As an occupational therapist who loves groups and group therapy, I get frustrated when colleagues treat OT groups as if their only home is the acute mental‑health ward.  Yes, that is the most common place you’ll see OTs presenting groups, but it is by no means the limit.  There is a huge, unmet need for groups in outpatient settings, across every field of OT and right inside communities.  I want to show, from five years of community work with MoreThanMeerAs NPC and through our recent Pool Family Trust project, how community groups can be both preventative and rehabilitative, how they build real skills, and how they prepare people for the open labour market.

If you’re wondering how I run community groups, how participants are sourced, how long programmes last, how frequently we meet, and what the aims are, this article sets out exactly what we did and learned. I’ve set out the full method so other teams can adapt it safely and effectively; in group OT, transparent process underpins consistency, ethics, outcomes, and credible funder reporting. Below I walk through the full approach used with Pool Family Trust, including planning steps, session structure, theoretical grounding, evaluation, and participant feedback.

Clear, repeatable steps help colleagues implement responsibly help us explain why each decision was made.

Why Community OT Groups Matter to Me

Groups aren’t just a service model.  They are a way to hold space for healing, learning and practical skill development at scale.  When we place groups in community settings we can:

• Prevent problems before they become crises;
• Offer rehabilitation where people live and work;
• Build workplace readiness, entrepreneurial skills and social participation; and
• Strengthen households and neighbourhood economies by turning inclusion into everyday practice, enabling people to work, start small income activities, share caregiving more sustainably, and spend locally.

I’ve seen the difference this makes, people regain hope, learn to manage tasks and relationships, try small income‑generating activities, and return to their daily lives with renewed energy. The Pool Family Trust showed how all participants well-being improved.

Complete Step‑by‑Step Approach (Faithful to the Original Programme Details)

Below I reproduce the full, faithful process I use, the same one I used for the Pool Family Trust programme in Worcester.  If you want to implement something similar in your community, here are some suggestions to follow.

Step 1: Funding and Alignment

• Consider who will pay for the service.
• What funders can you approach?
• Which funders’ values align with the outcomes of your group programme?

In our Worcester example we invited a number of NPOs and ECD centres to an information session about the year‑long programme.  After the session, participants were encouraged to sign up and were given two weeks to apply.  Baseline assessments were then completed with every person who signed up.  Participants were then split into two cohorts: one for ECD practitioners and one for NPO leaders, each group with approximately 10 – 12 people.

Step 2: Sourcing Members and Communicating Value

• Consider how you will source group members.
• How will you encourage them to sign up?
• What is the value of your group for potential participants?

For us, the overall outcome for both cohorts was identical: to empower community leaders to inspire others, to become effective leaders within their own NPOs, and to recognise a broader responsibility for shaping their communities, in short, to become agents of change.

If you’re planning a programme, make sure the outcome is clearly defined from the start; it becomes your compass for recruitment, content and evaluation.

Step 3: Define the Overall Programme Outcome and Needs

• Determine your overall outcome for the programme.
• Consider what needs or problems you will be addressing with your programme.

Map the needs you’re addressing (trauma, burnout, workplace skill gaps, market access, etc.) and link every activity back to that outcome.

Step 4: Structure, Frequency and Theoretical Basis

• Determine how you will reach your overall programme aim.
• How often should group members meet?
• What should be incorporated to meet the outcome?
• Decide what theoretical basis will be the foundation of your groups.

For the MoreThanMeerAs NPC / Pool Family Trust collaboration we decided on three one‑week group sessions over the year: two one‑week group‑therapy blocks and one creative week grounded in the Model of Creative Ability, during which group members identify and complete a group project.  Between these intensive weeks we scheduled  monthly follow‑up sessions to support integration and application of learning.

Step 5: Weekly Outcomes and Session Goals

• Determine outcomes for each week and then the goals for each group session in the programme.

We set clear weekly outcomes.  Week one focused on healing – trauma is pervasive and undermines people’s capacity to dream and engage.

Week two focused on nurturing leadership skills and fostering an awareness of responsibility towards the greater community.  Each week’s outcome was further broken down into session goals.

