Group Intervention Ideas for Occupational Therapy

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If you are an OT clinician being asked to incorporate more groups or an OT student planning a group for a class presentation or for a fieldwork assignment, a question mark may be floating in your mind! It becomes difficult to create a group that can have influence on each client. One client may require direct 1:1 attention, another is quite high level and needs more challenge, and someone else may be the hater (never wants anything to do with therapy, but can really benefit).
So, how do you strike that balance? I have been an OT for 5 years and struggle with this at times. If you're stuck, don't worry. It means you're normal!
I'll give you some ideas that may work for you that I have used in the past.
Pediatrics:
Edible Playdough Group
Kids love to eat or just bite on things they play with. This is great if you have a client with latex precautions too.
Pincer grasp: Have your clients roll their dough into a snake and then pinch sections of it.
Coordination: Rolling the dough in the hands or pulling small pieces off of a roll.
Bilateral Integration
Proprioception: If the client can stand or sit at a higher surface than the table, they can knead or press into the dough.
Play: Need to see how a client interacts with other children and stimuli? This may help you out with your assessment.
Sensory Integration: If your client has difficulty with different textures this may be a way to grade your interventions (progress up/down). Maybe add other edible treats in there, like skittles, for them to pick out.
Postural Stability: Have the client sit on a theraball while manipulating dough.
Follow this link for recipes on making and storing various types of edible pladough: http://www.familycorner.com/family/kids/crafts/edible_play_dough.shtml
Adolescents:
Outdoor Sport Activity
Clients in this age range may present with more behavioral diagnoses. Providing an atmosphere for them to expend their energy, interact with others, while also succeeding is great. Finding a sport that can provide this may be difficult. Here are some ideas.
Softball: This is a sport that offers many positions for your client to feel they are contributing to the group, and offers them a chance to be successful given their strengths. One way to downgrade this group is to play catch and then progress to a larger group for a softball game.
Golf: While this is a more tame sport, it requires great attention and thought-process.
Volleyball: Sometimes this game allows for some wiggle room if you do not have enough players. A way to downgrade this if you don't want to use a volleyball is a balloon.
Relay races
*Remember you do not need to follow the game rules100%. Participation is key and games can be adapted.
Adults/Older Adults:
The choices in this area become vast, as you are addressing a myriad of diagnoses. Below are a few suggestions.
Home Safety: Show pictures of an unsafe environment and have the group discuss how the home can be modified. Present adaptive equipment and provide information on costs and/or insurance reimbursement. Try to make this interactive to gain and keep everyone's attention. Have handouts with medical supply stores, companies that provide home modifications, and invite family.
Cooking/Homemaking: This poses problems in several facilities because many do not have a stove, oven, or sink. Sometimes you really need to tug on your creativity strings. One idea is try making a fruit bouquet. Buy some skewers and fruit. Use cookie cutters to be creative with making shapes for the fruit and stick them on the skewers. You can take it further and have a styrofoam block to stick the fruit skewers in to make a bouquet. A higher level client can help with the item transport.
Exercise: Exercise is important while trying to increase a client's activity tolerance, coordination, ROM, and more. If possible, incorporate the exercises into a group that you may be giving to the client upon their discharge. This may help them make it part of their daily routine. This would also be a good time for education: issue theraband or educate them on what they can use at home for weights (i.e., canned food, bag of beans), tell them why exercising their arms and/or legs is important, and educate them on how to breathe when exercising. Any precautions a client may have should also be addressed (i.e., cardiac).
Leisure: This can be fun! Choose something many can benefit from like bowling, balloon volleyball, air hockey (improvise on this; instead of a puck use a large checker), jenga, or hangman.
PNF: Grading this task can be done creatively. Think of the PNF diagonals as your core and expand upon it by incorporating balls, sitting on a theraball, reaching in the kitchen, or gardening.
Use your clinical judgment when addressing groups. The best part of being an OT clinician or student is the use of your creativity. The way you document and expand on how your group addresses your client's functional performance areas will make you exceptional.
Also, do not feel pressured to incorporate groups due to productivity requirements, to manage a large caseload, or because of a client's payor source. While these are important, remember to do what is best for the client.