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?"
A
The most effective action the nurse leader can take will be the one that encourages the group to solve its own problem. Pointing out changes in the group and asking members to respond to them lays the foundation for a discussion of group dynamics. Asking members to respond to Mary puts Mary in an awkward position, likely increasing her anxiety as others focus on Mary herself rather than the group process; as anxiety increases, monopolizing behavior tends to increase as well, so this response would be self-defeating. Asking members what is going on is a broader opening and might lead to responses unrelated to the issue that bears addressing; narrowing the focus to the group process more directly addresses what is occurring in the group. Focusing on Mary would be less effective and involves the leader addressing the issue instead of members first attempting to do so themselves (giving them a chance to practice skills such as assertive communication).
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