L1C-Debriefing

This video describes my time from my Level 1:C fieldwork rotation in community mental health.

Here is an alternate link for the video, if the above link does not work.
https://youtu.be/r1opgjBpIww

Exploring Volunteer Opportunities "Volunteer Adventures"

Planning this group was harder than the last group facilitation. There were eight groups that took place before mine and some of the activities that I wanted to incorporate were already used. I did not want to repeat what someone had already done, so I had to be creative with activity choices. I also wanted to improve in two areas from the last co-lead group session: I wanted to extend the group time and be ready with a plan B if I needed to adapt the group to any situations like length of group.

Before I facilitated the group, I meet with three other group leaders. We all discussed our group sessions. We bounced ideas off of each other and expressed our opinions about each other’s group session. More information on the group session can be found on my blog under Leadership Summit.

For this group I decided to use The Ecology of Human Performance Model. This model emphasizes the importance of contexts and environments within which people of all ages perform tasks. This group focused on finding occupational performance through volunteerism. Occupational performance is achieved when there is a balance between the person, task, context, and performance. The OTPF defines four occupational contexts: personal, cultural, temporal, and virtual; and two environments: physical and social. In this session, the focus will be on the social environment and temporal context. The temporal context I want participants to consider is after graduating OT school. The social environment will be the groups they choose to volunteer in.

As a warm up activity, I passed out three blank pieces of paper and I asked everyone to obtain a different color marker. I asked participants to write out three areas they are passionate about, each one on a separate piece of paper. The participants shared their passions with the group. I did this as a warm up activity because I believe to volunteer, an individual need to be passionate about something. If they are, they will continue to volunteer in that area. To facilitate their understanding of passion, I gave them this definition: Passionate is defined as having or compelled by intense emotions or strong feelings.

I did not do the best at communicating a schedule to the group. I was nervous during the beginning of the group. However, I did give a schedule of the group after the warm up activity.

For my activity I choose to play a matching game with volunteer opportunities. The volunteer opportunities were the different tasks that would be explored. The idea was to find a match and discuss if this would be a match to their context (after graduating OT school). The group discussed each match found to see if this was an area they would volunteer in. if no match was found then it would be the next participants turn. I feel that I was adequately prepared for this group. Since I was the last person to go, I was able to tailor the volunteer experiences to the individuals in the group. I laid out the cards before the group started to allow smooth transition from the warm up to the activity. Again, one area that I wanted to improve was to increase the length of the group. I tried to pick an activity that would take up more time; however, I did not anticipate the amount of discussion that took place. I was thrilled to have participants discussing volunteer opportunities, but I did have to watch the time and use plan B to finish the session without skipping over the main points at the end. Next time I do this activity, I will know to put less cards out. I did try to make the cards fun by using colored cards and ink. The environment that the game created was very therapeutic. Participants were cheering others on, celebrating a match, embracing the unknown of not knowing what cards to pick, and laughing with each other. I was thrilled to see this level of participation and fun that each participant had.

I have already mentioned that I was running short on time. They gave me a great opportunity to improve from the last group I co-lead. I had a plan B! Plan B included modifying the processing, generalizing, application, and summary. For processing, I had wanted to go around the table and discuss a new area of interest to volunteer in. Instead, I had participants, through nodding head yes or no, express if they learned a new area to volunteer. I feel that processing happened internally for some of the group members through the discussion portion of the activity. For generalizing, I noted that even though the majority of the group wants to work with adults, they can still volunteer with kids. They have all been through OT school. They have knowledge that they can all use. It is okay not volunteer in an area an individual is not passionate about. I pointed out similarities and differences in group answers. I did make it a point to say, “listening to others allows us to see different perspectives and discover new areas to be involved.” I wanted to say this, so that, participants would see the benefit of listening to others and trying new things. For the application, I asked the participants to return to the cards from the warm up activity. I wanted them to write a way their passion could be achieved though volunteerism after graduating OT school? This could include a volunteer area previously discussed. I wanted every participant to share one, but with time restrictions I asked a few people to volunteer to share. Finally, I summed up the group through encouraging them to volunteer after graduating. They have all learned valuable skills that can be used in different populations and setting. I thanked them for participating.

I did have an opportunity to limit inappropriate behavior. Because the activity required some discussion, the group would occasionally get off topic. At one point, I did ask to limit the off-topic discussions. I love that they are discussing volunteerism, but they can further talk after the group. This aided in respecting the other group members time by finishing the group within the hour time frame.

I do believe I improved my weaknesses from the last group facilitation. I had a plan B and was able to incorporate using it in this group facilitation. I did extend the time of this group, but I would have loved more time to facilitate the group how I planned. I have seen two extremes with the time, so now I need to work on fine tuning the time of the activity to the session. This will help me to better facilitate the group as I have planned it.

