NSG 526 EXAM 2
STUDY GUIDE + REVIEW
Clinical Modalities in Advanced Psychiatric
Mental Health Nursing Practice - Wilkes
NSG 526 – Exam 2 STUDY GUIDE + REVIEW
Course Title:
Clinical Modalities in Advanced Psychiatric Mental Health Nursing
Practice
Focus:
Advanced therapeutic interventions and psychotherapeutic modalities
, Study Guide for Test 2
We all live and interact among groups throughout our lives. We are born into a family group and
grow up with various peer groups, such as those at school, work, and church and within the
community.
A group consists of two or more people who come together for the pursuit of common goals
and/or interests. Each group has characteristics that influence its progress and outcomes,
including:
● size
● defined purpose
● degree of similarity among members
● rules
● boundaries
● content (what is said in the group)
● process (underlying dynamics among group members)
The primary purpose of group therapy is to facilitate changes by the patient to address identified
problems.
Examples: A technique for dealing with an over talkative client and silence from other
participants in a group during therapy is to make an observation about the group’s silence and
invite the others to comment. During group members sharing methods they personally use for
dealing with problems are using the technique of “Information Giver”.
Group psychotherapy or group therapy is a method whereby individuals with a common purpose
come together and benefit by both giving and receiving feedback within the dynamic and unique
context of group life. Group therapy is a powerful healing technique with several different
formats. The basic premises of group therapy are: (1) that human beings are social animals, and
(2) that we heal in community. This is why group therapy is so efficacious. This correlated to
Maslow’s third level in his hierarchy of needs; the need for love and belonging. Group therapy
provides a valuable form of social support.
,Terms Central to Therapeutic Groups
PMH-APRNs must familiarize themselves with terms central to therapeutic groups. These are
defined below:
Terms Describing Group Work
● Group content – all that is said in the group
● Group process – the dynamics of interaction among the members (e.g., who talks to
whom, facial expressions, and body language)
● Group norms – expectations for behavior in the group that develop over time and provide
structure for members (e.g., starting on time, not interrupting)
● Group themes – members’ expressed ideas or feelings that recur and have a common
thread (The leader can clarify a theme to help members recognize it more fully.)
● Feedback – letting group members know how they affect each other
● Conflict – open disagreement among members (Positive conflict resolution within a
group is key to successful outcomes.)
Terms Describing Types of Groups
● Heterogeneous group – a group in which a range of differences exists among members
● Homogeneous group – a group in which all members share central traits (e.g., men’s
group, group of clients with bipolar disorder)
● Closed group – a group in which membership is restricted; no new members are added
when other leave
● Open group – a group in which new members are added as others leave
Advantages and Disadvantages of Group Therapy
There are advantages and disadvantages of the group approach. Advantages include:
● Engaging multiple clients in treatment at the same time, thereby saving costs
● Participants benefit not only from the feedback of the group leader but also that of peers
who may possess a unique understanding of the issues
, ● Providing a relatively safe setting to try out new ways of relating to other people and
practicing new communication skills
● Promoting a feeling of belonging
Disadvantages include:
● Time constraints in which an individual member may feel cheated for floor time,
particularly in large groups
● Concerns that private issues may be shared outside the group
● Dealing with disruptive member behavior during an emotionally vulnerable point
To develop a successful group, planning should include a description of specific characteristics,
including:
● Name and objectives of the group
● Types of clients or diagnoses of members
● Group size
● Small
○ 8 to 10 people
○ Cohesive
○ Richer interpersonal experience
○ Leaders (1 or 2)
○ Ideal for complex individual issues
● Large
○ >10 members
○ More cost-effective
○ Open-ended, ongoing
● Group schedule (frequency, times of meetings, etc.)
● Seating arrangements
● Use circle seating without barriers (tables)
● Rectangular tables tend to promote positions of power at the end of the table