovery: A Strengths Recovery Self-Help Workbook

    by Ridgway, McDiarmid, Davidson, Baynes, and others (coping skills, expressive media, self expression, leisure skills)

    What Color is Your Parachute

    by Bolles (work or productivity skills)

    ADL: A Manual of Group Activities and Written Exercises

    by McCarthy (life skills, leisure skills)

    The Life Presentation Guide

    by Grand (life skills)

    A Guide to creative Group Programming in the Psychiatric Day Hospital

    by Passi (coping skills, expressive media, work or productivity skills, life skills, leisure skills, self expression

    100 Interactive Activities for Mental Health and Substance Abuse Recovery

    by Butler (self expression, expressive media)

    Your Perfect Right: A Guide to Assertive Living

    by Alberti and Emmons (self expression)

    Scriptographic pamphlets (all)

    Exercises at the conclusion of each chapter in The Artists Way by Cameron (expressive media)

    Be careful, until you gain some extra expertise with DBT training techniques, before working with people who have borderline personality traits, characteristics, or a full-blown disorder. But there are DBT Workbooks by Linehan, McKay, Sprandlin, and Marra. (self expression)

    Books and pamphlets, emphasizing 12 step philosophy and practice (coping skills)

    The free Illness Management and Recovery Workbook from the SAMSHA website (coping skills, expressive media, leisure skills)

    Exercises in the Life Skills Management books from Wellness Reproductions, though they tend to be scattered, dated and simplistic (all)

     

    104 Activities that Build

    by Alanna Jones. (?)

    The Self Regulation Workbook

    & The Sensory Connection (coping skills, leisure skills, and ?)

    Tina Champagne's website OT-Innovations.com

    Resouces identified at the conclusion of Strategies for Anger Management by Moles

     

  • Rick,

    Do you happen to have any sample lesson plans or information that you give to the patients with any of your groups?  I'm new to the mental health field, and are working with a similar Young Adult in-patient group.  Any information would be great!

    Rob

  • I use the SEALS books alot...my patients aren't always young but they can benefit from them with a little tweaking...SEALS stands for self esteem and life skills