Strategies for Success in
Group Therapy Sessions
● Be prepared.
● Accommodate for all children.
● Establish a structured routine.
● Keep it fun!
● Give positive reinforcement.
● Be flexible.
● Modify large groups.
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Strength in Numbers - Tips for Successful Pediatric Group Therapy Sessions
by Margaret Rice PT
As printed in ADVANCE issue on 4/23/07

Many children receive group physical and occupational therapy sessions.  Children benefit from  group therapy sessions by modeling their
peers, using cooperation and acknowledging each other’s strengths.  In a group setting children can communicate their ideas with each other
and problem solve motor activities.  In addition, group therapy may benefit children by providing social interaction.  By achieving skills and tasks
in front of their peers, a child’s self esteem may improve.  These benefits are wonderful when the group therapy session goes smoothly.  But,
what about when the therapy session does not go so smoothly such as having children who refuse to participate or exhibit non-compliant
behavior?   

There are several ways to help ensure that the group therapy session is successful.  First and foremost, be prepared.  Children tend to exhibit
inappropriate behavior when they become complacent during unstructured times.  It is critical to plan out in advance exactly what goals you will
be addressing during the session and design an activity keeping those goals as the focus.  Always have in mind a few extra activities.  Some
activities that you may think will take 20 minutes may
take 5 minutes leaving you with a chunk of unstructured time.     

When determining what activities to utilize during a group
session, keep all of the children’s skills and goals in mind.  
Make sure that all of the children can complete the tasks while
being challenged.  If one child finds a task too difficult,
frustration may result in non-compliance.  On the other hand,
one child may find the task too easy which could lead to
inappropriate behavior while waiting for the next activity to
begin.  Creating that balance for all the children in your group
can be difficult but with proper planning it can be achieved.

Establish a structured routine and clearly communicate rules that you will follow each therapy session.  The children will know what to expect
each and every session.  Perhaps, begin with a short warm up activity, followed by the main task and then finish up with a cool down activity.  
Another option, would be to open and close each session with a particular song which gives the children a clear sign that group is starting and
ending.  

The activities and tasks that are planned for the session should be fun, exciting and novel as well as pertinent to the children’s goals.  If the
children are having fun while achieving their goals the participation level will most likely increase.  In addition, a motivated child will exhibit
appropriate behavior in order to participate.  

Provide positive reinforcement to the children in order for them to realize that effort is just as important as accomplishing the task.  All children in
the group may not be able to participate at the same level.  If the child is working hard, recognize their determination.

Remember to be flexible.  If the children are not able to complete a planned activity they may become frustrated, refuse to participate or exhibit
inappropriate behavior.  Be sure to adjust accordingly.  First, try to simplify or repeat the directions to ensure that the children understand what is
being asked of them.  Also, try to simplify the tasks or break the skill down into smaller parts so that the children can accomplish the activity.  If
the children continue to exhibit difficulties after modifying the planned activity, you may need to move on to a new activity.    

If you are working with a large group, try recruiting another staff member to create a collaborative treatment session.  Motor activities provide an
excellent resource for language development.  For example, concepts such as prepositions can be physically acted out lending further
understanding of the words. Perhaps the speech therapist can address certain goals while you are also addressing your goals.

Another option when working with a large group, is to break the group up into smaller groups.  Establish several activity stations to be
accomplished during a certain amount of time.  You can monitor one station where the children will need more supervision.  Plan several other
stations that can be completed independently.  Rotate the smaller groups through each of the stations.  The smaller group setting will allow each
child to participate more often again limited the amount of unstructured time.

If you are unable to break a large group up or recruit other staff members to assist make sure that the children are actively engaged at all times.  
Attempt to plan activities that keep the whole group active throughout the session.  If the activity does require turn taking, try having the children
line up shoulder to shoulder or in a large circle, instead of one behind the other.  This allows the children to benefit from seeing each child take a
turn.  For some children, seeing the task repeated over and over again can make it easier for them to complete the task.          

Group occupational and physical therapy sessions can be greatly beneficial for the children involved.  By carrying out good planning strategies,
flexibility and positive reinforcement,  therapy sessions can be more effective.  If you are looking for easy and quick group sensory motor
activities,
25 Instant Sensory Motor Group Activities, is a great resource.