Group Therapy: Maximizing the Potential – melissa n., SLP

Medicare A restrictions regarding group therapy guidelines became effective October 1, 2010. According to the website for the American-Speech-Language-Hearing Association (http://www.asha.org/practice/reimbursement/medicare/grouptreatment.htm) group therapy is defined as providing skilled speech pathology services "simultaneously to two or more individuals by a practitioner as group therapy services (97150). The individuals can be, but need not be performing the same activity. The physician or therapist involved in group therapy services must be in constant attendance, but one-on-one patient contact is not required." Guidelines specify that clinicians must limit group size to four patients, with up to 25% of therapy per week per patient allowed per discipline. Patients/clients involved in group therapy must have the same or similar goals, and the total minutes in a group session can be counted for each patient.

Group therapy is an excellent venue in which to use creativity and individual patient interest to facilitate functional communication strategies. Finding new and interesting themes and concepts for group therapy often seems challenging. However, utilizing available resources and being imaginative when planning activities can maximize the effectiveness of group therapy.

An easy and free resource to broaden themes for group therapy activities is Googling strange and interesting holidays observed on the day of the group. For example, January 20th, 2011 was National Penguin Awareness Day. On that day for group therapy targeting cognitive-communication deficits/symbolic dysfunction, the patients took pre-cut shapes and followed directives to create a construction paper penguin. This task included sequencing, problem solving, and functional communication. Patients were then presented a story about a penguin who was knighted in Norway for being the King's Guard's mascot. Questions to target immediate memory skills were asked and information reviewed. A snack of an Eskimo Pie was given (all of the patients in the group were allowed thin fluids), and then questions to target delayed recall were asked and answered. Just by using a random, strange holiday theme, the patients were more engaged and motivated with therapy tasks due to the novelty.

Group therapy is a requirement of many companies and insurances in an attempt to maximize clinician productivity and minimize costs. When approached in a positive, functional manner, group therapy can be a fun and effective means through which to stimulate patient motivation and interest in speech therapy tasks and goals. As we all know from experience, if a student is not interested, the attention to task is decreased and learning is minimal. "Education is not the piling on of learning, information, data, facts, skills, or abilities--that's training or instruction--but is rather a making visible what is hidden as a seed..." - Thomas Moore

References/Resources:
http://www.ncshla.org/aaa-nc/new-medicare-rules-concurrent-co-treatment-and-group-treatment-skilled-nursing
http://www.medicarenhic.com/providers/pubs/Physical%20and%20Occupational%20Therapy%20Guide.pdf
http://www.speechtherapyideas.com
www.recreationtherapy.com/tx/actindex.htm
http://www.brownielocks.com/month2.html
http://familyfun.go.com/
http://www.theactivitydirectorsoffice.com/Gina_ActivityIdeasThatWork_Alzheimers.html
http://www.activitytherapy.com/alzh.htm#101things