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23rd Meeting of the Society for Psychotherapy Research
              Ravenscar, UK, March 2010
              www.psychotherapyresearch.org


              Compendium: A computerised
              programme for the tracking and
              measurement of group process

              Marion Brown, Andy Downie, Nicole Howard
              Oxfordshire and Buckinghamshire Mental Health
              NHS Foundation Trust, Aylesbury

              Simon Buckingham Shum
              Knowledge Media Institute
              Open University, Milton Keynes
                                                                       1
© Simon Buckingham Shum
How do we evidence that group analytic process
   is an effective medium of change?

     Group analysts believe that group process is a vital factor in
      helping individual members change pathological patterns of
      relating to themselves and others?

     This is complex to record and measure: notes alone rarely do it
      justice

     Cognitive science and information design give us ways to
      visualize complex phenomena

     A good visualization relieves memory load, and draws analysts’
      attention to significant aspects

     Any map filters out noise in order to support specific kinds of
      interpretation

     “Compendium” is a way to map group process, with the addition
      of a database, in order to build a searchable evidence base
                                                                        2
© Simon Buckingham Shum
How do we record and understand what’s
   happening in a group?

     How do we demonstrate that this process enables
      change in individual members?
             By tracking interactions in the group
             Identifying significant themes, key moments and
              patterns…
                     between members

                     between members and the group as a whole

                     within individual members

             Understanding how these change over time

                                                                 3
© Simon Buckingham Shum
Murray Cox: Group Interaction Chronogram


                          Patient:


                                     iii End        i Beginning




                                               ii Middle




© Simon Buckingham Shum
Murray Cox: Group Interaction Chronogram
                                                        iii End        i Beginning



                                                             ii Middle




                            iii End       i Beginning
                                                                                          iii End       i Beginning


                                    ii Middle
                                                                                               ii Middle




                                                                                      ?
                                    +
                                                                                      +
                          iii End       i Beginning                 -                       iii End       i Beginning

                               ii Middle
                                                                                                    ii Middle




                                                         iii End        i Beginning



                                                                  ii Middle




                                                        Therapist
© Simon Buckingham Shum
Compendium software (Open University)
   http://compendium.open.ac.uk/institute



     “Semantic hypermedia” software

             grounded in 25 years’ computing research in the design
              of flexible tools for managing information and ideas

     Analogy: “a spreadsheet for ideas”

             tools to build a visual language, and arrange, connect,
              index and search information and ideas

     A bit like mindmapping, but with a full database
      underpinning it to enable a long-term evidence base

     Free and open source, works on all platforms, funded
      by UK Research Councils (AHRC; ESRC; EPSRC; e-Science Programme; JISC)   6
© Simon Buckingham Shum
© Simon Buckingham Shum
Context: A brief focused analytic group

       A closed 24 session homogeneous analytic group
        comprising 8 individuals, 4 male, 4 female and one
        group conductor
       Group members were within the moderate to severe
        level of mental health difficulty
       All had complex personal and mental health histories
        leading to significant difficulty in intrapersonal and
        interpersonal relationships in their adult lives
       The theme that emerged most clearly at assessment
        was repressed and/or suppressed anger correlating
        with severe anxiety/panic and depressive
        symptomatology
       This formed the group focus
                                                                 8
© Simon Buckingham Shum
Theme 1: Anger




            Analyst’s
         record of her
         interpretation
          to the group
              on the
            emerging
              theme

                          9
© Simon Buckingham Shum
Theme 2: Reaching out to one of the group




     The tags on a
     patient’s icon
       show the
      behaviours
     perceived by
      the analyst




                                               10
© Simon Buckingham Shum
Theme 3: Medication




        Analyst’s
      notes on the
       theme that
        emerged
      towards the
         group’s
       conclusion




                          11
© Simon Buckingham Shum
The individual in the group




                                   Map of the
                                 group from a
                                    specific
                                  individual’s
                                 perspective




                                                 12
© Simon Buckingham Shum
Map of all dynamics

    No links from         Highly active
        other                patient
     patients…
                                   Red ring
                                   reminds
                                analyst of one
                                patient’s effect
                                 on the group




     Private                       Particularly
      notes                           strong
       on a                        relationship
     patient
       (dashed
         link)                                 13
© Simon Buckingham Shum
Which behaviours do two patients share?
   Tags shared in common are orange, tags from one patient in green




                                                                      14
© Simon Buckingham Shum
Analysing the evidence base across sessions




                                                 15
© Simon Buckingham Shum
Analysing a patient across Sessions 1 and 11




       Focusing on the
       “tag profile” for a
       patient in different
       sessions
                                                  16
© Simon Buckingham Shum
Next steps (1):
   additional ways of evidencing changes
   Group level:
             Compare maps from two or more sessions by placing
              them next to each other
             Compare the group tag profiles from sessions: by
              selecting all nodes in a map, all relevant tags ‘light up’
   Individual level:
             Compare the tag profile for a patient over time, from pre-
              group assessment, through early, midway and closing
              sessions, to review.
             Compare relationships between specific patients across
              sessions

