9 Termination

7/27/2019 9 Termination

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TERMINATIONTHE CONCLUDINGPHASE OF GROUP THERAPY; A CRITICALLY

IMPORTANT BUT FREQUENTLY NEGLECTEDPART OF TREATMENT.

Yalom p. 382 - 390


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TERMINATION

Word Termination often has negativeconnotations

However, a mutual, planned ending to

therapy is an integral part of therapeuticwork

It includes:

Review

Mourning

Celebration of and preparation forcommencement of the next phase of life


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TERMINATION

Feelings about termination must be

explored from different perspectives:

The individual member

The therapist

The group as a whole


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TERMINATION OF THE INDIVIDUAL MEMBER

Largely dependent on the length and goals oftherapy

Even though further potential for growth may

be clear, therapist must, in some cases ask,will further growth be countertherapeutic?

E.g. A client might, with further change,

outgrow her spouse rupturing of anirreplaceable relationship unless concomitantchanges occur in the spouse


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Termination is appropriate when the client is

able to use psychotherapeutic resources

constructively in their personal environment

Prepare for setbacks after termination

some will need to seek short term help from

time to time


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Almost all members experience anxiety and

depression just before or after leaving a

group

A period of mourning is an inevitable part of

the termination process

Termination may evoke memories of earlier

losses


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BEHAVIOURS TO LOOK OUT FOR

Process may be so intolerable that someindividuals:

Withdraw prematurely to avoid the issue entirely

Act out and devalue the group/members Experience a brief recurrence of original

symptomotology

Manifest increased tardiness/absence

Begin to share hitherto concealed material Invent reasons why they must stay in the group

Therapists role is to help client understand the

behaviours for what they are: protest against


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N.B. Termination can be very problematic for

clients particularly sensitized to

abandonment illness/symptoms become the

tool through which they remain in the group

In an attempt to avoid termination, these

clients may minimise or conceal progress


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Fear of endings may dictate clients wholepattern of avoiding connections and avoidingintimacy

They may also have a history of abruptlyending relationships in a manner that is coldand jarring

Therefore to ignore this phase of therapy isto neglect an important area of humanrelationshipsthroughout ones life, onemust say goodbye to important people


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Many terminating members attempt to lessenthe shock of departure by creating bridges tothe group they can use in the future

Therapist must not collude in the denial oftermination ending should be clear andfocused, nota petering out

As a rule, clients who complete individualtherapy may return, but clients who leave thegroup can never return


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EFFECT OF ONE MEMBER LEAVING

Each members graduation from the groupmust be processed:

Competitive members may rush towardpremature separation

Senior members may feel envy or shame (inextreme cases devalue the achievement of thegraduating member)

Newer members may feel intimidatedTherefore, generally wise not to bring in new

members without reserving one or twomeetings to process loss of a member


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TERMINATION AND THE THERAPIST

Therapists MUST examine their own feelingsabout the termination process and goodbyes

We may unaccountably and unnecessarily delay

a clients termination Perfectionist therapists may expect too much,

refusing to accept less than perfect resolution

Pride may step in: difficult to say goodbye tosomeone who is, in part, our creation

We may lack faith that client can go on withoutus


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TERMINATION AND THE THERAPIST

Therapist must work through own issues

surrounding terminating the group/group

member in order to become an effective

model of letting go

It is no easy task: Therapists as well as

members, will miss the group/group

membersWork is best facilitated by therapist disclosing

true feelings

9 Termination

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