Between You and Me: Creating Connections Through Adolescent Groups

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Between You and Me Creating Connections Through
Adolescent Groups

• Rebecca Talbot-MaleOccupational
  Therapist/Groupwork Coordinator
  
• Elise Franke Youth Arts Worker/Arts Coordinator
• Helen Bibby, Susan Sampson Natalie Anderson
• The Department of Adolescent Medicine,
• The Childrens Hospital at Westmead, Australia

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• adolescents are a special group because of
  their developmental stage and the special
  problems which this presents. If we try to work
  with them using strategies and techniques which
  are suitable for children or adults, it is
  unlikely that we will have a high level of
  success.
• (Geldard Geldard, 1999)

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Workshop Aims

• To introduce the key processes and practises of
  adolescent groupwork with a complex group of
  teenagers.
  
• For participants to develop practical skills and
  ideas for adolescent groupwork.
  
• To introduce the use of different media in
  adolescent groupwork.
  
• To provide opportunity for networking and idea
  sharing.
  

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Getting started mixing it up!

• Emotional faces

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Adolescent Development

• Adolescence covers the ages 10-25 years
• Defined culturally as to the exact ages of this
  period
  
• 3 stages of Adolescent Development
• Early
• Middle
• Late

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• A time for rapid biological, social, emotional
  and intellectual changes
  
• Puberty
• Attitude/belief systems
• Social development defining oneself according
  to their peer group and relationships
  
• Identity development
• Cultural development (entering youth culture)
• Interest in intimacy and sexual relationships
• Cognitive development
• Future planning
• (Bennett Rowe, 2003 Lougher ed., 2001
  Geldard Geldard,2006)
  

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Youth Health

• There are approximately 3.7 million young people
  living in Australia
  
• There are approximately 700,000 young people
  living in New Zealand
  
• In Australia
• 14 of young people experience mental health
  problems
  
• In Australia 19 of young people are affected by
  a chronic illness
  

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Adolescent Groupwork

• Groups are a naturally occurring phenomenon
• Benefits
• Acceptance and support by virtue of similar
  experiences
  
• Reduces isolation and allows for a sense of
  belonging
  
• Socialisation- social skill development and
  forming of the social identity
  
• Supportive environment to explore feelings,
  thoughts and trial new skills
  

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Benefits continued

• Individual experiences are normalised
• Voice opinions
• Explore new ways of coping
• Can offer faster and more permanent change
  (social)
  
• Group cohesiveness
• Instillation of hope
• Experiential learning and peer learning
• (Geldard Geldard, 1999, Johnson Johnson 2003
  Creek 2002 Frisch Frisch 1998 Liebmann, 2004
  Brown DAmicio, 2002, Flanigan in Lougher ed.,
  2003, Manor, 1999)

I like to come to group cos it gets me away from
the screaming babies on my ward and I can hang
out with other people my age! 13 year old
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A complex group
..Imagine this group..A young person with

• A manic episode of bi-polar disorder
• Cystic Fibrosis and ADHD
• Crohns Disease and long line drip
• Pseudo-seizures
• Conversion disorder lower limb paralysis

• Muscular Dystrophy with head movement only
• Anorexia Nervosa and ADHD
• Depression and auditory hallucinations
• Anorexia Nervosa x 4
• First episode psychosis

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The Challenges

• Apathy
• Adolescent behavioural difficulties
• Influence of patients diagnosis and associated
  behaviours
  
• Group dynamics
• Peer pressure
• Age of participants
• Medical state

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Challenges cont. . .

• Practicalities- wheelchairs, drip stands, bed
  rest etc
  
• Developmental and cognitive stages
• Behavioural difficulties
• Social Skill Difficulties
• Compulsory or voluntary participation
• Communication styles
• Types of activities
• Engagement
• (Geldard Geldard, 2002 Johnson Johnson,
  2003 Flanigan in Lougher ed., 2003).

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Skills of an Adolescent Groupworker

• Understanding of adolescent development
• Ability to connect with your inner adolescent
• Genuine/honest warm
• Empathic non-judgemental
• Remain flexible
• High energy
• Role modelling
• Playfulness/humour
• Belief in the group process
• Self reflection and self awareness
• Boundaries
• (Corey Corey , 2002, Geldard Geldard, 2007,
  Selekman, 2005)
  

You are only limited by what you perceive as your
own limitations
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The AMU Groupwork Program

• Facilitated by a multi-disciplinary team
• 4-5 days during the week from 200-330pm
• Purpose built adolescent area
• Open to all adolescents within the hospital,
  providing they are high school students
  
• Compulsory or voluntary attendance
• Types of groups
• Psychosocial Relaxation
• Life Skill development
• Drama Music
• Art Community Cultural Development

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• The AMU inpatient groupwork program was
  developed to support young people, in the context
  of a peer group setting, to continue typical
  adolescent development whilst in hospital. This
  includes social, spiritual, emotional, creative,
  physical and intellectual domains.

