Debrief from Level 1 FW C OT 640

Overeaters Anonymous Reflection

Tonight I attended an Overeaters Anonymous (OA) 12 step meeting. I thought this would be very interesting and different from the experience of many of my classmates who attended Alcoholics Anonymous or Narcotics Anonymous. Overeaters Anonymous operates from the 12 step model just like AA and NA, because the members really do see food as their drug of choice.
The leader was very directive in assigning roles to the different group members, incorporating activities of her choosing, and facilitating the flow of conversation throughout the meeting.
The group leader encouraged participation by initially stating that she wanted each group member to share after we completed activity. When only two individuals had not yet gone, she said,"Okay, which one of you would like to go first?" She was very respectful and validated what each person had to say. Every person thanked each individual who shared throughout the group session. Because each OA group runs in a fairly formulaic pattern, no individual personalities stood out too much to the point where the group leader would need to intervene. However, she did do a good job of making me feel comfortable as a newcomer and introducing me to the other members.
The group meeting took place in a small meeting room in the basement of the church. Members had to enter a backdoor of the church and walk through a winding hallway to get to the correct meeting space. I think that the fact that this felt so cozy and private made it easier for group members to open up and share throughout the session. As part of the OA model, only OA approved literature is displayed on the table so this element of the environment may have promoted some insights or reflections specific to the way that OA is run if they were familiar with that literature. Positive messages and OA, NA, and AA specific encouragements and steps were displayed all over the room. It was a small group of members, so the small size of the room made it easy to hear everyone and be comfortable.
I believe that this session was therapeutic. Each member shared something that they struggle with and a goal as part of their action plan. Also, there were several recitations that they seem to read aloud at every group meeting that positively reinforces the messages of OA in each group member's mind. I got very excited during the goal-writing portion (which I believe was a bit out of the ordinary from what they usually do). The leader said that she wanted each person's goal to be specific, measurable, attainable, relevant, and time-constrained. I was so glad to see this kind of effective goal writing as part of a 12 step program! Each member shared their goals and many took notes on each other's goals as they were read out loud. At the end of the session, the group leader asked the members to share how long they have been a part of OA and what this group has meant to them. Each person that shared had a unique and deeply personal story that showed the true impact OA has had over decades of their lives. Although I know this was probably for my benefit, it was so inspiring and therapeutic to hear how well this group really works.
I think that this group was directive because the leader selected each activity, assigned the reading passages to different members, and directed the flow of the whole meeting. The leader was very active in encouraging group participation.

Reflection on Journal Article Review of Group Intervention

In the article, "Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomized control trial," researchers examined the effects of a long-term, non-pharmacological group intervention on cognitive function and ability to carry out activities of daily living versus usual care for people with degenerative dementia. The intervention group was divided into smaller groups of 10 individuals who received motor stimulation, practice in ADLs, and cognitive stimulation as a part of a group therapy intervention. The control group received usual treatment for cognitive function and ability to perform ADLs. This study took place over a span of twelve months. In the end, the researchers discovered that a highly standardized, non-pharmacological, multi-component group intervention in a nursing home was able to significantly postpone a decline in cognitive function in dementia patients and in their ability to carry out activities of daily living. At the end of the twelve months, the group that received usual care had a significant decline in cognitive function and ability to perform ADLs.

I chose this article because I have a personal connection to dementia and have been so frustrated with understanding the role of occupational therapy in treating clients with dementia. I am so desperate to learn how to slow the process of cognitive decline and help clients with dementia be as independent as possible for as long as possible. I find it so encouraging that this article found a significant difference in the population that received group intervention and the population that received usual care.

I think that this article definitely speaks to the power of groups. I know for me personally, I have benefitted so much from building connections, talking out problems, and finding common ground with my group members. By participating in groups, the individuals in these study experience significantly less cognitive decline and inability to perform ADLs. I believe that there is a very real mind-body connection between working out the emotional and psychological problems we face and the ability of your body to function to the best of its ability. In the future, I want to utilize groups as much as possible in my practice in order to provide the biggest benefit possible to my clients.

Graessel, E., Stemmer, R., Eichenseer, B., Pickel, S., Donath, C., Kornhuber, J., & Luttenberger, K. (2011, December 1). Non-pharmacological, multi-component group therapy in patients with degenerative dementia: a 12-month randomized, controlled trial. Retrieved March 7, 2018, from https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-129

Individual Group Facilitation

The purpose of the group that I led was to facilitate thinking and preparation for taking on the caregiver role in the future. I encouraged my group to think of ways to promote self-care once they step into the role of caregiver with their parents or in-laws.
For the introduction, I explained the purpose of the group and the time frame that we would follow. I chose a warm-up activity that was very light and related to the "sandwich" generation. This was fun and lighthearted, and I encouraged each person to share their individual qualities that the sandwich quiz revealed about them.
For the main activity, I had a bundle of popsicle sticks that each signified a different caregiver burden that many caregivers face. I encouraged each group member to pick at least two burdens out of the stack that they could think of a way to adapt or delegate so that burden was no longer so taxing. It was very interesting to hear about the different resources that people in my group were able to come up with.
Each member of the group shared a very deep and personal story and allowed the other members in the group to find common ground in the way that their family members cared for others. It was very interesting to recognize themes of caregivers providing too much help or not allowing themselves enough personal time to participate in self-care activities.
Through processing, each member was able to identify the negative aspect of caregiving and how they might incorporate more self-care when they are able to in the future.
By generalizing, each group member was able to identify at least two self-care activities that they plan to keep in the future once they take on the caregiving role.
I feel as though group motivation was very high because there were many personal stories that were shared with families either doing too much or not enough for their loved ones as they age. It was very interesting to hear from group members about how they might change their caregiving styles in the future.
Limit setting was very difficult in this group because I know that each member shared a very deep and personal story and I did not want to interrupt them from sharing their life experiences. I know that I need to find a balance between leaving the floor completely open and cutting off people too early. Many great stories were shared in our group time.
As I was summarizing the group session, I did my best to apply the knowledge that we learned to real-life scenarios. Although this was a very heavy topic, I am confident that each group members learned how they could delegate at least one caregiver burden once they take on that role.

