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GROUP Group is a collection of individuals who have a relationship with one another, are interdependent, and may share some common norms. A collection of individuals in a face-to-face setting working on a task that requires a cooperation. Any number of people who interact with one another, are psychologically aware of one another and perceive themselves to be a group. PRIMARY GROUP The family we are born into is the small group to which most of us owe our primary allegiance for the first fifteen or twenty years of our life, and, indeed for many people in our society, it remains a focus for allegiance throughout their lives." (Douglas (1983) , Quoted from Tajfel) The family may be defined as the individuals primary group. WHAT IS THE NEED OF A GROUP? Fundamentally, the complex nature of organizational activity makes it virtually impossible for individuals to cope at a satisfactory level. Status Power Self esteem Goal achievement Affiliation GROUP DYNAMICS Group dynamics refers to the underlying forces that work to produce behavior patters within groups. The group dynamics include both the group content and the group processes. Explains how people interact and Build unity. CHARACTERISTICS OF A GROUP Size of the group. Homogeneity or heterogeneity of group members. Stability of the group. Degree of cohesiveness or bonding. Climate of the group. Conformity of the group norms Degree of agreement between the leaders and the group norms. Ability to deal with members infractions Goal directedness and task orientation of group works.

TYPES OF GROUP Primary group In primary group members have face to face contact. They have boundaries, norms, and explicit interdependent roles. Eg. Family. Secondary group Usually larger and more impersonal than primary groups. Members of this group do not have relationships bonds or emotional ties of members of a primary group. Eg. Business party or a political party. Open group

An open group is one where participants come and go, depending on their individual needs. In an open group, participants may come for as many sessions as they perceive their needs: these groups are common on in-patients and as self help groups. Closed group A closed group begins with a certain number of participants and is not open to new members once the group is formed and the sessions have started. Eg. A group for psychotherapy. Formal group Formal group has structure and organization. Authority in a formal group usually emanates from above and interaction in the group is usually limited. Eg. A faculty meeting. Informal group An informal group provides much of a persons education and contributes greatly to his or her cultural values. Group members join the group on basis of interest. Eg. Friendship or hobby group. Super group/ team & self managed teams

COMMON DIMENSIONS IN A GROUP Group structure Power Communication Norms Group function Cohesion Group roles GROUP STRUCTURE It refers to the underlying order of the group. It describes the boundaries, communication and decision making processes, and authority relationships in a group. The structure of the group offers it stability and helps to regulate behavioral and interactional patters in a group GROUP COMMUNICATION Reveals how the group approaches its tasks and psychosocial functions. Intrapersonal communication Interpersonal communication Public communication Group communication technique Approval. Support Acceptance. Intervention Clarification Reflection Exploration Understanding Identification Teaching Interpretation Listening Information giving Silence Reassurance Limit setting GROUP FUNCTION All groups have two basic needs or functions: the need to work on or complete a task or a goal, and the need to satisfy some psychosocial or emotional need or needs of its members Task or Goal connects the group to its external environment. Primary task- necessary for the groups survival or existence. Secondary task- these may enhance the group but are not basic to its survival. According to Zander (1985) groups serve many functions in modern society. Protecting members from harm. Accomplishing arduous task. 2

Setting rules/ standards for others. Changing opinions of outsiders. Teaching information/skill to members. Integrating information from diverse specialist. Giving advise to others. Administering a complex organisation. GROUP ROLES The role of a member in a group is determined by the communication and behavioral pattern of that member while in that group. The factors influencing role selection Personality of the individual The group size The groups tasks Interaction in the group Individuals position in the group. Group Roles and Functions The Benne and Sheats categorized 3 major kinds of roles individuals can play in groups. 1) Maintenance or Group building roles 2) Task Roles Leader Encourager Questioner Compromiser Facilitator Gate keeper Summarizer Follower Evaluator Rule maker Initiator Problem solver 3) Individual roles Victim Monopolizer Seductor Mute Complainer Moralist GROUP POWER Power is the members ability to influence the group and its other members. GROUP NORMS These are standards of behavior that are adhered to by the group. GROUP COHESION It is the strength of desire of the members to work together toward common goals and to support one another. Cohesion has been associated with positive group outcomes, increased interactions, norm conformity and goal directedness. Group Cohesiveness: Factors affecting group Cohesiveness; Group goals Communication structure Similarity among members Group activities Type of interdependence among Group atmosphere members Group size. Leader behavior GROUP DEVELOPMENT 3

