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1
Topic: Practitioners knowledge and skills in the use of group dynamics in Community Based rehabilitation (CBR) programmes in Uganda by Phoebe Katende.
 

Introduction:
Group dynamics is viewed from the perspective of the positive power that groups tend to acquire and influence their members over time. This process is gained through their formation and how successfully they handle internal struggles. This also requires their ability to establish effective norms and begin to perform collectively on agreed tasks. This in the long run influences the behaviour of their individual members for positive change.
CBR practitioners believe that group dynamics is an important part of the rehabilitation process, but there has been no analysis as to whether the CBR training curricula adequately caters for these techniques. There is need to establish whether to improve the training curricula so that it adequately caters for the group interaction processes. Thus the need to deliberately include group dynamics at all levels in CBR training.

Benefits of group dynamics.
Social workers often work with groups to achieve the social integration of marginalized groups in community development activities (Hyde, 1999). As social integration is one of the main goals of CBR, group work may also be an effective tool for practitioners. This idea is further explained by Timmel and Hope (1999), who say that the most important first step in any process of empowerment is giving those who have been oppressed a new confidence. This is possible in a group interaction process, where issues like group composition or size of the group is considered to be a means of promoting the social functioning of an individual. These processes shape an individual for leadership, confidence building, better decision making, and taking responsibility, all important skills for CBR practice. Group dynamics techniques are vital for CBR training programmes and should be encouraged.


CBR curricula coverage of group dynamics.
Although CBR might benefit from the use of group dynamics, most CBR curricula do not effectively reflect group dynamics. For instance the Community Based Rehabilitation Alliance (COMBRA) CBR training curriculum might address group dynamics when dealing with community development strategies. In Ministry of Gender, Labour and Social Development (MGLSD) the trainees may be introduced to group dynamics under the teaching and learning. Other areas of group dynamics in the curricula include; leadership styles, group processes, pressure groups, types of groups, group formation and networking. The UNISE courses cover group dynamics under income generating activities, empowerment and participation. This situation is not only characteristic of Uganda, but also other curricula. (Peats, 1997), includes interpersonal and communication skills in the core CBR training programmes. All these efforts to include group dynamics are not adequate.

Assessing the knowledge and skills of CBR practitioners in group dynamics.
In order to measure the knowledge and skills of CBR practitioners in the use of group dynamics, a study was done in Mbarara district in Uganda. The participants were 30 trained and 30 untrained CBR practitioners. The participants’ knowledge was tested in key areas such as group composition, roles in groups, decision-making, communication patterns and group norms.
The results of the test showed little difference in knowledge of group dynamics between trained and untrained practitioners. Only 8 participants passed the knowledge test, all of whom had received CBR training.

In order to measure group dynamics skills, the participants were given hypothetical situations, in which they had to determine which skills they would apply. The results showed that the trained practitioners were more skilled in decision making, leadership and problem solving compared to the untrained practitioners.
• 55 % of the trained CBR workers knew decision making compared to 5% of the untrained.
• 39 % of the trained and 10 % of the untrained knew problem solving techniques.
• Both groups had basic skills in conflict resolution.
• 13 % of the trained CBR workers and 16 % of the untrained could at least influence the communication process.
• 63% of the trained and 12 % of the untrained CBR workers showed leadership qualities.
These results showed that there is need for more training for CBR practitioners.

Another study was conducted to measure the effect of group dynamics to PWDs and their care givers. The participants were 160 PWDs and care givers, who were all members of CBR groups. Each participant was interviewed and asked about his/her participation in activities of daily living, confidence gained, leadership skills and obtaining of appliances. The results were as follows:
• Of the 160 people participating in five or more activities of daily living 14.6 % were working with trained CBR practitioners and 2.5 % with untrained;
• 20.3 % of participants working with trained practitioners had gained confidence since starting the programme as opposed to 13.4 % working with untrained practitioners;
• 20.3 % of those working with trained practitioners had leadership skills, as opposed to 13.4 % working with untrained practitioners;
• 24.8 % of the participants working with trained practitioners were able to independently obtain appliances like wheel chairs and crutches as opposed to 13.4 % working with untrained practitioners.


Although many CBR curricula do not adequately cover group dynamics, these results suggest that CBR workers trained in these skills have more impact on the quality of life of PWDs and their care givers.

Recommendations.
CBR trainers should include group dynamics in CBR curricula. This could be achieved by:
• designing a tool, which measures the knowledge and skills of CBR practitioners, so that tailor made courses can be designed.
• organizing workshops for training institutions to identify areas of group dynamics for the curricula.

Conclusion.
The result of these studies indicates that group dynamics should be included in CBR training programmes. The use of group dynamics theory has the potential to improve CBR practice. This will assist with improving the quality of life PWDs.

 
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CBR Section, Faculty of Special Needs, Kyambogo University, P.O.Box 114 Kyambogo Uganda, Tel: 0414 574462 , Email:: info@afri-can.org or grace@afr-can.org

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