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Group Ideas!

• Stress management
• making stress balls, coping cards
• Relaxation mindfulness
• multi sensory garden, development of
  visualisation scripts
  
• Pamper group
• face masks, hand massage, nails
• Goal setting
• games with goals, goal oriented team activities,
  SMART principles
  
• Empowerment
• Ownership of space, painting, sculpture, CD Art,
  Upside down garden
  

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More Group Ideas!

• Study skills
• mind mapping
• Balanced lifestyle
• leisure, self care productivity, beading
• Budgeting
• The price is right, gameshow, auction.
• Outings in the community
• Use of art to explore ideas and emotions
• colour, textures.
• Self expression through photography and music

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Groups and Creativity

• Types of creative mediums
• Art (clay, drawing, painting, craft etc)
• Photography
• Music
• Drama
• Media

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Rationale for creativity

• Developmentally appropriate
• Promotes wellbeing, health and development
• Self expression
• Non-threatening
• Exploratory tool into psychosocial issues
• Building of resilience and the ability to problem
  solve
  
• Spontaneity

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Group Activities

• Break into small groups to do group activities
• Modelling of Crazy Animals
• Spaghetti towers
• Photo Montage
• Jenga with questions
• Rapidoh
• Stress management (stress less cards)
• Strengths cards
• Share with the group the activity and experience
  and uses with adolescents

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7 Tips for Successful Teen Groups!

• CONNECT
• C Creativity
• O Organise, plan and evaluate
• N Normalise
• N Numbers (money, size)
• E Empower (enticement, encouragement)
• C Communication
• T Timing

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The structure of a group

• Warm up- building trust, rapport,
• Encouraging participation
• Group rules- creating or revising
• Introduction of topic
• Main discussion/content
• Conclusion summing up, confidentiality, plan
• Cool down activity

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Scenarios

• Break into small groups for group idea planning
• Each group will have a scenario to consider and
  present back to the larger group
  
• Remember to CONNECT!

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• CONNECT
• C Creativity
• O Organise, plan and evaluate
• N Normalise
• N Numbers (money, size)
• E Empower (enticement, encouragement)
• C Communication
• T Timing

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• Group 1
• You are running a educational group about
  depression with fifteen Year 8 students in a
  school. The students know each other relatively
  well and have been identified as experiencing
  difficulties with low mood.
• Outline a warm up activity that you could you
  use to engage and introduce the topic .
  
• What might be the challenges when working with
  this age group?
  

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• Group 2
• You are running a Art group at a drop-in centre
  for teenagers living in the area. The average age
  of attendees is 14 17. You dont know how many
  young people will attend but usually its between
  5-10 and they may have met each other once or
  twice before.
• Outline a main art activity you could use to
  engage this group.
  
• What funding and equipment will you require? And
  how could you source this?
  

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• Group 3
• You are working in an early intervention service
  for young people with an first episode of
  psychosis. You have been asked to run a
  leisure-based group to assist the young people in
  developing social and communication skills.
  There are 8 young people who have been regularly
  attending for 3 months and 1 new person.
• Outline some activities that would be
  developmentally appropriate. What difficulties
  may you encounter?
  

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• Group 4
• You are a school counsellor running a weekly
  group after school for students aged 11-13 years.
  The group is about anger management. Some
  students referred themselves, others were
  suggested by a parent or teacher. 8-12 students
  attend the group.
• This is your third group out of a series of ten.
  Last week you learnt about angry body cues (how
  we experience anger in our bodies). Devise an
  activity to help the students revise this
  information during this weeks group.

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• Group 5
• You are a youth worker working in a community
  health centre and you are planning a holiday
  program for teenagers in their final year of
  school to develop their study skills.
• Outline how you would evaluate this group
  program, including specific questions and
  reflections.
  
• How would you recruit for this program and how
  many places would you have available?

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• Groups also provide a forum for participants to
  be filled with hope as they learn from others and
  allows them to see that they are not alone in
  their journey towards recovery.
• (Elder Evans Nizette, 2005 Cooper, Hooper
  Thompson 2005).

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Youre only human

• The importance of debrief
• Seek extra training
• Laugh
• You dont have to know everything, you just have
  to know how to find it!
  
• Be organised
• Dealing with difficulties as they arise dont
  brood
  
• Seek peer supervision
• Report important information to treating team
• Ask for help
• Evaluation

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• Each individual carries with them a unique
• knowledge base and set of life experiences and
• through sharing this they can contribute to the
• learning of others, as well as learn
  reciprocally
  
• from their peers.
• It is essential that a facilitator
• harness each individuals strengths,
• give them credit for their knowledge
• and positively praise them for their
• contributions, however small,
• to the group.

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Our details

• Adolescent Medicine Unit
• The Childrens Hosptial at Westmead
• Locked Bag 4001
• New South Wales, Australia, 2145
• Ph. 61 2 9845 2446
• Email Rebecct2_at_chw.edu.au EliseF_at_chw.edu.au

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References

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