Gopal Singh, MSN, Lecturer

GROUP DYNAMICS
GROUP

Group is a collection of individuals who have a relationship with one another, are interdependent,
and may share some common norms.
A collection of individuals in a face-to-face setting working on a task that requires a cooperation.
Any number of people who interact with one another, are psychologically aware of one another and
perceive themselves to be a group.
PRIMARY GROUP
The family we are born into is the small group to which most of us owe our primary allegiance for
the first fifteen or twenty years of our life, and, indeed for many people in our society, it remains a
focus for allegiance throughout their lives." (Douglas (1983) , Quoted from Tajfel)
The family may be defined as the individuals primary group.

WHAT IS THE NEED OF A GROUP?
Fundamentally, the complex nature of organizational activity makes it virtually impossible for
individuals to cope at a satisfactory level.
Status
Self esteem
Affiliation
Power
Goal achievement

GROUP DYNAMICS
Group dynamics refers to the underlying forces that work to produce behavior patters within
groups. The group dynamics include both the group content and the group processes.
Explains how people interact and Build unity.

CHARACTERISTICS OF A GROUP
Size of the group.
Homogeneity or heterogeneity of group members.
Stability of the group.
Degree of cohesiveness or bonding.
Climate of the group.
Conformity of the group norms
Degree of agreement between the leaders and the group norms.
Ability to deal with members infractions
Goal directedness and task orientation of group works.

TYPES OF GROUP
Primary group
In primary group members have face to face contact. They have boundaries, norms, and explicit
interdependent roles. Eg. Family.
Secondary group
Usually larger and more impersonal than primary groups. Members of this group do not have
relationships bonds or emotional ties of members of a primary group. Eg. Business party or a
political party.
Open group
An open group is one where participants come and go, depending on their individual needs. In an
open group, participants may come for as many sessions as they perceive their needs: these groups
are common on in-patients and as self help groups.
Closed group
A closed group begins with a certain number of participants and is not open to new members once
the group is formed and the sessions have started. Eg. A group for psychotherapy.
Gopal Singh, MSN, Lecturer

Formal group
Formal group has structure and organization. Authority in a formal group usually emanates from
above and interaction in the group is usually limited. Eg. A faculty meeting.
Informal group
An informal group provides much of a persons education and contributes greatly to his or her
cultural values. Group members join the group on basis of interest. Eg. Friendship or hobby group.
Super group/ team & self managed teams

COMMON DIMENSIONS IN A GROUP
Group structure
Communication
Group function
Group roles
Power
Norms
Cohesion
GROUP STRUCTURE
It refers to the underlying order of the group.
It describes the boundaries, communication and decision making processes, and authority
relationships in a group.
The structure of the group offers it stability and helps to regulate behavioral and interactional
patters in a group
GROUP COMMUNICATION
Reveals how the group approaches its tasks and psychosocial functions.
Intrapersonal communication
Interpersonal communication
Public communication
Group communication technique
Approval.
Acceptance.
Clarification
Exploration
Identification
Interpretation
Information giving
Reassurance
Support
Intervention
Reflection
Understanding
Teaching
Listening
Silence
Limit setting

GROUP FUNCTION
All groups have two basic needs or functions: the need to work on or complete a task or a goal, and the need
to satisfy some psychosocial or emotional need or needs of its members
Task or Goal connects the group to its external environment.
Primary task- necessary for the groups survival or existence.
Secondary task- these may enhance the group but are not basic to its survival.
According to Zander (1985) groups serve many functions in modern society.
Protecting members from harm.
Accomplishing arduous task.
Setting rules/ standards for others.
Changing opinions of outsiders.
Teaching information/skill to members.
Integrating information from diverse specialist.
Giving advise to others.
Administering a complex organisation.
GROUP ROLES
Gopal Singh, MSN, Lecturer

The role of a member in a group is determined by the communication and behavioral pattern of that
member while in that group.
The factors influencing role selection
Personality of the individual
The group size
The groups tasks
Interaction in the group
Individuals position in the group.
Group Roles and Functions
The Benne and Sheats categorized 3 major kinds of roles individuals can play in groups.
1) Maintenance or Group building roles
Encourager
Compromiser
Gate keeper
Follower
Rule maker
Problem solver
2) Task Roles
Leader
Questioner
Facilitator
Summarizer
Evaluator
Initiator
3) Individual roles
Victim
Monopolizer
Seductor
Mute
Complainer
Moralist

GROUP POWER
Power is the members ability to influence the group and its other members.
GROUP NORMS
These are standards of behavior that are adhered to by the group.
GROUP COHESION
It is the strength of desire of the members to work together toward common goals and to support one
another. Cohesion has been associated with positive group outcomes, increased interactions, norm
conformity and goal directedness.
Group Cohesiveness: Factors affecting group Cohesiveness;
Group goals
Similarity among members
Type of interdependence among
members
Leader behavior
Communication structure
Group activities
Group atmosphere
Group size.