Tuckman's Stages model 5 Stages Of Group Development Stage I: Forming Group members learn about each other and the task at hand. Indicators of this stage might include: Unclear objectives, Uncommitted members, Confusion, Low morale, Hidden feelings, Poor listening, etc. Stage II: Storming As group members continue to work, they will engage each other in arguments and struggle for status in the group. These activities mark the storming phase: Lack of cohesion, Hidden agendas, Conflicts, anger, Inconsistency, Failure Stage III: Norming Now the group understands each other better, and can appreciate each other's skills and experience. They feel they're part of a cohesive, effective group Indicators include: Questioning performance, Reviewing/clarify objective, Changing/confirming roles, Listening, Testing new ground, Identifying strengths and weaknesses Stage IV: Performing Not all groups reach this stage, characterised by a state of interdependence and flexibility. Everyone knows each other and trusts each other enough to allow independent activity. Group identity, loyalty and morale are all high, and everyone is equally task-orientated and peopleorientated. Indicators include: Creativity, Initiative, Flexibility, Open relationships, Pride, Concern for people, Learning, Confidence, High morale, Success, etc. Stage V: Adjourning This is about completion and disengagement, both from the tasks and the group members. Individuals will be proud of having achieved much and glad to have been part of such an enjoyable group. They need to recognise what they've done, and consciously move on. Some authors describe stage 5 as "Deforming and Mourning", recognising the sense of loss felt by group members. Tubbs' Systems model Stewart Tubbs "systems" approach to studying small group interaction led him to the creation of a fourphase model of group development. Orientation: In this stage, group members get to know each other, they start to talk about the problem, and they examine the limitations and opportunities of the project. Conflict: Conflict is a necessary part of a group's development. Conflict allows the group to evaluate ideas and it helps the group avoid conformity and groupthink Consensus: Conflict ends in the consensus stage, when group members compromise, select ideas, and agree on alternatives. Closure: o In this stage, the final result is announced and group members reaffirm their support of the decision. COMMUNICATION IN DIFFERENT PHASES OF GROUP

PHASES OF GROUP WORK Orientation phase Its the time during the initial meetings of the group. The participants begin to get to know and establish trust with each other. There for there are rules of group behaviour that must be made explicit at the outset. Sometimes a written contract or verbal agreement is needed. The facilitator will encourage the participants to involve in active discussion. Working Phase It refers to the time when the participants are actively accomplishing the purposes of the group. They may share their feelings and fears with one another. The leader serves to guide the group to achieve its goals by keeping discussions related to group goals. This phase provides the participants to learn about their behaviours and to achieve their own goals. Termination Phase This phase occurs when it is a time-limited , closed group and number of sessions comes to an end or when an open group no longer needs to meet because the purpose have been met. The leader/facilitator helps each participant to see participation in the group has benefited him or her. The termination brings about inevitable feelings of change, often including the loss or sadness of parting. The group members may want to provide support to one another during parting. GROUP LEADERSHIP STYLES OF GROUP LEADERSHIP Leadership style is the manner and approach of providing direction, implementing plans, and motivating people. Kurt Lewin's Leadership styles Autocratic leadership style In this the leader exercises significant authority and control over the group members , rarely seeks input from the group and does not encourage participation from the group. In certain situations the autocratic leadership may prove to be effective as in emergencies, it conserves energy, time and dictates roles and responsibilities to the members. This type of leadership may result in hostility or scapegoating behavior. Democratic leadership style Encourages group interaction and participation in group problem and decision making. The leader values the input of each member, seeks spontaneous and honest interaction among the members, and creates an atmosphere in which members are rewarded for their contributions. Requires more time and energy. Group efforts are more productive and cohesive. Provides the members with a sense of participation in decision making Laissez Faire leadership style 5

Group members are free to operate as they choose. This style may be effective if members are highly knowledgeable, task oriented and motivated. It is time consuming and often inefficient in accomplishing group tasks. Dictator leadership style A leader who uses fear and threats to get the jobs done. As similar with a leader who uses an autocratic style of leadership, this style of leader also makes all the decisions.

