Nanda Books

Clients are treated in a psychiatric hospital or mental space is generally a complaint can not be managed at home, such as amok, silent, no shower, wandering, disturbing others and so on. After being admitted to the hospital and, the same thing often happens that many clients still, alone with no activity. Day-to-day care passed with eating, drinking and sleeping medication. There among the clients on their own initiative seek change in the situation with a walk in the hospital, but there are among those who do not know the way home so that if caught he was branded as a client who had fled then put it back into the isolation room. What exactly is done by the client??

Therapeutic Group Activities is one of the nursing actions for clients with mental disorders. This therapy is a therapy practice is the sole responsibility of a nurse. Therefore a particular nurse life nurse must be able to perform therapeutic group activities in a timely and correct.

To achieve the above needs to be an implementation guide therapeutic group activities such as group socialization activity therapy, energy distribution, sensory stimulation and reality orientation.

Goals

Therapeutic Group Activities is an attempt to facilitate a psychotherapist for a number of clients at the same time to monitor and improve interpersonal relationships between members.

In general, the goal of therapy is to improve the ability of the group's activities a reality through communication and feedback with or from others, to socialize, to increase awareness of emotional connection with the actions or reactions denfensif behavior and increases the motivation to progress cognitive and affective functions. In particular, the goal is to improve the identification, channel emotions constructively, improving interpersonal relationships or social skills.

In addition, the goal of rehabilitation is to improve the skills of self-expression, social, increase self-confidence, empathy, enhancing knowledge and problem solving skills.

Characteristics of Patients

Based on the observation and study of the status of the client then the client characteristics were included in the therapeutic activity of this group are clients with nursing issues such as the risk of injuring yourself, others and the environment, violent behavior, self-care deficits, social isolation: withdrawal, and changes in sensory perception.

Basis Theory

1. Group Activity Therapy Model

• Focal conflic models - Developed by unconscious conflicts and focuses on a group of individuals. Task of leaders is to help the group understand the conflict and help resolve problems. Eg; disagreements between members, how the issues addressed members and leaders direct alternative problem solving.
• Communication Models - Developed based on the theory and principles of communication, ineffective communication that will bring the group to be dissatisfied. Aim to help improve interpersonal and social skills group members. The task leader is to facilitate effective communication between members and teach the group that there is need for communication within the group, members are responsible for what is said, on all types of communication: verbal, non-verbal, open and closed, and the message must be understood others .
• Interpersonal Models - Behavior (thoughts, feelings and actions) is depicted through interpersonal relationships within the group. In this model also describes the causal behavior of members as a result of the behavior of other members. Therapists work with individuals and groups, members learn from interaction between members and therapists. Through this process, behavior or errors can be corrected and learned.
• Psychodrama Models - With this model can motivate group members to act in accordance with the new events occur or past events, according to the role that was exhibited. Members are expected to play a role in accordance events ever experienced.

2. Method

• Didactic groups
• Social Therapy Group
• Repressive-inspirational
• Psychodrama
•  Group interaction-free

3. Focus Group Activity Therapy

• Reality Orientation - The idea is to provide a therapeutic group activities with impaired orientation to person, place and time. The purpose is the client able to identify internal stimuli (thoughts, feelings, somatic sensations) and external stimuli (climate, sound, natural situation around), the client can distinguish between reverie and reality, the reality of the conversation appropriate client, the client is able to recognize himself and the client was able know others, time and place. Characteristics of clients: reality orientation disorder (GOR), hallucinations, delusions, illusions, and depersonalization that have been able to interact with others, cooperative client, able to communicate well verbally and physically in good health condition.
• Socialization - Its purpose is to facilitate psychotherapy to monitor and improve interpersonal relationships, respond to others, expressing identical and exchange perceptions and receive external stimuli from the environment. The goal of improving interpersonal relationships among group members, communicating, caring, respond to others, express ideas and receive external stimulus. Client characteristics: lack of interest or no initiative to follow the activities of the room, often in a bed, withdrawal, lack of social contact, low self esteem, anxiety, suspicion, fear and anxiety, there is no initiative to start talks, respond as necessary, appropriate answers questions, and to build trust, willing to interact and physically healthy.
• Stimulation of perception - Its purpose is to help clients who experience setbacks orientation, in an effort to stimulate the perception of motivating thought and affective processes and reduce mal adaptive behavior. Purpose of improving the ability of reality orientation, focused, intellectual, express opinions and accept other people's opinions and express feelings. Characteristics of clients: perceptions of disorder associated with the values, withdrawal from reality, inisiati or negative ideas, healthy physical condition, able to communicate verbally, cooperative and social activities.
• Sensory Stimulation - The idea is to stimulate the sensory on clients who experience sensory decline. The aim of increasing the ability of sensory, focus, physical fitness, and express feelings.
• Distribution of energy - The idea is to channel energies constructively. The purpose of destructive energies into constructive, express feelings and improve interpersonal relationships.

4. The stages in the therapeutic group activities.

According to Yalom cited by Stuart and Sundeen, 1995, phases in the therapy group activities are as follows:

a. Pre group
Starting with making goals, planning, who is the leader, members, where, when the group carried out the activities, and the evaluation process to members of the group, explaining the necessary resources such as projectors groups and if possible the cost and finance.

b. The initial phase

In this phase there are 3 possible stages that occur ie orientation, conflict or togetherness.

• Orientation. - Members began to develop their social system, and the leader began to show treatment plan and take contracts with members.
• Conflict - Is a difficult time in the group, members start thinking about who is in power in the group, how the role of members, duties and interdependence that will happen.
• Togetherness - Members begin working together to solve problems, members began to discover who own.

c. Phase of work

At this stage the group has become a team. Positive and negative feelings corrected by trusting relationship that has been fostered, work together to achieve the agreed objectives, decreased anxiety, the more stable and realistic, explored further in accordance with the goals and tasks of the group, and creative problem solving.

d. Phase termination

There are two types of termination (final and interim). Members of the group may experience premature termination, unsuccessful or successful.

e. Role of Nurses in group activity therapy.

• Preparing for group activity therapy program.
• As leader and co leader
• As a facilitator
• As an observer
• Addressing issues that arise during the implementation.