GROUP DEVELOPMENT
Tuckman's Stages model
5 Stages Of Group Development
Stage I: Forming
Group members learn about each other and the task at hand.
Indicators of this stage might include: Unclear objectives, Uncommitted members, Confusion, Low
morale, Hidden feelings, Poor listening, etc.
Stage II: Storming
As group members continue to work, they will engage each other in arguments and struggle for
status in the group.
Gopal Singh, MSN, Lecturer

These activities mark the storming phase: Lack of cohesion, Hidden agendas, Conflicts, anger,
Inconsistency, Failure
Stage III: Norming
Now the group understands each other better, and can appreciate each other's skills and
experience. They feel they're part of a cohesive, effective group
Indicators include: Questioning performance, Reviewing/clarify objective, Changing/confirming
roles, Listening, Testing new ground, Identifying strengths and weaknesses
Stage IV: Performing
Not all groups reach this stage, characterised by a state of interdependence and flexibility. Everyone
knows each other and trusts each other enough to allow independent activity.
Group identity, loyalty and morale are all high, and everyone is equally task-orientated and people-
orientated.
Indicators include: Creativity, Initiative, Flexibility, Open relationships, Pride, Concern for people,
Learning, Confidence, High morale, Success, etc.
Stage V: Adjourning
This is about completion and disengagement, both from the tasks and the group members.
Individuals will be proud of having achieved much and glad to have been part of such an enjoyable
group. They need to recognise what they've done, and consciously move on.
Some authors describe stage 5 as "Deforming and Mourning", recognising the sense of loss felt by
group members.
Tubbs' Systems model
Stewart Tubbs "systems" approach to studying small group interaction led him to the creation of a four-
phase model of group development.
Orientation:
In this stage, group members get to know each other, they start to talk about the problem,
and they examine the limitations and opportunities of the project.
Conflict:
Conflict is a necessary part of a group's development. Conflict allows the group to evaluate
ideas and it helps the group avoid conformity and groupthink
Consensus:
Conflict ends in the consensus stage, when group members compromise, select ideas, and
agree on alternatives.
Closure:
o In this stage, the final result is announced and group members reaffirm their support of the
decision.
COMMUNICATION IN DIFFERENT PHASES OF GROUP

PHASES OF GROUP WORK
Orientation phase
Its the time during the initial meetings of the group. The participants begin to get to know and establish
trust with each other. There for there are rules of group behaviour that must be made explicit at the
outset. Sometimes a written contract or verbal agreement is needed.
Gopal Singh, MSN, Lecturer

The facilitator will encourage the participants to involve in active discussion.
Working Phase
It refers to the time when the participants are actively accomplishing the purposes of the group. They
may share their feelings and fears with one another. The leader serves to guide the group to achieve its
goals by keeping discussions related to group goals. This phase provides the participants to learn about
their behaviours and to achieve their own goals.
Termination Phase
This phase occurs when it is a time-limited , closed group and number of sessions comes to an end or
when an open group no longer needs to meet because the purpose have been met.
The leader/facilitator helps each participant to see participation in the group has benefited him or her.
The termination brings about inevitable feelings of change, often including the loss or sadness of parting.
The group members may want to provide support to one another during parting.
GROUP LEADERSHIP
STYLES OF GROUP LEADERSHIP
Leadership style is the manner and approach of providing direction, implementing plans, and motivating
people.
Kurt Lewin's Leadership styles
Autocratic leadership style
In this the leader exercises significant authority and control over the group members , rarely
seeks input from the group and does not encourage participation from the group.
In certain situations the autocratic leadership may prove to be effective as in emergencies, it
conserves energy, time and dictates roles and responsibilities to the members.
This type of leadership may result in hostility or scapegoating behavior.
Democratic leadership style
Encourages group interaction and participation in group problem and decision making.
The leader values the input of each member, seeks spontaneous and honest interaction among
the members, and creates an atmosphere in which members are rewarded for their
contributions.
Requires more time and energy.
Group efforts are more productive and cohesive. Provides the members with a sense of
participation in decision making
Laissez Faire leadership style
Group members are free to operate as they choose.
This style may be effective if members are highly knowledgeable, task oriented and
motivated.
It is time consuming and often inefficient in accomplishing group tasks.
Dictator leadership style
A leader who uses fear and threats to get the jobs done.
As similar with a leader who uses an autocratic style of leadership, this style of leader also
makes all the decisions.

