Hello Sandi:

I  believe  that  group  treatment  can  be either a very positive or a very
negative  experience.  The  primary  determiner of the experience is not the
clients,  it  is  the therapist. I have done and seen many group treatments.
For  the  most  part,  these  groups  held  little therapeutic value for the
clients   -   in  fact,  sometimes  the  groups  were  harmful  to  clients.
Additionally, while group treatment has it roots in psychosocial settings, I
believe  that  most  rehab settings use group treatment because it is easier
for therapists.

The  primary  purpose  of  running  any  group  treatment  should be for the
therapeutic  benefit  group dynamics. Additionally, ALL clients in the group
should have a medical necessity for these benefits. Keep in mind, that there
should  be  something that therapeutically happens in a group treatment that
without the group would otherwise not happen. The benefit of group treatment
is  the  dynamic  interchange  between  group  members. A group that is well
planned,  consists  of  medically  necessary  clients, and is well moderated
offers  tremendous challenge and reward for both clients and therapists. The
further  a therapists moves away from focusing on the group dynamics benefit
of  their  treatment  group,  the  further  they  are  moving  away from the
therapeutic benefits of a group.

Ron

=================================================================

On Saturday, April 3, 2004, you wrote:


SF> Hi All!
SF> I am a COTA at an ALF/SNF facility for a contract facility....just started
SF> accepting Med A pts.  I have done groups previously in Med A setting and
SF> enjoy them.  I have been asked to instruct different SNF's on types of
SF> groups.  I have been told the reason groups are not used is pt's are too low
SF> level to participate.  I believe if the group is set up correctly, and an
SF> appropriate group is used, it is a great experience both for the
SF> practitioner and the patient.  

SF> What is everyone's feelings on the utilization of groups?
SF> Why do you use them....Why don't you?

SF> It's an informal talk that I am giving, and started some handouts:
SF> How to bill, medicare allowable minutes, types of groups, and a small list
SF> of activities for various cognitive levels.  I tried to include a small
SF> sampling of groups that also include PT and speech, as they will also be
SF> attending.  I was hoping you can help me add to my group activities, and I
SF> will be happy to share too....and those PT's (and maybe even ST's) that are
SF> on the list serve...I would LOVE your input, as I am kind of guessing on
SF> appropriate activities.
SF> I have:
SF> Wheelchair Mobility Group (OT/PT)
SF> Advanced Gait Group (OT/PT)
SF> Balance Group ((OT/PT)
SF> Cooking Group (OT/ST)
SF> Home Safety Group (OT/PT)
SF> Fine Motor Coordination Group (OT)
SF> Posture Group (OT/PT)
SF> ROM Group (OT/PT)
SF> Strengthening Group (OT/PT)
SF> Cognitive Group (OT/ST)
SF> That way everyone has a small sampling of types of groups.  Included in each
SF> group is criteria, small sampling of activities, equipment, and group goals.
SF> I will list everything in my advanced gait group because I believe that is a
SF> group that people would tend to say it is primairly PT......    :)
SF> ADVANCED GAIT (high level group)

SF> Criteria:
SF>     Ambulate with or without assistive device with min supervision
SF>     Able to follow directions with min v/c's        
SF>     No evidence of vertigo or orthostatic hypotension
SF>     Ability to maintain correct weight bearing status
SF> Example of Activities:
SF>     Timed Ambulation
SF>     Obstacle Course
SF>     Courtyard Ambulation
SF>     Treasure Hunt
SF>     Question/Answer session on use of assistive devices
SF>     Verbal Instruction/Correction when performing activities
SF> Equipment:
SF>     Assistive Devices (if needed)
SF>     Adaptive Equipment(if needed) (ie: reacher, walker basket/bags)
SF>     Gait Belts
SF>     Stopwatch 
SF>     Obstacles (stairs, cones, slopes, different terrain, etc.)
SF>     List of items to find during courtyard ambulation/treasure hunt
SF> Group Goals:
SF>     Increase functional mobility
SF>     Instruct/Increase safety awareness during ambulation
SF>     Decrease gait deviations
SF>     Increase gait velocity
SF>     Improve community ambulation skills
SF>     Demo proper gait pattern and use of assistive device 
SF>     Demo/Instruct safe use of assistive device and adaptive equipment

SF> Anyone have any ideas in any categories in any group listed above?  I would
SF> love for everyone to share group ideas that have worked for them!

SF> Thanks for your input
SF> Sandi


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