Group Approaches and Theories

Developmental

Proposed by Dr. Mosey and include 5 types of sub-groups:

1. Parallel (18 months – 2 years) – individuals work or play in the presence of others with minimal sharing of tasks.
2. Project (2 – 4 years) – member involvement is short-term and requires some shared interaction, cooperation, and competition. The task is paramount and there is minimal interaction outside the task.
3. Egocentric-cooperative (5 – 7 years) – group members select, implement, and execute long-term tasks through mutual interaction. Members identify group norms and goals.
4. Cooperative (9 – 12 years) – members have homogeneous membership and the task is often secondary. Members engage in a cooperative group.
5. Mature (15 – 18 years) – members have heterogeneous membership and are flexible to take on a variety of roles. There is a balance between member’s need for satisfaction and accomplishing tasks.¹ 

Sensorimotor

• Sensorimotor group addresses deficits in motor, sensorimotor, perceptual, and cognitive skills that arise from developmental or acquired conditions.
• Many of these conditions affect the brain.
• The sensorimotor approach includes Trombly’s Occupational Functioning Model (OFM), the task-oriented approach, motor learning theory, Motor Relearning, and Ayres sensory integration theory.
• The OFM hierarchy is composed of:
  • Sense of self-efficacy
  • Life role satisfaction
  • Life role task competence
  • Activities and habits
  • Abilities and skills
  • Capacities
  • Organic substrate
• Motor Relearning is assessed by:
  • Supine to sidelying
  • Supine to sitting
  • Balance sitting
  • Sitting to standing
  • Upper hand functions
  • Hand movements
  • Advanced hand activities
• This approach facilitates the learning of motor skills by applying controlled sensory input to the body structures of the client. Examples include process skills, emotional modulation, eye-hand coordination, and academic learning.
• OT groups utilize activities that stimulate the senses and the CNS to produce purposeful movement for real-life tasks.² 

Humanistic

• The humanistic perspective views human nature as good.
• Humans have an inherent potential to maintain healthy and meaningful relationships.
• The choices humans make are in the interest of the self and others.
• The focus is on the present conscious process instead of unconscious processes or the past.
• The source of problems is due to not being true to one’s self.
• Therapists help clients to work on problematic assumptions and attitudes to live fuller lives.
• Therapists emphasize growth and self-actualization instead of curing diseases or alleviating disorders.
• The therapeutic relationship is important as it helps with psychological growth through acceptance and trust to actualize the client’s inner drive for health.³ 

Lifestyle Performance Model

• A phenomenological-based model that addresses occupation for ‘occupation’s sake’ using occupation as a therapeutic intervention.
• An emphasis is placed on the client’s contexts including their environment.
• The personal, social, and cultural components are significant for the clients and their relationships.
• Groups and group participation help to promote a sense of autonomy in the following domains.
• Four domains that work together to maintain a quality of life include:
  • Self-care/self-maintenance: e.g., ADLs, IADLs to care for the environment
  • Intrinsic gratification: activities that are perceived as fun for enjoyment
  • Reciprocal interpersonal relatedness: social connections
  • Societal contribution: activities that help benefit others⁴ 

1. Donohue, M. V. (1999). Theoretical bases of Mosey’s group interaction skills. Occupational Therapy International, 6(1), 35-51.[↩]
2. Cole, M. (2012). Group dynamics in occupational therapy: The theoretical basis and practice application for group intervention (4th ed.). Thorofare, NJ: SLACK Incorporated.[↩]
3. Center for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 34.) Chapter 6 –Brief Humanistic and Existential Therapies. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64939/[↩]
4. Fidler GS. Life-style performance: from profile to conceptual model. Am J Occup Ther. 1996 Feb;50(2):139-47. doi: 10.5014/ajot.50.2.139. PMID: 8808418.[↩]