LEADERSHIP SKILLS
Skill of personal behavior
Sensitive to the feelings of the group
Identifies self with the needs of the group
Helps others feel important and needed
Does not criticize another persons situation
Skills of communication
Listen attentively
Establish positive communication with the group as a routine part of the job.
Recognizes that everyones contributions are important.
Skills of organization
Develop short and long range objectives
Gopal Singh, MSN, Lecturer

Share responsibilities and oppertunities
plan., act, follow-up and evaluate
Skills of self examination
Aware of personal motivations
Helps the group to be aware of their attitudes and values
DESIGNING AND MANAGING WORK GROUPS.
Richard Hackman (2002)
1. Being a real team
2. Compelling direction
3. Enabling structure
4. Supportive context
5. Expert coaching

GROUP THINK
Group think is a type of thought exhibited by the group members who try to minimize conflict and
reach consensus. The term was coined in 1952 by William.H.Whyte
During group thinking the group avoid promoting the viewpoints outside the comfort zone of consensus
thinking.
Symptoms of group think Irving Janis (1977)
Illusion of invulnerability
Collective rationalization
Belief in inherent morality
Stereotyped views of out-groups
Direct pressure on dissenters.
Self-censorship
Illusion of unanimity
Self-appointed mindguards
DECISION MAKING IN GROUPS
Decision making can be regarded as an outcome of mental processes (cognitive process) leading to
the selection of a course of action among several alternatives. A group that makes sound decisions is a group
that functions effectively. It helps to construct well-conceived, well-understood and well-accepted realistic
actions toward the goals.
Effective decisions
The resources of the group members are well used
The groups time is well used
The decision is of correct or of high quality
The decision is put into effect fully by group members
The group members feel committed to the decision and responsible for its implementation
The problem solving ability of the group is enhanced.
Members feel satisfied with their participation, and a positive atmosphere is created.
Decision making methods
Consensus decision making
Consensus requires that a majority approve a given course of action, but that the minority agree to
go along with the course of action.
In other words, if the minority opposes the course of action, consensus requires that the course of
action be modified to remove objectionable features.
Dictatorship decision making
Where one individual determines the course of action.
Voting based methods
Range voting: Lets each member score one or more of the available options. The option with the
highest average is chosen. The most popular decisions will be the groups decision.
Majority voting
Requires support from more than 50% of the members of the group.
Plurality
Where the largest block in a group decides, even if it falls short of a majority.
Authority after discussion
The designated leader makes the final decision, but first discuss the issue with the members to get
their ideas and views.
Gopal Singh, MSN, Lecturer

Minority control decision
A small minority may also quickly and forcefully railroad the decisions (force the group to accept
them by exerting intense pressure).

GROUP DISCUSSION TECHNIQUES
Identification
It is good to address each other by name.Later, refer to the plan and address people by their names.
In large groups, name tags can be helpful.
Whole Group
The value of whole group discussion is the evolution of a group idea. A group idea is not simply the
sum of individual ideas, but the result of the interaction of ideas during discussion. Whole group
discussion can be unstructured and productive.
Small Group
Breaking into smaller groups can be very useful. These small groups can be dyads or triads or even
larger. They can be selected randomly or self-selected. If used well, in a relatively short amount of
time all participants have the opportunity to share their own point of view.
Brainstorming
This is a very useful technique when ideas need to be solicited from the whole group. The normal
rule of waiting to speak until the facilitator recognizes you is suspended and everyone is encouraged
to call out ideas to be written by the scribe for all to see.
Go-rounds
The facilitator states a question and then goes around the room inviting everyone to answer briefly.
This is not an open discussion.
Fishbowl
The fishbowl is a special form of small group discussion. Several members representing differing
points of view meet in an inner circle to discuss the issue while everyone else forms an outer circle
and listens. At the end of a predetermined time, the whole group reconvenes and evaluates the
fishbowl discussion.
Active Listening
If the group is having a hard time understanding a point of view, someone might help by active
listening. Listen to the speaker, then repeat back what was heard and ask the speaker if this
accurately reflects what was meant.
Caucusing
The difference between caucuses and small groups is that caucuses are composed of people with
similar viewpoints, whereas small group discussions are more useful if they are made up of people
with diverse viewpoints or even a random selection of people.
Nominal group method
Group members, without any discussion, independently write down their ideas about a problem or
task. Each group member presents an idea to the group without discussion. This process continues
around the table until all ideas have been expressed. The ideas are summarized and listed on either
a chart or a chalkboard.
Members discuss each of the recorded ideas for the purpose of clarification and evaluation.
Members independently give their own priority ranking of ideas. These independent rankings are
added together and averaged. The final group decision emerges from the pooled outcome of the
independent rankings. The format utilizes both the independent thinking of members (example,
writing down ideas) and group interaction, (example, discussing the ideas) in order to arrive at a
joint decision.
Delphi method
Gopal Singh, MSN, Lecturer

