Deck 34: Therapeutic Groups

Question 1

Which remark would the nurse expect to hear during the working stage of group therapy?

A) "My problems are very personal and private;how do I know you people will not tell others what you hear in group?"
B) "I have enjoyed this group;hard to believe that only a few weeks ago I couldn't even bring myself to talk here."
C) "One thing everyone seems to have in common is that sometimes it's hard to be truly honest with those you love most."
D) "I don't think I agree with that;it might help you,but it seems like it would upset your family."

Answer 1

"I don't think I agree with that;it might help you,but it seems like it would upset your family."

Question 2

A patient in a group therapy session listens for a time and then remarks,"I used to think I was the only one who felt afraid.I guess I'm not as alone as I thought." This is an example of:

A) ventilation.
B) altruism.
C) universality.
D) group cohesiveness.

Answer 2

universality.

Question 3

A group is in the working phase,and one member has a history of being left alone as a 4- and 5-year-old when his parents worked or drank.His parents also belittled him and criticized him mercilessly;nothing he did was ever right or good in their eyes.Which comment would the group leader expect to be made by this member?

A) "My boss is always expecting more of me than the others,but talking to him would only make it worse."
B) "I'm sorry for talking all the time,but there is just so much going on,and I can't remember what I already said."
C) "You could be right,maybe that would help,or at least it wouldn't hurt to give it a try next time."
D) "This group is stupid;nobody here can help anybody else because we are all so messed up.It's a waste."

Answer 3

"My boss is always expecting more of me than the others,but talking to him would only make it worse."

Question 4

A new nurse is reviewing the various types of groups available on her new unit.One group adds new members as others leave.She recognizes this type of group as a(n)________ group.

A) open
B) closed
C) homogenous
D) heterogeneous

Question 5

During a group therapy session,a newly admitted patient suddenly says to the nurse,"How old are you? You seem too young to be leading a group." The most appropriate response the nurse might make is:

A) "I am wondering what leads you to ask.Could you tell me more,please?"
B) "I am old enough to be a nurse,so that would make me in my 20s at least."
C) "My age is not pertinent to why we are here and should not really concern you."
D) "You are wondering whether I have enough experience to lead this group."

Question 6

During an inpatient therapy group that uses existential/Gestalt theory,feelings experienced by patients at the time of their admission to the unit are discussed.As a silence falls,one member mentions,"We have heard from several people who describe feeling angry.I would like to hear from some people who experienced other feelings." The nurse identifies this comment as an example of the group role of:

A) energizer.
B) compromiser.
C) encourager.
D) self-confessor.

Question 7

"It doesn't really matter what we do,I'm just here because they make me attend."

A) Playboy
B) Energizer
C) Organizer
D) Gatekeeper
E) Follower

Question 8

"We aren't getting much done;let's speed things up and make our decision."

A) Playboy
B) Energizer
C) Organizer
D) Gatekeeper
E) Follower

Question 9

The nurse is planning a new sexuality group.Which location would best enhance the effectiveness of this group?

A) A unit conference room
B) The hospital's auditorium
C) The unit day (living)room
D) A corner of the music therapy room

Question 10

During group therapy,John states,"When I first started in this group,Betty wasn't able to make a decision.Now she can.She has made a lot of progress.I am beginning to think that maybe I can conquer my fears too." According to Yalom,this statement reflects:

A) hope.
B) altruism.
C) catharsis.
D) cohesiveness.

Question 11

"Last week we finished our first goal,and today we are starting on our second."

A) Playboy
B) Energizer
C) Organizer
D) Gatekeeper
E) Follower

Question 12

A nurse assigned to the well child clinic realizes that a number of the mothers have misconceptions about the most effective ways of disciplining their children.The nurse decides that forming a group to resolve this problem would be an effective strategy.The focus of the group should be:

A) support.
B) socialization.
C) health education.
D) symptom management.

Question 13

Three members of the therapy group share covert glances as other members of the group bring up problems.One of them often makes a statement that subtly puts down another speaker or takes exception to a comment by the group leader.The others then nod in agreement.What explanation should the leader suspect underlies this group dynamic?

A) Some members are acting as a subgroup instead of as members of the main group.
B) The members in question are showing their frustration with slower members.
C) Some of the members have become bored and are tuning out the rest.
D) The members in question are passive aggressive in their personality style.

Question 14

A young female member in a therapy group relates to an older female patient as one might to a mother,accusing her of trying to control her whenever the older member offers observations or suggestions to her.Which therapeutic factor of a group is represented by this behavior?

A) Instillation of hope
B) Existential resolution
C) Development of socializing techniques
D) Corrective recapitulation of the primary family

Question 15

A patient,Mary,has talked constantly throughout the group therapy session.She has repeated the same material several times.Other members were initially attentive then became bored,inattentive,and finally sullen.Which intervention would be most effective for the nurse leader to take?