Step 6: Design Sessions and Write Group Protocols

• Now design a group for each session and write a group protocol for it.

For the Pool Family Trust Programme:

• The two group‑therapy weeks ran Monday – Friday, 9:00 – 16:00, at a specific venue identified in advance.
• One week is presented in March/April and the other in September/October to allow time for deep healing and integration between blocks.
• Each week has a specific outcome (Week 1: Healing; Week 2: Leadership and Community Responsibility).
• Each week was divided into group sessions plus time for journaling and reflection.  In our programme each week contained nine groups; each group session was roughly two hours long.
• We wrote a group protocol for every session and collated these into a manual.  Each protocol included: a clear goal for the group; an activity designed to enable that goal; and a post‑activity discussion for reflection and consolidation.
• Facilitation was grounded in Interaction Group Model (IGM) principles: here‑and‑now attention, use of I‑language, direct communication, process illumination, facilitating instead of lecturing, building cohesion and deep engagement, promoting reflective self‑awareness, and encouraging new healthy behaviour patterns and relationship building.
• Even with written manuals, facilitators remained open to the emergent group process and responsive to members’ needs.
• At the end of each week participants were asked to provide feedback to funders.

Step 7: Evaluation, Testimonies and Feeding Back to Funders

• Plan how you will evaluate the programme and measure the impact of your groups on community members.
• Request group members provide testimonials of their experiences.
• Give feedback and reports to your funder.

After the second group therapy week with the NPO leaders we collected feedback that included statements such as:

• “I better understand my team members and see that they have different strengths than me”.
• “My relationships at home have changed”.
• “I can now move forward in my life; my ‘handbrake’ is no longer holding me back”.
• “I felt hopeless and now have hope for my community”.
• “This group is my ‘other’ family”.

These qualitative responses, together with attendance and any practical indicators you choose (job placements, market activity, or new initiatives started by participants, and the like), form the backbone of funder reporting and future bids. We completed re-assessments to ensure we did not only focus on subjective experiences but also on objective measures.

How the Community Groups Differ from Inpatient Mental Health Groups and How They are the Same

The structure I use for community groups is the same format I use when I facilitate mental health groups; the difference lies in the overall outcome and therefore in the specific goals and activities.  The “what” changes (content, activities, outcomes, etc.), but the “how” remains consistent.  The IGM and its facilitation principles are robust and apply across population groups.  I have been privileged to facilitate groups for:

• Persons who are homeless;
• Home‑based carers suffering from burn‑out;
• Persons with disabilities who want to enter the open labour market;
• Team‑building cohorts; and
• Touwsriver community members working to take responsibility for their area.

There is something sacred and deeply satisfying about this work; seeing people heal, come alive when they are heard and seen, be validated, and be accepted for who they are irrespective of their past.  It is joyful and humbling to watch people reclaim their energy and belonging. 

Practical Facilitation Tips (Straight from Practice)

• Keep group size around 10 – 12 people for meaningful engagement.
• Use baseline assessments with a short application window to manage selection and readiness (we used a two‑week application window after the information session).
• Combine emotional work (healing, regulation, reflective practice) with vocational or practical tasks (planning,  social skills, small‑enterprise practice).
• Build in time for journaling and reflection after active sessions.
• Schedule monthly follow‑ups between intensive blocks to support transference of information and integration.
• Write protocols for consistency but stay flexible to follow the group’s process.
• Consider the benefits of including  a creative project week (Model of Creative Ability) to practice planning, collaboration, and hands‑on delivery.

Final Reflection and Invitation

If you’re an OT reading this, I want to say please move into this space.  Community group work heals individuals and strengthens communities.  It prepares people for the open labour market and creates visible contributions to households and neighbourhoods.  The IGM and creative approaches work across populations; they are tools that allow us to “Heal SA one group at a time.”

If you’d like to implement this model, I can consult with your team and guide you through the process sharing key insights, implementation steps, and high‑level frameworks and co‑design a programme timeline and session structure tailored to your context. I remain committed to growing this work because I have seen hope return, well‑being improve, leadership skills form, and real change happen when groups are effectively facilitated and inclusion is genuinely embraced.