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Introduction
Upon the completion of the working portion of a group, the final stage becomes prominent. It is termed by Corey (2015) as the stage of termination and consolidation, and despite being less time-consuming than the previous phase, it is also crucial for the effectiveness of the therapy. In this paper, this stage and its features will be considered and connected to a brief psychoeducation therapy for people with depression. The methods of terminating the group and related interventions will be discussed, and evaluation plans will be made. The paper will demonstrate that the final stage needs to be handled with utmost care.
Effective Termination
The problems of termination are rather multi-faceted, and therapists have different approaches to this stage (Norcross, Zimmerman, Greenberg, & Swift, 2017), but certain common features can be determined. First, the issue of termination should not be ignored; it is vital to bring it up in time and provide members with the guidance that they need for a successful closure (Corey, 2015). Second, the goals of the stage need to be recognized; basically, it aims to ensure the ability of the members to apply the information and skills that they learn to non-therapy settings (Corey, 2015; Norcross et al., 2017).
As a result, sufficient attention needs to be paid to helping the members revisit the newly discovered knowledge (which is especially relevant for a psychoeducational group that is being proposed), consolidate it, and think of the ways in which it can be practiced in their real life.
Pre-termination stages are also going to involve such activities to an extent, but the termination one focuses on it. Finally, the management of termination depends on integrity and honesty; the challenges of it need to be acknowledged and discussed the way similar hurdles were addressed during the initial stages (Corey, 2015). To summarize, as recommended by the literature on the topic, the proposed group will be terminated effectively if the challenge is approached directly to achieve knowledge consolidation and transfer the group’s effects into the members’ everyday life. The specific tools that are required to deliver that outcome are discussed below.
Interventions
The general interventions that are employed during this stage are reflected by their name. Thus, it is necessary to consolidate the lessons of the group by revisiting the topics that have been covered, as well as interpreting and reevaluating them (Corey, 2015; Cupractice, 2011). Furthermore, it is helpful to celebrate the members’ progress and accomplishments and encourage them to recognize their own role in any improvements (Norcross et al., 2017).
In general, feedback is an important tool for this stage (Corey, 2015). Moreover, to ensure the transition to non-group environments, it is essential to help members construct goals and plans for post-group periods (Norcross et al., 2017).
For example, the depression-focused psychoeducation groups that were studied by Tanoue et al. (2018) and Tong et al. (2019) employed this intervention as the primary method of terminating. According to many of the professionals surveyed by Norcross et al. (2017), such plans should incorporate the possibility of challenging days and failures; they need to be normalized, and participants should examine the resources that they can employ in such situations. This suggestion seems to be particularly important for people with depression since it may be a chronic condition.
These activities are going to take up one or two sessions; it is currently planned to remind the participants about the ending of the group two sessions before the final one and task them with reflection homework. In it, they will summarize their lessons and consider the impact of the group on them, as well as their feelings about the group and its termination. These considerations will become the theme of the final sessions.
The primary functions of the leader and group members are likely to be similar to those performed during previous stages. Indeed, the leader should be focused on offering guidance, and the members should employ the group’s opportunities to their benefit and assist themselves and others in consolidating their psychoeducation. However, there are significant problems and obstacles in performing these roles. A very common difficulty is that the stage may be associated with various negative or stressful feelings, including, for instance, uncertainty, anxiety, and even grief; members and the leader may experience them (Corey, 2015; Cupractice, 2011; Donovan, 1988; Pessagno, 2013).
Processing and discussing such emotions can help; it is also reasonable to encourage the participants to share their feelings about the therapy in general, including positive and negative ones (Corey, 2015; Donovan, 1988; Norcross et al., 2017). Furthermore, reflection can assist in the process; the above-described reflection homework will help in ensuring that the members review the various elements of the group and its termination, including their emotional reaction to it.
The termination stage is also associated with any unfinished activities; Corey (2015) points out that some issues might not even be resolved by the end of the group, but they should still be discussed and addressed. If possible, their solutions might be incorporated into future plans. In addition, the conceptualization of knowledge and therapy outcomes may be a challenge that the leader can help to resolve by guiding a member toward a more critical perspective on the events. Finally, a major issue that Corey (2015) highlights is that participants might perceive the end of the group as the end of their efforts to address their problem.
The above-presented planning intervention should help to resolve this concern. In summary, the specifics of the stage determine its potential difficulties and obstacles, but with the help of honesty and self-reflection, the leader may encourage the members to approach and resolve them.
Evaluation
After the final stage, the concerns of evaluation and follow-ups are to be reviewed. For this group, it is proposed to perform evaluations during its first session and the termination stage. Special tools will be prepared for the group, although they will incorporate some elements of Beck’s Depression Inventory, which is the most common instrument for depression assessments (García-Batista, Guerra-Peña, Cano-Vindel, Herrera-Martínez, & Medrano, 2018).
In general, however, the tools will be interconnected and focused on a goal-based assessment system to help members establish their own goals and check their progress. In addition, the final evaluation will include a set of questions about the group and group leader’s activities; they will be used to find out how the process could be improved. Also, based on Corey’s (2015) recommendation, one pre-negotiated follow-up will be arranged for discussing the long-term effects of the group, providing support, and motivating members to carry out the post-group plans. The date will be determined based on the participants’ preferences, but about one month is expected to pass between the final session and the follow-up one.
Summary
The difficulties of the termination stage are the result of its features and importance. Participants may find it challenging and disheartening, and negative emotions may also be a concern for the leader. However, if everybody is given enough time to prepare to and reflect on the group and its termination, the problem should be resolved. The interventions of this stage will be aimed at summarizing and reevaluating the group’s accomplishments and assisting with their application outside of the group. Multifunctional assessment tools will be used during the first and last sessions, and a follow-up session will be scheduled to motivate participants and assess their progress.
References
Corey, G. (2015). Theory and practice of group counseling (9th ed.). Belmont, CA: Thomson Brooks/Cole.
Cupractice. (2011). Group 1 ending stage (12:19 minutes) [Video file]. Web.
Donovan, A. (1988). Transparency and termination in group psychotherapy: A resident’s perspective. Jefferson Journal of Psychiatry, 6(2), 46–53. Web.
García-Batista, Z., Guerra-Peña, K., Cano-Vindel, A., Herrera-Martínez, S., & Medrano, L. (2018). Validity and reliability of the Beck Depression Inventory (BDI-II) in general and hospital population of Dominican Republic. PLOS ONE, 13(6), e0199750. Web.
Norcross, J., Zimmerman, B., Greenberg, R., & Swift, J. (2017). Do all therapists do that when saying goodbye? A study of commonalities in termination behaviors. Psychotherapy, 54(1), 66-75. Web.
Pessagno, R. (2013). Group therapy. In K. Wheeler (Ed.), Psychotherapy for the Advanced Practice Psychiatric Nurse (pp. 407-420). New York, NY: Springer.
Tanoue, H., Yoshinaga, N., Kato, S., Naono-Nagatomo, K., Ishida, Y., & Shiraishi, Y. (2018). Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study. International Journal of Nursing Sciences, 5(3), 218-222. Web.
Tong, P., Bu, P., Yang, Y., Dong, L., Sun, T., & Shi, Y. (2019). Group cognitive behavioural therapy can reduce stigma and improve treatment compliance in major depressive disorder patients. Early Intervention in Psychiatry, 2019, 1-7. Web.
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