Group and family interventions in psychiatric nursing

¶ … dominant leadership styles exist. The first is the autocratic type, in which the leader makes use of a highly controlling style and seeks minimal input or participation from other group members. This would not be an appropriate leadership style to use for an interactive support group of any kind. A democratic style in contrast, is highly participatory. A great deal of input is actively solicited from the group members. This would be the most appropriate style of leadership for the breast cancer support group. The group structure is supposed to be tailored to the needs of the individual group members. A laissez-faire approach, or a 'hands off' style might be insufficiently directive, especially during the early stages of group formation, when members are still getting to know one another and only just beginning to coming to terms with how to psychologically deal with their diagnosis. A democratic leader still directs group interactions, but directs according to the expressed needs and desires of the group.

1b. Like group leaders, group members can also play different roles. These roles fall under three different categories: task, maintenance, and individual roles. Task roles include that of information seekers and givers; initiators of discussion and orienteers (people who bring the group back to its focus); recorders (such as group secretaries) and coordinators (who take care of logistical details. Maintainers play emotionally supportive roles such as encouraging and accepting other group members; as well as facilitating, encouraging, and harmonizing group interactions. Maintainers may observe others and act as followers as well. However, group members who simply act as individuals only serve "the needs of only one group member. They hamper, rather than enhance, group functioning" (Mohr 2009, p.248). These are the group aggressors or blockers who belittle the accomplishments and status of others, call attention to themselves through boasting or intimidation and use humor as a way of diverting the group from its purpose.

2a. Objective burdens faced by the family might include the need for Sam and Joan to keep working, to ensure that Janet has adequate health insurance to cover the costs of her treatment; the need to find the right type of counseling and medical treatment for Janet; and the need for Max and Sarah to support the family during this difficult time by taking on additional responsibilities and not being an additional burden upon their parents. Max may have to move home to take care of his younger sister rather than establish an autonomous identity away from his family. Subjective burdens are burdens perceived by family members may include guilt, such as Sam and Joan's worry that they may have caused Janet's breakdown; the fears of Janet's siblings that they might manifest a mental disorder later on or pass on the tendency to their own children; and the anger they feel that their parents' attention is disproportionately focused upon Janet (Mohr 2009, p.272).