GROUPWORK DESIGN

____________________________
(Name of the Group)

I. INTRODUCTION (1 page)

II. GENERAL DESCRIPTION

Name of the Group :

Group Size/Population :
Members Profile :
INDIVIDUAL FOCUSED
1. NAME ___________________________________________________________
Problem Presented: _________________________________________________
Assessment___________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________
2. NAME ___________________________________________________________
Problem Presented: _________________________________________________
Assessment___________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________
3-15. (continue)

CONSOLIDATED INFORMATION OF GROUP MEMBERS

NAME AGE GRADE/YR SEX CHARACTERISCTIC PROBLEM NEED/S

LEVEL S PRESENTED

Group Criteria : example

Fatherless children age ranging from 11-15 yrs ld
Resident/ward of __________
Willing to learn ad participate
 A student in
Ages :____________________________________
Kind of Group :____________________________________
Type of Group :_____________________________________
Address/Location :_________________________________
Group Model/Approach :Developmental/Educational/Rehabilitative, etc
Time Frame : _____________________________________
Number of Sessions :_____________________________________
Clientele Category :_____________________________________
General Goal :______________________________________
Specific Objectives :
1.
2.
3.

Group Commonality of Needs: 1.

2.
3.

III. COMMON PRESENTING PROBLEM OF THE GROUP :

IV. ASSESSMENT STATEMENT (GROUP FOCUSED )

IV.INTERVENTION PLAN

GOAL: ________________________________________________________________

OBJECTIVES ACTIVITIES INPUT/ENABLING TIME EXPECTED OUTCOME/S

MECHANISM FRAME OUTPUT

V. EVALUATION (1. What is their common problem? 2. What is the cause of that problem? 3.
What are the possible solutions or intervention to that problem/s? AND THEN 4. evaluate
every activities or interventions you have undertaken to the goup, is their any effect or what
is the impact of that interventions towards your group and its members?)
 VI. RECOMMENDATION ( after all the interventions you have done, what will be your
recommendation? For termination or continue?)

NAME OF GROUPWORKERS:

1.

2.

3.

Noted :

______________________________________________
SW 124 Instructor

Documentation :

 Group Sessions
 Photos
 Attendance
 Outputs
 etc

Attachments: (PER MEMBER)

 Intake SHEET
 Individual Profile or INDIVIDUAL CASE STUDY
 Other supporting docs