LEADERSHIP SKILLS Skill of personal behavior Sensitive to the feelings of the group Identifies self with the needs of the group Helps others feel important and needed Does not criticize another persons situation Skills of communication Listen attentively Establish positive communication with the group as a routine part of the job. Recognizes that everyones contributions are important. Skills of organization Develop short and long range objectives Share responsibilities and oppertunities plan., act, follow-up and evaluate Skills of self examination Aware of personal motivations Helps the group to be aware of their attitudes and values DESIGNING AND MANAGING WORK GROUPS. Richard Hackman (2002) 1. Being a real team 4. Supportive context 2. Compelling direction 5. Expert coaching 3. Enabling structure GROUP THINK Group think is a type of thought exhibited by the group members who try to minimize conflict and reach consensus. The term was coined in 1952 by William.H.Whyte During group thinking the group avoid promoting the viewpoints outside the comfort zone of consensus thinking. Symptoms of group think Irving Janis (1977) Illusion of invulnerability Direct pressure on dissenters. Collective rationalization Self-censorship Belief in inherent morality Illusion of unanimity Stereotyped views of out-groups Self-appointed mindguards DECISION MAKING IN GROUPS Decision making can be regarded as an outcome of mental processes (cognitive process) leading to the selection of a course of action among several alternatives. A group that makes sound decisions is a group that functions effectively. It helps to construct well-conceived, well-understood and well-accepted realistic actions toward the goals. Effective decisions 6

The resources of the group members are well used The groups time is well used The decision is of correct or of high quality The decision is put into effect fully by group members The group members feel committed to the decision and responsible for its implementation The problem solving ability of the group is enhanced. Members feel satisfied with their participation, and a positive atmosphere is created. Decision making methods Consensus decision making Consensus requires that a majority approve a given course of action, but that the minority agree to go along with the course of action. In other words, if the minority opposes the course of action, consensus requires that the course of action be modified to remove objectionable features. Dictatorship decision making Where one individual determines the course of action. Voting based methods Range voting: Lets each member score one or more of the available options. The option with the highest average is chosen. The most popular decisions will be the groups decision. Majority voting Requires support from more than 50% of the members of the group. Plurality Where the largest block in a group decides, even if it falls short of a majority. Authority after discussion The designated leader makes the final decision, but first discuss the issue with the members to get their ideas and views. Minority control decision A small minority may also quickly and forcefully railroad the decisions (force the group to accept them by exerting intense pressure). GROUP DISCUSSION TECHNIQUES Identification It is good to address each other by name.Later, refer to the plan and address people by their names. In large groups, name tags can be helpful. Whole Group The value of whole group discussion is the evolution of a group idea. A group idea is not simply the sum of individual ideas, but the result of the interaction of ideas during discussion. Whole group discussion can be unstructured and productive. Small Group Breaking into smaller groups can be very useful. These small groups can be dyads or triads or even larger. They can be selected randomly or self-selected. If used well, in a relatively short amount of time all participants have the opportunity to share their own point of view. Brainstorming This is a very useful technique when ideas need to be solicited from the whole group. The normal rule of waiting to speak until the facilitator recognizes you is suspended and everyone is encouraged to call out ideas to be written by the scribe for all to see. Go-rounds The facilitator states a question and then goes around the room inviting everyone to answer briefly. This is not an open discussion. 7

