For my journal review, I decided to talk about a little more sensitive topic, and how group therapy can be an effective intervention to use with a particular population. I found an article entitled State of the Science: Group Therapy Interventions for Sexually Abused Children which was an interesting read to say the least. According to the article, 16–27% of females and 8–16% of males retrospectively report child sexual abuse (CSA)  incidents.. that is a staggering statistic to me, which makes me wonder how OT can enter into especially if there is a significant population that needs critical psychological and traumatic care. The article listed multiple long-term effects of CSA on children that follow them long after their childhoods... many of them experience occupational imbalance, PTSD, and "negative life orientation, which impacts both their functioning and occupations as they grow up. So what can be done? well this article specifically looked at the effects of social support in the form of group therapy, and how it could impact the trajectory of these CSA children's lives. There are several immediate benefits to this approach: 1. it is more cost effective 2. children may feel safer in a group rather than in one on one therapy and 3. its major impact on therapeutic impact on several of the effects listed above. Group therapy provides another dimension to recovery which may not necessarily be addressed in one on one therapy sessions. The major conclusion that this article came to was that group therapy sessions are indeed an incredible effective intervention for children who have experienced as CSA. Within a group, group members can process life events together and fight the shame and stigma that is often associated with sexual abuse. This provides a safe processing space for these children, which truly could have a significant impact on those later effects that are often seen after childhood traumas. Even though this was technically an article posted by nurses ,
this article gave a lot of food for thought, and I definitely think that this subject falls under our OT practice.   OT's are trained to lead group sessions with individuals from all different walks of life and backgrounds, and could really bring in a therapeutic use of occupation while working with a group like this.  I am posting the link below so that more of my classmates can read up on this subject as well.
http://www.psychiatricnursing.org/article/S0883-9417(13)00114-3/fulltext

For one of our assignment in our group process class, we were to find and attend a 12 step meeting in the Memphis area. I have never been to a 12 step meeting, so I was both interested and a little too skeptical to step into a group as both a participant and an observer to see how these groups were led. Even more importantly, I was curious if group sessions like this were REALLY effective for the members that came to them. I choose to go to an alcoholics anonymous meeting at a downtown Memphis church that was held during lunch with two other girls in my class. We arrived just as the meeting was starting, and my first observation was of the people that were sitting in the chairs around me. Some seemed interested and alert while others looked like they could care less about the meeting. The leader was standing at the front of the podium wearing all black with a big cross necklace around his neck. He, for the most part, took a very directive facilitative role throughout the meeting and guided the members through the process, ensuring that everyone stayed on topic and provided assistance when needed. At first, I felt as if he was a bit intense but by the end of the meeting, I understood why. He himself was an alcoholic that had lived on the streets and saw his life fall apart because of alcoholism (which he called his disease). He was intense because he understood what it was going to take from the other group members to make it through all 12 -steps. He handled differently personalities differently, praising some for their honesty while cutting others short if what they were sharing was not on topic. I believe this was an effective way to lead this group because there was such an assortment of individuals at the meeting with different cognitive abilities By using this directive facilitation he was able to provide appropriate parameters for the members to share and learn in the meeting. The environment of the meeting was also quite interesting to me because it was held in the basement of the church in a little chapel. I did not realize how deeply spiritual AA meetings were and I was surprised that this meeting definitely had Christian undertones (including saying the Lord's Prayer at the conclusion of the meeting.) This definitely had an impact on the individuals who were there, and I wondered if any felt uncomfortable especially if they weren't Christians. I think this may have been just this particular meeting because after looking on their website, I came to understand that while AA is indeed very spiritual, it is not inherently Christian and simply refers to a "higher power". I do think that AA is effective in helping people who struggle with alcoholism, however, I also think that I did not see the most therapeutic AA meeting in the Memphis area. There were times where the leader just came off really strong, and I felt that some members couldn't really truly express themselves. I would, however, definitely consider this a support group because group members were allowed to openly share with one another where they were in the process. People applauded one another for coming to the meeting, and one group member shared his story which was truly inspiring and specifically looked at another group member saying "you can do this too, you've already taken the first step." I am so thankful that I got to enter into this group and just observe how a 12 step program works. I left the group inspired, and really do believe now after hearing some of the members stories, that AA is one of the reasons why they were still alive and in that meeting. I would love to go to another 12 step meeting in the future to observe again sometime soon.

I was able to meet with two other OT students (Lauren M and Lauren N) to discuss our upcoming group facilitation that we will be turning in next week. This was so helpful because we were able to not only able to bounce ideas off of one another but were also able to impact each others session by adding our own ideas or insights that maybe weren't seen when we were initially writing our group protocols. An example of this is that I was able to help one of the Lauren's with her game by suggesting that she let the group members make their own bingo boards bu suggestions that they had come up with as a group. I also was able to help the other Lauren with her title for her group, and her introduction activity.
This meeting was also a very beneficial time to talk through the frames of references that we chose for our sessions and to explain why we chose that particular FoR.  After talking wihth the other group leaders, I actually ended up changing my FoR after we met, and feel much better about this RoR that the initial one that I had chosen.Having this opportunity to walk through each of our groups was extremely helpful to troubleshoot and work through our ideas and sessions together. They brought a different perspective to the table for me to think about as I finalize this group protocol. Although I wish that I could see how their group plays out, I know that they will both do a great job facilitating their groups. This leadership summit has made me feel  a little more confident  going into this group session because I have been able to talk through my session before actually doing it.

You never realize how much work goes into something until you are the person doing that something. This is how I felt about leading a group session. Just from observing our teachers lead group sessions in class, it seemed pretty simple. Come up with a fun activity that gets everyone involved, and allow everyone to process what was said in the group so that they all walk away with a new nugget of information. Maybe it's because my teachers have done this awhile, or maybe it was that I really was naive about this whole group thing. One thing is for sure, leading a group is not as easy as it looks. In fact, I found myself in the middle of leading the session that was supposed to be easy thinking "Oh no, this is definitely not how I saw this group playing out in my head." Sure, we did all the planning. We got a really fun activity, created our goals, had everything prepared and laid out for our group members. But then the group member showed up and our activities and discussion went in a totally different direction than we had planned. It turned out that our collaboration activity was actually really hard for the group members to work together on, and by the end of the activity, several of them concluded that they would much rather just work by themselves than by a group. (Not exactly the glowing response or golden nugget that we wanted them to take away from the activity.) Good thing our frame of reference allowed some wiggle room for the group members to define where the discussion of the group went (Thank you MOHO and Psychodynamic Approach). All of this sounds a bit dramatic and maybe (hopefully) we looked a little more pulled together and like we knew what we were doing than I am writing, but even my teacher pointed out at the end of the group that I looked a bit frazzled and unsure of how to get the group members back on track on our fascinating topic of collaboration, rather than talking about their upcoming basketball game. But I think that is where I have had time to think and process (and were I know there is plenty of room to grow.) Group sessions will always be a little unpredictable, a little free-spirited, and totally dependent on the group members response (as well as the leadership of the facilitator.) This is not necessarily a bad thing, and when it is lead well, can actually lead to a very positive group experience that allows group members to express and learn as they go. That being said, the take away from this experience that you always need to be prepared as the facilitator to be willing go where the group leads, and use different situations for rich learning opportunities. If plan A doesn't work out, have plan B, C, and maybe even a plan D that you can follow through with. The goal at the end of the day isn't to have a perfectly run, well-oiled group... It is to help and hear your group participants out, to provide them with opportunities to share and work and open up and connect with other group members. I still have a long way to go before I think I will feel really comfortable doing this, but that will come with more practice and time.