All in all, this was a great group experience!

12-step meeting

I attended a twelve-step meeting for friends and family members of alcoholics (Al-Anon). I went during lunch time and I did not think there would be many people there. I was wrong. There were around thirty individuals there discussing their experiences. The first person I noticed was the group facilitator. She was mixed in with the group. She would read a point, talk about it, and then ask the group to discuss. She would allow three to five people to respond then go to the next point. She handed out responsibilities before the group started and called on those individuals when she need them. The facilitator handled different personalities in the room well. She allowed people to share their thoughts. Depending on what was shared, she would add a comment. The comment either summarized what was said or she added a new thought. The environment in the room was comfy and allowed for excellent group interaction. Even thought there were a lot of people in the room, it felt as thought the group was small. The group was co-ed and represented a variety of ages and stages of life. I believe the session was therapeutic. It did not look exactly like the groups we are facilitating in school, but they did frequently discuss the twelve steps and how that has impacted them. Having a sponsor for the program was frequently mentioned. Many individuals noted the importance of a sponsor and how it has impacted them. I believe this group used the cognitive behavioral frame of reference. A goal of this frame of reference is to change a performance pattern that an individual has. This could be a role, routine, habit, or ritual. During the group, the facilitator asked for examples where members have struggled within the twelve steps and what benefited them. Again, the majority of the group expressed the benefit of a sponsor and the success they had seen within themselves through the partnership. I really enjoyed listening to the triumphs the group has had and how they all encouraged each other.

Leadership Summit

I meet with three other students this week to discuss my next group session. I will be leading this session alone, which is a little nerve racking. We all discussed each other’s protocol and how others have led the groups. I found this time to be extremely helpful! After my first draft was reviewed, I had a few areas to improve. My main focus was to improve my goals and how I would assess each participants involvement in the group. My goals were “all or nothing goals,” meaning my goals left little room for choice. What if the client didn’t want to do something, then they wouldn’t meet the goal. I changed these goals to make them easier to apply to the group, but still measurable and achievable. The other area I needed to improve was how to measure each participants participation and success in meeting the goals in the class. A suggestion was made to have checklist. I am going to try this; however, I don’t want it to be something elaborate. I do not want it to distract from the session. I am going to have names written down and use check marks for goals that are met. I am excited about this group facilitation. I think it is going to be thought provoking and inspiring.

OT led playgroups in early intervention.

How can group process impact children? This is a question I was hoping to find the answer to. The group process that I have been learning about in school involves a strict structure of events that occur during each session. The group starts with an introduction, moves to and activity that usually includes sharing, then processing, generalizing, and application take place before finally ending with a summary of the group. So how does this translate to children, especially those receiving early intervention services? Play. A child's occupation is to play. Play contributes to a child's growth, socialization, communication, and development. A child who is unable to play, may be affected in any of the previously mention categories. I found an article in The American Journal of Occupational Therapy that looks at play in children with special needs. The objective of the study was to investigate the effects of a community playgroup on playfulness in children with special needs ages 15 months to 3 years and the responsiveness of their caregivers. I like that the study looked at caregivers too. A caregiver is a child's first playmate. This partnership supports a child's play, playfulness, well-being, and participation.

The study used two assessment tools, one for children and one for adults. The Test of Playfulness is a standardized observational assessment for children. It looks at intrinsic motivation, internal control, freedom to suspend reality, and framing. This assessment has been proved to yield valid and reliable results in developing children. The other assessment looked at caregivers. Qualitative Ratings for Caregiver Sensitivity and Responsiveness is an observation scale to measure sensitivity and responsiveness. The study took place over eight weeks with eight participants with varying diagnosis'. Video recordings of free play between caregiver and child were used to score the assessments at baseline, pre-community playgroup, post community playgroup, and sustainability. Statistics were used to compare the scores.

The results showed that all the participants benefited regardless of age, gender, ethnicity, or diagnosis. This implies that all children receiving early intervention services should be offered the opportunity to participate in a community play group. Observed changes after the community playgroup are increased active participation , persistence, and pretending. Strong positive changes wee seen in the children, while smaller observed changes were noticed in the caregivers. Caregivers did seek out other opportunities for engagement outside the playgroup. Examples include birthday parties, outings to the park, and horseback riding. The study did find that caregivers who are sensitive and responsive are likely to seek out opportunities for their child to play. So playgroups can help families transition from play at home to social play in community.

What I take away from this study is that community playgroups are beneficial. Community playgroups can help children, who are lacking in play skills, develop play skills. This aids in the development of a child's growth, socialization, communication, and overall development. Even though the group process steps may look a little different for children and adults, they are accomplishing the same principle.  That is to use a group to assist an individual in developing an area of dysfunction.