Fishbowl The fishbowl is a special form of small group discussion. Several members representing differing points of view meet in an inner circle to discuss the issue while everyone else forms an outer circle and listens. At the end of a predetermined time, the whole group reconvenes and evaluates the fishbowl discussion. Active Listening If the group is having a hard time understanding a point of view, someone might help by active listening. Listen to the speaker, then repeat back what was heard and ask the speaker if this accurately reflects what was meant. Caucusing The difference between caucuses and small groups is that caucuses are composed of people with similar viewpoints, whereas small group discussions are more useful if they are made up of people with diverse viewpoints or even a random selection of people. Nominal group method Group members, without any discussion, independently write down their ideas about a problem or task. Each group member presents an idea to the group without discussion. This process continues around the table until all ideas have been expressed. The ideas are summarized and listed on either a chart or a chalkboard. Members discuss each of the recorded ideas for the purpose of clarification and evaluation. Members independently give their own priority ranking of ideas. These independent rankings are added together and averaged. The final group decision emerges from the pooled outcome of the independent rankings. The format utilizes both the independent thinking of members (example, writing down ideas) and group interaction, (example, discussing the ideas) in order to arrive at a joint decision. Delphi method Group members are sent a questionnaire which asks them to identify important questions or issues on a specific topic. Members responses are compiled and a second questionnaire is administered which asks members to assess and prioritize the list of responses derived from the first round Above Step is repeated in subsequent rounds. Each time the priorities of members are summarized and narrowed down to those, which are the most important. The results are returned to each group member for further ranking and evaluation. In the last phase, a final summary and ranking is provided to each member of the group. . The major disadvantage of the Delphi method are that it does not allow for the development of emotions and feelings in the group, and it does not allow for face to face feedback and clarification. GROUPS IN HEALTH CARE SETTINGS Task group Purpose: performance of a specific job or goal agreed by all members at initiation of group. Role of leader: to establish exchange of information among members and direct group towards task accomplishment. Title of leader: chairperson Title of members: committee members Length of group life: target date usually set in advance. Self-awareness or Growth groups Purpose: Development or use of interpersonal strengths. 8

Role of leader: To establish group interaction among members and to serve as a resource person. Title of leader: Trainer Title of members: Trainees Length of group life: Tend to short term with target date in advance. Therapy Groups Purpose: To do the work of therapy, towards self understanding, handling stress etc. Role of leader: To establish group interaction between self and individual members and among group members. Title of leader: Therapist Title of members: Clients or patients Length of group life: Usually not set, the termination date determined mutually by therapist and members. Supportive Group Purpose: To offer support, education, and/or socialization and/or recreation. Role of leader: To meet basic requirements for social companionship or education. Title of leader: Host/Teacher/Therapist Length of group life: May be set in advance or spontaneously determined. GROUP THERAPY Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group. Emphasis various therapeutic factors according to group purpose and goals. Group therapist focuses on interpersonal learning and change. Therapeutic factors of group therapy Universality Imitative behavior (Modeling process) Altruism Cohesiveness Instillation of hope Existential factors Imparting information Catharsis Corrective recapitulation of the primary Interpersonal learning family experience Self-understanding Development of socializing techniques SUPPORTIVE GROUPS-TYPES AND APPROACHES Socialization groups A group of persons come together with a facilitator to interact with each other in an informal setting. The main purpose is to increase the interaction and develop social skills. In this group activities are aimed at providing clients with experiences in social situations and assisting them to learn methods of interaction with others. Recreation groups An extension of socialization group. Approach is to plan and experience activities of enjoyment and socialization. Isolated clients can also participate in these structured activities. Educational groups Purposes is providing education in group setting. More cost-effective to teach a group of people together than one-to-one basis. Bringing the group together provides benefits of universality. Reality orientation groups These are often conducted in inpatient setting. The main approach is to reorient the client to time, place, and season and to provide information of current events. Reminiscence group Groups for elderly. Specifically aimed at permitting reminiscence or life review. 9

Self-help groups These are groups of persons coming together who are facing a common difficulty. Community support groups Group for victims of violence Support offered: To individuals and families who have been physically or emotionally abused. Examples: Safe house, rape trauma, Battered children Birth anomaly support groups Support offered: To individuals and families with birth defects and congenital anomalies. Eg. Down syndrome, cerebral palsy Acquired disease support group Support offered: To individuals and families coping with and adjusting to diseases originating after birth that are not inherited or innate. Eg. Diabetes, leukaemia, AIDS Chronic illness support groups Support offered: To individuals and families in which there is an illness of long duration and slow progression. Eg. Cancer, arthritis, COPD, Work related support groups Support offered: To workers who experience job related stress. Eg. Burn out groups, Friday evening groups. CONFLICTS AND CONFLICT MANAGEMENT Conflict: Conflict is generally defined as the internal or external discord that results from differences in ideas, values or feelings between two or more people. It is also created when there are differences in economical and professional values. Types of Conflicts Relationship Conflicts Interest Conflicts Data Conflicts Inter-group conflicts Personal-group conflicts Structural Conflicts Value Conflicts