Group members are sent a questionnaire which asks them to identify important questions or issues
on a specific topic. Members responses are compiled and a second questionnaire is administered
which asks members to assess and prioritize the list of responses derived from the first round
Above Step is repeated in subsequent rounds. Each time the priorities of members are summarized
and narrowed down to those, which are the most important. The results are returned to each group
member for further ranking and evaluation. In the last phase, a final summary and ranking is
provided to each member of the group. .
The major disadvantage of the Delphi method are that it does not allow for the development of
emotions and feelings in the group, and it does not allow for face to face feedback and clarification.

GROUPS IN HEALTH CARE SETTINGS
Task group
Purpose: performance of a specific job or goal agreed by all members at initiation of group.
Role of leader: to establish exchange of information among members and direct group towards
task accomplishment.
Title of leader: chairperson
Title of members: committee members
Length of group life: target date usually set in advance.
Self-awareness or Growth groups
Purpose: Development or use of interpersonal strengths.
Role of leader: To establish group interaction among members and to serve as a resource person.
Title of leader: Trainer
Title of members: Trainees
Length of group life: Tend to short term with target date in advance.
Therapy Groups
Purpose: To do the work of therapy, towards self understanding, handling stress etc.
Role of leader: To establish group interaction between self and individual members and among
group members.
Title of leader: Therapist
Title of members: Clients or patients
Length of group life: Usually not set, the termination date determined mutually by therapist and
members.
Supportive Group
Purpose: To offer support, education, and/or socialization and/or recreation.
Role of leader: To meet basic requirements for social companionship or education.
Title of leader: Host/Teacher/Therapist
Length of group life: May be set in advance or spontaneously determined.

GROUP THERAPY
Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists
treat a small group of clients together as a group.
Emphasis various therapeutic factors according to group purpose and goals.
Group therapist focuses on interpersonal learning and change.
Therapeutic factors of group therapy
Universality
Altruism
Instillation of hope
Imparting information
Corrective recapitulation of the primary
family experience
Development of socializing techniques
Imitative behavior (Modeling process)
Cohesiveness
Existential factors
Catharsis
Interpersonal learning
Gopal Singh, MSN, Lecturer

Self-understanding

SUPPORTIVE GROUPS-TYPES AND APPROACHES
Socialization groups
A group of persons come together with a facilitator to interact with each other in an informal
setting. The main purpose is to increase the interaction and develop social skills. In this group
activities are aimed at providing clients with experiences in social situations and assisting them to
learn methods of interaction with others.
Recreation groups
An extension of socialization group. Approach is to plan and experience activities of enjoyment and
socialization. Isolated clients can also participate in these structured activities.
Educational groups
Purposes is providing education in group setting. More cost-effective to teach a group of people
together than one-to-one basis. Bringing the group together provides benefits of universality.
Reality orientation groups
These are often conducted in inpatient setting. The main approach is to reorient the client to time,
place, and season and to provide information of current events.
Reminiscence group
Groups for elderly. Specifically aimed at permitting reminiscence or life review.

Self-help groups
These are groups of persons coming together who are facing a common difficulty.

Community support groups
Group for victims of violence
Support offered: To individuals and families who have been physically or emotionally abused.
Examples: Safe house, rape trauma, Battered children
Birth anomaly support groups
Support offered: To individuals and families with birth defects and congenital anomalies. Eg. Down
syndrome, cerebral palsy
Acquired disease support group
Support offered: To individuals and families coping with and adjusting to diseases originating after
birth that are not inherited or innate. Eg. Diabetes, leukaemia, AIDS
Chronic illness support groups
Support offered: To individuals and families in which there is an illness of long duration and slow
progression. Eg. Cancer, arthritis, COPD,
Work related support groups
Support offered: To workers who experience job related stress. Eg. Burn out groups, Friday evening
groups.