© Simon Buckingham Shum
Next steps (2):
   additional ways of evidencing changes
   Technological potential:
             Video annotation: indexing video data with icons and
              connections
             Summary reports/graphs generated from the incidence
              of tags, links, etc


   Theoretical potential:
             We would hope to see a shift from negative to more
              positive tags over time
             Can we find patterns in tags or links congruent with
              theoretical predictions? (e.g. matching tags between
              patients = “mirroring”)
© Simon Buckingham Shum

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Compendium... for tracking group process

  • 1. 23rd Meeting of the Society for Psychotherapy Research Ravenscar, UK, March 2010 www.psychotherapyresearch.org Compendium: A computerised programme for the tracking and measurement of group process Marion Brown, Andy Downie, Nicole Howard Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, Aylesbury Simon Buckingham Shum Knowledge Media Institute Open University, Milton Keynes 1 © Simon Buckingham Shum
  • 2. How do we evidence that group analytic process is an effective medium of change?   Group analysts believe that group process is a vital factor in helping individual members change pathological patterns of relating to themselves and others?   This is complex to record and measure: notes alone rarely do it justice   Cognitive science and information design give us ways to visualize complex phenomena   A good visualization relieves memory load, and draws analysts’ attention to significant aspects   Any map filters out noise in order to support specific kinds of interpretation   “Compendium” is a way to map group process, with the addition of a database, in order to build a searchable evidence base 2 © Simon Buckingham Shum
  • 3. How do we record and understand what’s happening in a group?   How do we demonstrate that this process enables change in individual members?   By tracking interactions in the group   Identifying significant themes, key moments and patterns…   between members   between members and the group as a whole   within individual members   Understanding how these change over time 3 © Simon Buckingham Shum
  • 4. Murray Cox: Group Interaction Chronogram Patient: iii End i Beginning ii Middle © Simon Buckingham Shum
  • 5. Murray Cox: Group Interaction Chronogram iii End i Beginning ii Middle iii End i Beginning iii End i Beginning ii Middle ii Middle ? + + iii End i Beginning - iii End i Beginning ii Middle ii Middle iii End i Beginning ii Middle Therapist © Simon Buckingham Shum
  • 6. Compendium software (Open University) http://compendium.open.ac.uk/institute   “Semantic hypermedia” software   grounded in 25 years’ computing research in the design of flexible tools for managing information and ideas   Analogy: “a spreadsheet for ideas”   tools to build a visual language, and arrange, connect, index and search information and ideas   A bit like mindmapping, but with a full database underpinning it to enable a long-term evidence base   Free and open source, works on all platforms, funded by UK Research Councils (AHRC; ESRC; EPSRC; e-Science Programme; JISC) 6 © Simon Buckingham Shum
  • 8. Context: A brief focused analytic group   A closed 24 session homogeneous analytic group comprising 8 individuals, 4 male, 4 female and one group conductor   Group members were within the moderate to severe level of mental health difficulty   All had complex personal and mental health histories leading to significant difficulty in intrapersonal and interpersonal relationships in their adult lives   The theme that emerged most clearly at assessment was repressed and/or suppressed anger correlating with severe anxiety/panic and depressive symptomatology   This formed the group focus 8 © Simon Buckingham Shum
  • 9. Theme 1: Anger Analyst’s record of her interpretation to the group on the emerging theme 9 © Simon Buckingham Shum
  • 10. Theme 2: Reaching out to one of the group The tags on a patient’s icon show the behaviours perceived by the analyst 10 © Simon Buckingham Shum
  • 11. Theme 3: Medication Analyst’s notes on the theme that emerged towards the group’s conclusion 11 © Simon Buckingham Shum
  • 12. The individual in the group Map of the group from a specific individual’s perspective 12 © Simon Buckingham Shum
  • 13. Map of all dynamics No links from Highly active other patient patients… Red ring reminds analyst of one patient’s effect on the group Private Particularly notes strong on a relationship patient (dashed link) 13 © Simon Buckingham Shum
  • 14. Which behaviours do two patients share? Tags shared in common are orange, tags from one patient in green 14 © Simon Buckingham Shum
  • 15. Analysing the evidence base across sessions 15 © Simon Buckingham Shum
  • 16. Analysing a patient across Sessions 1 and 11 Focusing on the “tag profile” for a patient in different sessions 16 © Simon Buckingham Shum
  • 17. Next steps (1): additional ways of evidencing changes Group level:   Compare maps from two or more sessions by placing them next to each other   Compare the group tag profiles from sessions: by selecting all nodes in a map, all relevant tags ‘light up’ Individual level:   Compare the tag profile for a patient over time, from pre- group assessment, through early, midway and closing sessions, to review.   Compare relationships between specific patients across sessions © Simon Buckingham Shum
  • 18. Next steps (2): additional ways of evidencing changes Technological potential:   Video annotation: indexing video data with icons and connections   Summary reports/graphs generated from the incidence of tags, links, etc Theoretical potential:   We would hope to see a shift from negative to more positive tags over time   Can we find patterns in tags or links congruent with theoretical predictions? (e.g. matching tags between patients = “mirroring”) © Simon Buckingham Shum