Fabrizi, S. E., Ito, M. A., & Winston, K. (2016). Effect of occupational therapy-led playgroups in early intervention on child playfulness and caregiver responsiveness: a repeated-measures design. The American Journal of Occupational Therapy, 70(2), 1-9.

Cultivating a positive attitude "Think happy thoughts"

Virginia Ward (co-facilitator)

2/12/18

11AM-12PM in Nolen Media Lab

In preparation for facilitation of a group session, Whitney and I meet to discuss a plan for the group. We based our group off of the cognitive behavioral frame of reference (FoR). In this FoR, a goal is to change a performance pattern that an individual has. This could be a role, routine, habit, or ritual. A goal for this session was to focus on establishing a routine for cultivating a positive attitude. During the session, members were asked to look within themselves for a time they had a negative thought in or about a situation. A variety of methods were used to assist in the cognitive thought process. The group session lasted no more than an hour and direct facilitation was provided from group facilitators.

As a warm up, each group member was asked to share their level positivity on a 1-10 scale. One is very negative and ten is very positive. This gave a based line of how each member felt before starting the activity. 

For the activity, a rock and a black sharpie was preset at each group members chair. They were asked to write a negative thought that they have had in or about a situation. Whitney gave an example to assist with focusing the members thought process. Members were given around five minutes to process the question and write it out on the rock. A stretchy fabric was passed out and each group member used both hands to hold the fabric. Directions were clearly given for each member to share their negative thought and place the rock on the fabric. After a few rocks were placed on the fabric, the fabric began to sag. Group facilitators recommend picking the fabric up higher to facilitate the tactile response. As group facilitators, we wanted each member to feel the weight that negative thoughts can have on a person. This could only be achieved by preventing the fabric from touching an object below it. Once the group shared their negative thoughts and placed rocks on fabric, members were asked to pick another group members rock and share a way the situation could be turned into a positive one. This is an area directions should be given clearly. The initial response from the members was to drop the fabric and grab a rock. The intended purpose was for group members to continue to hold the fabric and go in a circle to share. Instead of correcting the group, the group leaders let this happen. Directions were not given clearly and instead of scolding group, the goal was to keep things positive. Group members shared ways to find a positive in a negative situation. Members then passed rocks back to original creator, so they could process how they would look positively into their own situation. Metallic colors and glitter pens were provided to decorate the positive thoughts. Finally each group member was asked to share their positive thoughts they wrote on their rock. Sharing was accomplished through the warm up and activity.

Processing was facilitated by asking how each member felt during the activity. The facilitators wanted to know if the group members felt the negativity lifted off of them. This was shown though a nod of heads when asked if members have moved up on the positivity scale. Facilitators pointed out similarities in members answers.

Generalizing was similar to processing. Similarities and differences between group members answers were pointed out from start of activity to end. It was interesting to see the members move toward spirituality for their positive thoughts. A goal for future sessions is to reinforce the habit of positive thoughts in a negative situation to cultivate a positive attitude.

Group motivation was achieved from generalizing stage and the summary stage. The facilitators wanted the group members to not feel alone in their negative thoughts and see that others struggle with negative thoughts. Group members were encouraged to practice their positive thinking in the next week.

I do think our session could have been longer, but we did achieve a deeper understanding of each member through the activities. In retrospect, it would have been a good idea to have a plan B to extend the time.

For the application, members were asked to apply positive thoughts in their life in the next week and share the impact of what could happen. Application was taken a step further and members were asked to apply this to their future career in occupational therapy. This question received the greatest application. This allowed for members to think of themselves in their clients shoes. They could see the struggles their clients would face and how to assist them in thinking of positive thoughts.

All in all, the facilitators wanted the members to feel a burden lifted off of them, to have a new perspective on the negative situations they may face, and to see the implication in professional life.

As a facilitator of the group, I was nervous before leading the session. I loved that all the members participated and shared their real feelings. This helped the group to grow closer together. Areas of improvement for the next time facilitating a group would be to have a plan B if activities run short and to give clearer directions. Examples can been seen in the above reflection.

Learning Objective Paper for Evidence Based Practice 2-Fall 2017

Research is______________.

A.      Logical, understandable, confirmable, unique.

B.       Logical, undeniably awesome, confirmable, useable.

C.       Loco, understandable, confirmable, useable.

D.      Logical, understandable, confident, useable.

E.       Logical, understandable, confirmable, usable.

This is an important question because as evidence based practitioners, these principles must be asked of each article read. Logical refers to if the information is presented in a clear, rational thinking process. Understandable looks to see in the information makes sense and if it is transferable. Confirmable looks at the evidence strategies used. Are they clearly and logically identified. The principle of useable helps practitioners connects the research to practice. These are four simple principles that are easy to remember, but effective when trying to search articles that apply to a client or topic being researched.