Question

Case Study

Colleen, a psychiatric mental health RN, is leading a therapeutic group for inpatients who have a history of alcohol abuse. The group is in the orientation phase, and members are still getting to know one another. Even at this early stage, however, Colleen recognizes behavior and personality traits of two members, in particular, that could pose potential problems in the group. One member, Howard, comes across as extremely negative and fairly aggressive. At times, he directly criticizes and belittles other members. When one group member discusses his wife’s disapproval of his drinking, Howard replies in disgust, “I don’t understand spineless guys like you who let women run your life. No wonder you can’t quit drinking.” When not confronting members directly, Howard makes dismissive and disparaging sounds or gestures. Other members seem offended by his behavior. Another member of the group, Fatima, has not spoken at all, except when directly asked a yes-or-no question. She does not seem unpleasant or unhappy to be in the group, but she keeps her eyes down, as though she’s afraid to be “called on.”

What term describes the type of group behavior Howard is demonstrating? How might Colleen address this behavior most effectively?

Fatima is what type of group member? How is this best addressed? Should Colleen leave Fatima alone since she is not disrupting the group or causing any trouble? Or should Colleen be more proactive with this member?

The members of Colleen’s group are inpatients. What bearing, if any, should this have on your suggestions above for Colleen in addressing member behavior? How might this affect Colleen’s overall leadership style for this group?

Answer 1

The orientation phase focuses on the patient's problem. Colleen gets to know about the problem of Howard and Fatima in this phase and it is very obvious.

1) Howard has unsocialized, negative and aggressive behavior. For that colleen has to first make him comfortable and provide a safe and comfortable atmosphere for self-disclosure. And provide positive reinforcement, this gives ego support and encourages future growth. Rewarding comments of group members can be in some way fruitful to improve his behavior. Role-playing may help a member develop insight into how he relates to others. This can be the best way to handle Howard.

2)Fatima has a "fragile" behavior. Colleen should approach her in a gentle, supportive, and non-threatening manner. Colleen should help in increasing the socialization behavior of Fatima by maintaining eye contact or asking her to comment on the discussions. Colleen can ask a group member who she thanks can support Fatima as help from other group members can be fruitful. colleen should not leave Fatima instead approach differently.

3) having inpatients in a group can be in favor of Colleen as she can observe the behavior of every member and a change in behavior towards or against the good prognosis. This attentive and observing behavior of Colleen can improve the overall leadership style.