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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 OF THE INDIVIDUAL MEMBER
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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TERMINATION OF THE INDIVIDUAL MEMBER
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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TERMINATION OF THE INDIVIDUAL MEMBER
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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TERMINATION OF THE INDIVIDUAL MEMBER
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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TERMINATION OF THE INDIVIDUAL MEMBER
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
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