A) "Most of you have become quiet.I'm wondering if it might be related to concerns you may have about how the group is progressing today."
B) "Mary has been doing most of the talking.I think it would be helpful for everyone to tell Mary how that has affected your experience of the group."
C) "I noticed that as the group went on,most members became quiet,then disinterested,and now seem almost angry.What is going on?"
D) "Mary,you have been doing most of the talking,and others have not had much chance to speak as a result.Could you please yield to others now?"

Question 16

A leader is planning to start a new self-esteem group.Which intervention would be most helpful for assuring mutual respect within the group?

A) Describe the importance of mutual respect in the first session,and make it a group norm.
B) Exclude potential members whose behavior suggests they are likely to be disrespectful.
C) Give members a brochure describing the purpose,norms,and expectations of group.
D) Explain that mutual respect is expected,and confront those who aren't respectful.

Question 17

"You folks have had good ideas so far,so whatever you guys say is OK with me."

A) Playboy
B) Energizer
C) Organizer
D) Gatekeeper
E) Follower

Question 18

A patient tells the members of the inpatient therapy group that he hears voices saying his doctor is going to poison him.Another patient replies,"I used to hear voices too.They sounded real,but I found out later they were my imagination.The voices you hear are not real either." Which phenomenon common to groups is exemplified in this interchange?

A) Ventilation
B) Universality
C) Imitative behavior
D) Interpersonal learning

Question 19

Which outcome would be most appropriate for a symptom-management group for persons with schizophrenia? Group members:

A) state the names of their medications.
B) resolve conflicts within their families.
C) describe ways to cope with their illness.
D) rate anxiety at least two points lower.

Question 20

The nurse is co-leader of a group.The guidelines followed by the leaders include focusing on recognizing dysfunctional behavior and thinking patterns,then identifying and practicing alternate behaviors and thinking that are more adaptive.What theory is represented by this group approach?

A) Behavioral
B) Interpersonal
C) Psychodynamic
D) Cognitive-behavioral

Question 21

A group is in the working phase,and one member states,"That is the stupidest thing I've ever heard.I have never been in a group like this.Everyone is just whining and telling everyone else what to do when they have no clue,and people just sit there and take it.This is a waste of time." Which response by the group leader would be most therapeutic?

A) Meet privately with the member outside of group to discuss her anger.
B) Advise all that hostility is inappropriate and remove her if it continues.
C) Keep the focus on the hostile member so they can exhaust their anger.
D) Remember that angry members feel others are weak compared to themselves.

Question 22

The next-to-last meeting of an interpersonal therapy group is taking place.One would expect the leader to take which action(s)? Select all that apply.

A) Encourage members to reflect on their progress and that of the group itself.
B) Facilitate discussion and resolution of feelings about the end of the group.
C) Support appropriate expression of disagreement by the group's members.
D) Remind members of the group's norms and rules,emphasizing confidentiality.
E) Help members identify goals they would like to accomplish after the group ends.

Question 23

A group has two more sessions before it ends.One member who previously has been vocal and has shown much progress has grown silent.Which response by the leader would be most helpful for the quiet member and others as well?

A) "The end of a group can stir up a lot of feelings,both good and bad.I'd like to hear from each of you about what the end of the group is stirring up in you."
B) "Sometimes the end of a group is welcome,other times regretted.What are people feeling as we wind down and face the end of the group?"
C) "I've enjoyed the group and hope it has been helpful to you all.How about if today we focus on what everyone will be doing now that group is ending."
D) "The end of the group is upon us.I wish you all well and would appreciate it if everyone could take a moment to talk about what you have learned in group."

Question 24

A group has two more sessions before it ends.One member who previously has been vocal and has shown much progress has grown silent.What explanation most likely underlies his current silence?

A) He has said what is on his mind and now has nothing more to offer.
B) He wants to give quieter members a chance to talk in the time remaining.
C) Quiet members are dominating now in order to talk more before group ends.
D) He is having trouble dealing with his feelings about the group's ending.

Question 25

A group is in the working phase,and one member states,"That is the stupidest thing I've ever heard.I have never been in a group like this.Everyone is just whining and telling everyone else what to do when they have no clue,and people just sit there and take it.This is a waste of time." Which response by the group leader would be most therapeutic?

A) "You seem to think you know a lot already;since you know so much,perhaps you can tell us why you are back in the hospital?"
B) "I think you have made your views clear,but I wonder if others feel the same way.How does everyone else feel about the group?"
C) "It must be hard to be so angry.Perhaps the group can be of help.Mary,you were angry at first but not now;what has helped you?"
D) "I'd like to remind you that one of our group rules is that everyone is to offer only positive responses to the comments of others."

Question 26

During a multifamily support group,a patient who has schizophrenia says,"Sometimes I feel very sad that I will never have a good job like my brother,who is an executive.Then I dwell on it,and maybe I should not." The nurse leader can best facilitate discussion of this issue by responding:

A) "Grieving for what is lost is a normal part of having a mental disorder."
B) "How have others in the group handled painful feelings like these?"
C) "It is often better to focus on our successes rather than our failures."
D) "I wonder if you might also experience feelings of anger and helplessness."