Leadership Summit

Before facilitating my group individually, I had the opportunity to meet with three other students who would be leading a group on the same day. We were able to share our topics and plans for leading our group and give feedback to one another. The leadership summit was very helpful to me in thinking out the best way to effectively execute my group protocol, especially since I had a heavy topic. I was having a hard time thinking of a good warm-up activity, and I got great suggestions from my group including doing a high and a low from that weekend, doing a twister game, or doing a race to put a diaper on a baby doll. It was helpful for me to hear what they were doing for their warm-up activities. Even though I did not use any of these creative suggestions, I now have some additional ideas in my "OT toolbelt" for groups I will lead in the future. From this leadership summit, I learned that it is always a good idea to utilize your peers for intervention ideas, group activities, or finding the best evidence-based practice that they may have knowledge of that I do not know about.

Reflection on Group Facilitation #1

For my group facilitation along with Lauren and Caroline, we decided to lead a group on conflict resolution strategies. We thought this would be an important topic to address because as OTs we will frequently run into some sort of conflict with the client, the caregiver, or other healthcare providers and it is wise to be proactive to develop strategies ahead of time to preserve our goals and relationships with others. We decided to start the group by asking some warm-up questions, then we did an icebreaker, next Lauren led a Conflict Resolution Management Styles Assessment, then Caroline led the "How do you see it?" activity, and I concluded my leading a debriefing session and summarizing everything we did in the group.
Lauren started the group by clearly explaining our purpose and asking everyone how conflict was resolved in their families growing up. Everyone seemed relaxed and willing to share. We had a great pre-existing rapport with the group members so it was fairly easy for them to open up. She then outlined how the rest of the group would run.
Next, we led the group in three activities. They ran smoothly even when people got confused on directions. We were able to keep the ball rolling and be productive with our time. The materials we used for our activities were very effective tools that allowed our group members to learn more about themselves and others. Throughout the course of the activities, several people entered and exited the room, but we were able to stay focused and complete the activities successfully.
We invited each member to share during the debriefing session while also letting them know that they did not have to share if they didn't want to. I consciously tried to use good verbal and nonverbal cues to make the group members feel safe and open when sharing. I did my best not to butt in, look them directly in the eyes as they shared, and to convey empathy.
Processing occurred naturally during the debriefing session. I tried to ask questions that would elicit the members' feelings and beliefs about the experience. I also tried to help them see connections in what they learned about themselves and how they can generalize this new knowledge to a conflict resolution scenario.
I did my best to highlight similarities and differences in how each of the group members approaches conflict resolution by looking at their individual responses and drawing my own conclusions or by asking them questions that would lead them to draw their own. I ended the session by asking each group member to say something positive that they learned about themselves with the hope that they will remember that positive attribute next time they are in a conflict resolution scenario.
I tried to inspire confidence at the conclusion of the group by asking the group members to brag about themselves. I conveyed a positive and encouraging spirit and did my best to motivate others to speak up for their positive attributes and smile and thank them when they chose to speak out loud. My co-facilitators and I encouraged group interaction by having group members partner up for one activity.
Limit setting was definitely a challenge. Because our group has an already established rapport, it was easy to get off topic and keep having a conversation. While the conversation was productive and relevant to conflict resolution, it was more important to make our remaining points, so we regained their attention and veered back on course. I believe my co-facilitators and I were able to keep the ball rolling after too much conversation without being too controlling.
In the summary, we conveyed the meaning and significance of the experience while also asking them to reflect on what they learned. We brought up several situations in everyday life where these conflict resolution strategies could be used. We also asked group members to share times where they did not handle conflict resolution in a productive way.
In summary, we reinforced the activities that we did, why they were important, and thanked the group members for their participation. We ended the group in a timely manner.
For me, the most significant part of this experience was getting some practice on how long to leave the floor open for discussion without putting too much pressure on every person in the group to speak. I found that this was a delicate balance and I appreciated the practice. Overall, I think I feel more comfortable leading a group now than I did before. I learned more about how to ask further questions and convey empathy while leading the group members to draw conclusions about what they learned.

Miss You Can Do It- Neuro Note #5

This HBO documentary follows the "Miss You Can Do It" pageant for young girls with physical and mental disabilities. This pageant was started by a young woman with cerebral palsy named Abby Curran that competed in "mainstream" pageants. Her dream was to create an outlet for every young girl to express herself and feel beautiful no matter their ability or skill level. The pageant looks at each girls' unique situation and helps to even the playing field. Many of the girls featured in this pageant have a shortened life span, so the Miss You Can Do It pageant was life changing for these girls and their families. This pageant allowed the young girls' personality and talent to shine despite their physical limitations. One of my favorite lines in the whole movie was when a young girl said "When I grow up I want to be an occupational therapist, because they help you put your snow boots on in the winter!" I would definitely recommend this movie to my peers. It was eye opening and showed the need for a pageant like this to exist. It was truly a life changing experience to the families that were participating.