by Cindy S. Goot and Henrietta Rzany

The writers are a recreational therapist who created the group, and a social-worker, Mrs. Goots co-therapist, respectively. They work on an in-patient unit at Illinois State Psychiatric Institute with 28 young adults and adults who have various diagnoses. Milieu and family therapy are the two major types of treatment used, along with chemotherapy. There is a point-system, by which patients earn their passes. Appropriate behavior is measured by responsible actions such as being on time for medication and meetings.

The name "Social Recreation," was chosen for the group instead of "Leisure Group," for two reasons. First, it sounds less formal, thus less threatening to patients. Second, the title is more descriptive, which helped members relate to the group immediately. The purpose of this paper is to provide an example of a simple format for this particular type of group. Many therapists write about major issues and conclusions from their groups, but rarely is there a "recipe," to follow.

The social recreation group was a short term, closed discussion group, focusing on socialization and recreation issues. Each of eight groups met twice a week for one hour during a three-week session. The meeting place was the patients' lounge, which was located off the unit. This idea in itself was therapeutic, as it was similar to going to a social gathering away from home.

SELECTION OF MEMBERS- We started by scanning the patient roster for appropriate members. Those who we thought to be post-psychotic, thus probably able to relate fairly well, were qualified for the group. They seemed to have some need for such a group, as observed from the patients' behavior on the unit. Most prospective members elicited social skills that we hoped could be improved upon by participating in our group. A couple of social skills observed were the passing of ash trays and pouring coffee for one another. We excluded those who seemed too advanced for the group. The eligible patients were those who: 1. were able to earn passes, 2. could communicate with others, 3. seemed to be isolated at home or on the unit, 4. needed alternatives to drugs, housework, or idleness during leisure, 5. possessed some social and/or ego strengths; i.e., confidence or resourcefulness. The list of eligible patients was taken to the team supervision meetings for discussion, where some additional patients were excluded due to early discharges, work passes, and extended home visits. We then interviewed the patients who were approved by the teams.

The interviewing approach we liked best was for both therapists to interview each person individually in a brief meeting in a private office. We told patients facts about the group; its goals, meeting time and place, that it was a voluntary activity not on the point system, and we told them who we were asking to join the group. When people agreed to join, we asked that they begin thinking about some ideas and goals for themselves in their group.

Membership usually began with an average of eight patients. There was a planned structure to the group. Its design was to facilitate problem solving, decision-making, planning and fallow-through on recreational tasks. However, we altered some of these goals when we found that most issues centered around relationships. What became clear, was that the group experience was very important in terms of in-vivo social gathering which consistently turned out to be a positive experience for almost all the participants. It was interesting and surprising to see socially integrated skills being practiced by just about everyone.

Members knew how to be gracious and courteous in the examples of lighting each others cigarettes, and responding to one another in considerate and appropriate ways, and cleaning up after the sessions. We found that most people were concerned about how to meet people, maintain relationships, and how to say "no" to people and still be friendly with them. The therapists goals for the group were modified, and expectations were lowered after each three-week group. On the basis of their readiness, our expectations of their following through on a planned recreation activity, decreased. However, we discussed why they were unable to complete the task.

Some members seemed to view recreation as a low priority item in their disorganized current situation. They felt that recreation must come last or never. Some of their reasons were: housework, children taking up all their time, no ideas of what to do, no money, no friends, feelings of not deserving the pleasure of recreation. With this new information, our major goal was to provide a positive social experience. Other goals were to identify and

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then find alternatives to social and recreation difficulties, by pointing out their social and ego strengths.

FORMAT-Meeting 1: Define social recreation and personal goals for members in the group. This immediately stimulated discussion, throwing out ideas and leaving people with a good sense of participation.

Meeting 2: Finish discussing goals and set up a task around problem solving; having patients decide how to use $3.00 for refreshments. We found that this was quickly and effectively managed without much discussion, with dependable results.

Meeting 3: Pass out survey sheets that rank major life areas. Poorer functioning groups responded by telling the group their rationale for their ranking. We were surprised by their well expressed logic. One seemingly socially skilled group had difficulty discussing this exercise. There seemed to be a dampening quality in their meeting. People seemed depressed, they required precise instructions, and they did not open up as expected. Perhaps, the survey elicited strong feelings that these patients were dealing with during their hospitalization.

Meeting 4: We used the Hex-Appeal Questionnaire which focused on social skills. It generated enthused discussion, and it seemed that we never had time to complete it.

Meeting 5: The group discussed relationships, how to meet people, how they felt about making demands, and having demands placed on them. Some role playing developed in this meeting. At times, it seemed as though issues could not be terminated; but rather, they stimulated more thought and work by the patients.

Meeting 6: We said our goodbyes to members and asked them for feedback. At first, we asked for group-focused feedback; what was helpful, and in what ways the group could be improved. In the final series, group members were asked to give each other feedback, positive, and advice-giving.

Problems: 1. Adjusting to the continuous loss of members, because of discharges, work passes, etc. Occasionally, members were taken from the session because of schedule conflict; medical exams or therapy sessions. This meant that separation was a constant task. With one of the groups, we ended up with one patient by the sixth session. More often we ended with four members.

2. Misjudging patients' readiness, and how to manage that error in the group sessions. Two of the patients' first sessions were characterized by what appeared to be unusual disruptiveness for the group, creating tension in the therapists and probably the patients as well. We decided to evaluate them before each of the remaining sessions, keeping one girl out of the two following ones, until she seemed better integrated. These two women finished well in spite of their poor starts.

3. More of a question than a problem, was how were we to measure the effectivenss of the group? As therapists, we enjoyed working in the groups. There seemed to have been frequent discoveries of patients' ego strengths, including social responsiveness. Patient functioning at times, looked better in this group, than we have experienced in other milieu groups. Perhaps, their social-recreation identity was easier to define than their patient role. We saw cooperation from patients as far as attendance and verbalization. We experienced a sense of fluidness, spontaneity, and flexibility. Patients often said they felt good in the group and liked it. We concluded this to be some measure of effectiveness.

4. The status of a group on the unit depends largely upon promotional methods; such as reporting information in staff meetings. The therapists wrote notes evaluating each patient's participation, in their charts. However, it seems it would have been more useful to the staff to also verbally report a summary at the termination of each series.

Conclusions—The format for the group is well structured and designed. It is task oriented, and its practice lends itself to homogeneity, thereby quickly developing group cohesiveness. The group was essentially conflict-free, which is an advantage of task-oriented groups over person oriented groups. There was a sense of closure to the group, follow-through on goals and issues, and a sense of logic and progression. This is probably related to its being a close-ended series. The group consistently represented a positive social experience for its members. It was a gratifying group to work in. It took a great deal of time; about five hours a week on the average, for ongoing planning and co-therapy meetings.

This type of group may be useful not only on in-patient units, but in public facilities for people who would like to meet people, but seem to have social difficulties.

Illinois Parks and Recreation 21 July/August, 1977