Martin, Janna, Louis, Marcella & Elaine

  1. Which of the following challenges would be the most disruptive if unmanaged, and
    therefore that you would require a significant amount of your attention in facilitating
    the group:

    a. Hallucinations
    b. withdrawing behaviour
    c. Limited cognitive abilities
    d. Sexually inappropriate behaviour
    e. Frequent escalating emotional outbursts
    e. Frequent escalating emotional outbursts
  2. What would be the best course of action if a group member began escalating?

    a. Immediately end the group
    b. Raise your voice to match the level of the escalation
    c. Maintain a calm voice, intervene early, verbally direct the person escalating to take a
    deep breath and relax
    d. Wait for the moment to pass
    e. Leave the room to get help
    c. Maintain a calm voice, intervene early, verbally direct the person escalating to take a deep breath and relax
  3. Which components require attending to in the context of managing a group?

    a. The environment
    b. Verbal and non-verbal communication
    c. One’s own actions and inter-actions as a facilitator
    d. The emotional, psychological and physical state of the group members
    e. All of the above
    e. All of the above
  4. What strategies might you employ to best manage the group?

    A. Establish clear norms
  5. Which of the following challenges may require that the activity be modified:

    a. Fine motor abilities
    b. Cognitive limitations
    c. Impulse control
    d. Mood disturbances
    e. All of the above
    e. All of the above
  6. In order to develop and practice communication and social skills, the group is working on
    completion of a group collage requiring collaborative decision making and planning. Within the first 15 minutes of the session, the OT notes that Louis begins to have active hallucinations.

    How might you best respond to the situation:

    D. Acknowledge the disruption and use it as a discussion point
  7. Even with this adaptation, the clients were expressing frustration by talking loudly and abandoning the group activity. Joanna’s akathisia and inappropriate sexual behaviour seemed to be disrupting task completion and social interaction among group members.

    What might the OT have done differently?

    a. Have group members complete sub-tasks in parallel or pairs
    b. Break down the group collage task into smaller and shorter sub-tasks
    c. Have sub-tasks for various group member prepared to varying degrees of completeness that accommodate for the unique challenges of the group members
    d. Coordinate medication delivery with the nurse in advance of the group to minimize disruption
    e. All of the above
    e. All of the above
  8. What issues among group members might need to be addressed with the group?

    D. a and b (Components of appropriate social interaction and Verbal and non-verbal communication skills)
  9. Given the deficits faced by group members, which of the following might affect the
    ability of group members to develop social skills

    a. Insight, judgment and motivation
    b. Executive functioning abilities
    c. Perception of reality
    d. Impulsiveness
    e. All of the above
    e. All of the above
  10. How might you best handle Joanna’s inappropriate sexual behaviour in the group

    a. Redirect her
    b. Openly confront her
    c. Allow her to continue to engage in the behaviours
    d. Discuss appropriate social conduct with the group
    e. At an appropriate moment in the group process, ask group members of their level of
    comfort with behaviours exhibited in the group
    d. Discuss appropriate social conduct with the group
Card Set
Martin, Janna, Louis, Marcella & Elaine
In a busy city hospital outpatient behavioural health unit, an OT and OT Assistant are responsible for the provision of a social skills group for clients recovering from traumatic brain injuries (TBIs). The group has five members not including the leaders. Martin is a 55 year old former high school basketball coach who was involved in a serious car accident 5 months ago. He has frequent emotional outburst and a tendency toward disruptive behaviours that escalate. Janna is a 36 year old mother of two children. She was involved in an accident at her job with a power company. She fell from a bucket truck while on the job, which resulted in a TBI. Joanna frequently displays manic behaviors and at times is sexually inappropriate toward other group members. Louis is a 60-year-old street musician who was hit by an oncoming care when the driver lost control and ran up onto the sidewalk of a busy city square. Louis is quiet and mild mannered but often withdraws from the group activity or refuses to participate. He also experiences hallucinations. Marcella and Elaine are 22-year-old twins who were diagnosed with juvenile onset Huntington’s disease. Their frequent jerky movements and limited cognitive abilities are often complained about by other group members.