Conflict stages Latent conflict It exists whenever individuals, groups, organizations, or nations have differences that bother one or the other. Conflict emergence After a conflict has remained latent for some time, if the underlying grievances or frustrations are strong enough, a "triggering event" marks the emergence or the "eruption" phase of the conflict. Conflict escalation Escalation refers to an increase in the intensity of a conflict and in the severity of tactics used in pursuing it. Hurting or stalemate Once conflicts escalate for awhile, they often reach a stalemate: a situation in which neither side can win, but neither side wants to back down or accept loss either De-escalation or negotiation De-escalation often also associated with reduced grievances, at least for members of one side. This change occurs as relations between the adversaries change. Dispute settlement If most or all of the underlying causes of the conflict are finally remedied, the conflict may be resolved permanently or at least for a long time. Post-conflict peace building Even after a settlement is reached and a peace agreement is signed, this is by no means the end of the conflict. Usually, there is a long period of peace building among the grassroots people, Conflict process

Conflict Management- Strategies Denial or Withdrawal With this approach, a person attempts to get rid of conflict by denying that it exists. He or she simply refuses to acknowledge it. Suppression or Smoothing Over "We run a happy ship here." "Nice people don't fight." A person using suppression plays down differences and does not recognize the positive aspects of handling the conflict openly. Conflict Management- Strategies Power or Dominance Power is often used to settle differences. Power may be vested in one's authority or position. Power may take the form of a majority. Compromise or Negotiation Used when resources are limited or a speedy decision needs to be made. Integration or Collaboration This approach suggests that all parties to the conflict recognize the interests and abilities of the others. 11

Model of conflict resolution The following model is designed to assist nurses in assessing states of conflict and selecting a type of resolution for those under your management. There are four basic parts (or transformations) to this model that occur before a personnel (employee) dispute enters the legal system. The four are as follows and occur in this order: UNPIE to PIE - UNPIE, an unperceived injurious experience turns into a PIE, a perceived injurious experience (simply put, an incident occurs and at that time the you [the employee] may not perceive it as injury and on further thought begin to see it as an injury). Of course, how you perceive (or view, or react) to this is influenced by your age, experience, gender, personality traits, socioeconomic status and job satisfaction. Legal action is less likely to occur if the employee perceives the organization as caring. Naming - Here the specific grievance is described and named. Blaming/Attribution - Here employee's either blame themselves or others for injury. Blaming oneself may end the process. Blaming others may result in Claiming. Social position, cultural commitment and perception of prejudices. Claiming - If the claim is rejected, then it becomes a legal or labor dispute. Communication issues, insensitivity, and ignorance of each other's motivations can hinder progress toward conflict resolution. Nurse leaders must learn to interpret racial feelings even though these subjects are uncomfortable to discuss. Conflict management in culturally diverse health care groups Awareness building - 1st phase - Begins with top management providing personnel with a mission or goal statement that addresses diversity. It also includes the development and implementation of a culture audit using a combination of research efforts (i.e. focus groups, survey's and interviews with target personnel interested in exploring a specific diversity issues. Discrimination control - 2nd phase - Is a responsibility of nurse leaders and all levels of management. Discrimination (mistreatment of people based on factors that are irrelevant) and prejudice (inaccurate perception of others) are sensitive and threatening subjects. these perceptions result in dispersing blame (some type of mistreatment). Another component is reverse discrimination - which refers to laws or policies that may be considered as discriminatory by certain people of certain ethnicity, gender, race or handicap. (Ex: selecting a person of a particular gender over another gender, or a person from a particular ethnic group over someone who may have better credentials or education). Prejudice reduction - 3rd phase - is more difficult to manage than the first two phases because it is abstract, internal and perceptual. Actions for nurse leaders to prevent conflicts Openly acknowledge and discuss diversity issues. Be educated concerning different cultures. Promote educational programs for individuals from all cultures. Create a socially comfortable environment for culturally diverse staff members so they can experience the uniqueness of each other. Allow for cross-cultural representation in unit activities. Promote equal growth opportunities. Strive to eliminate prejudice, biases, and stereotyping. Monitor standards and norms to assure achievability. Reward those who successfully manage diversity. Openly discuss conflict with group members. 12