CONFLICTS AND CONFLICT MANAGEMENT
Conflict: Conflict is generally defined as the internal or external discord that results from differences in ideas,
values or feelings between two or more people.
It is also created when there are differences in economical and professional values.
Types of Conflicts
Relationship Conflicts
Interest Conflicts
Data Conflicts
Inter-group conflicts
Personal-group conflicts
Structural Conflicts
Value Conflicts
Gopal Singh, MSN, Lecturer

Conflict stages
Latent conflict
It exists whenever individuals, groups, organizations, or nations have differences that bother one or
the other.
Conflict emergence
After a conflict has remained latent for some time, if the underlying grievances or frustrations are
strong enough, a "triggering event" marks the emergence or the "eruption" phase of the conflict.
Conflict escalation
Escalation refers to an increase in the intensity of a conflict and in the severity of tactics used in
pursuing it.
Hurting or stalemate
Once conflicts escalate for awhile, they often reach a stalemate: a situation in which neither side can
win, but neither side wants to back down or accept loss either
De-escalation or negotiation
De-escalation often also associated with reduced grievances, at least for members of one side. This
change occurs as relations between the adversaries change.
Dispute settlement
If most or all of the underlying causes of the conflict are finally remedied, the conflict may be
resolved permanently or at least for a long time.
Post-conflict peace building
Even after a settlement is reached and a peace agreement is signed, this is by no means the end of
the conflict. Usually, there is a long period of peace building among the grassroots people,
Conflict process

Conflict Management- Strategies
Denial or Withdrawal
With this approach, a person attempts to get rid of conflict by denying that it exists. He or she simply
refuses to acknowledge it.
Suppression or Smoothing Over
"We run a happy ship here." "Nice people don't fight." A person using suppression plays down
differences and does not recognize the positive aspects of handling the conflict openly.
Conflict Management- Strategies
Power or Dominance
Power is often used to settle differences. Power may be vested in one's authority or position. Power
may take the form of a majority.
Compromise or Negotiation
Used when resources are limited or a speedy decision needs to be made.
Integration or Collaboration
This approach suggests that all parties to the conflict recognize the interests and abilities of the
others.
Model of conflict resolution
The following model is designed to assist nurses in assessing states of conflict and selecting a
type of resolution for those under your management.
Gopal Singh, MSN, Lecturer

There are four basic parts (or transformations) to this model that occur before a personnel
(employee) dispute enters the legal system. The four are as follows and occur in this order:
UNPIE to PIE - UNPIE, an unperceived injurious experience turns into a PIE, a
perceived injurious experience (simply put, an incident occurs and at that time the
you [the employee] may not perceive it as injury and on further thought begin to see
it as an injury). Of course, how you perceive (or view, or react) to this is influenced
by your age, experience, gender, personality traits, socioeconomic status and job
satisfaction. Legal action is less likely to occur if the employee perceives the
organization as caring.
Naming - Here the specific grievance is described and named.
Blaming/Attribution - Here employee's either blame themselves or others for injury.
Blaming oneself may end the process. Blaming others may result in Claiming. Social
position, cultural commitment and perception of prejudices.
Claiming - If the claim is rejected, then it becomes a legal or labor dispute.
Communication issues, insensitivity, and ignorance of each other's motivations can
hinder progress toward conflict resolution. Nurse leaders must learn to interpret
racial feelings even though these subjects are uncomfortable to discuss.
Conflict management in culturally diverse health care groups
Awareness building - 1
st
phase - Begins with top management providing personnel with a mission or
goal statement that addresses diversity. It also includes the development and implementation of a
culture audit using a combination of research efforts (i.e. focus groups, survey's and interviews with
target personnel interested in exploring a specific diversity issues.
Discrimination control - 2
nd
phase - Is a responsibility of nurse leaders and all levels of
management. Discrimination (mistreatment of people based on factors that are irrelevant)
and prejudice (inaccurate perception of others) are sensitive and threatening subjects. these
perceptions result in dispersing blame (some type of mistreatment). Another component is reverse
discrimination - which refers to laws or policies that may be considered as discriminatory by certain
people of certain ethnicity, gender, race or handicap. (Ex: selecting a person of a particular gender
over another gender, or a person from a particular ethnic group over someone who may have better
credentials or education).
Prejudice reduction - 3
rd
phase - is more difficult to manage than the first two phases because it is
abstract, internal and perceptual.
Actions for nurse leaders to prevent conflicts
Openly acknowledge and discuss diversity issues.
Be educated concerning different cultures.
Promote educational programs for individuals from all cultures.
Create a socially comfortable environment for culturally diverse staff members so they
can experience the uniqueness of each other.
Allow for cross-cultural representation in unit activities.
Promote equal growth opportunities.
Strive to eliminate prejudice, biases, and stereotyping.
Monitor standards and norms to assure achievability.
Reward those who successfully manage diversity.
Openly discuss conflict with group members.