The final stage of therapy is often referred to as consolidation or termination phase. It is noteworthy that modern researchers and practitioners tend to avoid using the word termination due to its negative connotation (Maples & Walker, 2014).
The positive approach to this portion of group psychotherapy often shapes the activities employed as well as the atmosphere the leader of the group is trying to establish. The focus should be on the participants’ progress rather than the end of the therapy. It is essential to consider some of the most important steps to undertake in order to ensure the effectiveness of this phase and the best client outcomes.
Effective Termination
One of the critical measures to implement is the participants’ preparation for the final stage and the last sessions. Donovan (1988) notes that termination can be a challenging period for some members of the groups especially when it comes to vulnerable groups. In order to avoid negative feelings or even clients’ regression, it is necessary to start discussing the consolidation phase as early as the working stage.
It can be beneficial for the participants to discuss some coping strategies related to the termination of relationships (Corey, 2015). Although male combat veterans can seem resilient enough, it is essential to make sure that all the members of the group are capable of going through the end of sessions. Transparency is one of the most important features of consolidation as it assists clients in becoming prepared for parting with the leader of the group and peers. The participants should be reminded that the sessions will end at a certain period and certain goals should be achieved by then.
It is also necessary to pay considerable attention to the goals that have been established at the beginning of the therapy and ways to maintain the participants’ focus on their attainment. Consolidation presupposes coming to conclusions and developing effective plans that can help group members in their life. It is pivotal to be sincere and evaluate the progress of each client properly. The leader should initiate discussions of the clients’ relationships with people outside the group and ways to improve them. The leader of the group should ensure that the atmosphere is positive and empathic during all stages of the therapy, but it is vital for the consolidation stage.
Interventions
One of the interventions that can be effective during the consolidation stage is the discussion of the participants’ progress. This can be held in the form of a pretend game. The participants can receive cards with certain roles randomly. The clients can be offered three roles: completers, runners, and escapers. Completers are the group members who attained the set goals and terminate the therapy with a sense of satisfaction.
Runners are those who have made certain progress but still have some issues and can find it difficult to take their leave. Escapers are group members who have made little or no progress but are willing to part with the group and never come back. Each veteran will contemplate on his hypothetical feelings, reasons for their status, and ways to make progress. After each reflection, the members of the group should provide their feedback and share their views on possible strategies to help their peer. They should give some pieces of advice as to the follow-up strategies.
At the end of such discussions, the veterans can be encouraged to identify their exact status and share their ideas on coping strategies suggested during the intervention. In this way, the clients will learn about ways to cope with certain issues and will be able to evaluate different strategies, as well as their applicability in their situation. This intervention is also instrumental in helping the participants to accept the fact that the therapy is coming to an end.
As far as the challenges associated with this intervention are concerned, the clients can be reluctant to share their real status. However, they can be asked to reveal it in an essay where they will reflect on their status and ways to achieve the goals that have been set at the beginning of the therapy. Based on these writings, the leader can initiate a discussion without mentioning any names. The leader can also find it difficult to accept the exact progress of each client.
Some people may be inclined to have a more optimistic perspective than it is in reality. In order to mitigate this risk, the leader should have a journal with written goals and the progress of each group member. The leader can always compare the established objectives with the current state of the client. This meticulous documenting can help the leader of the group remain objective.
Evaluation
During the consolidation stage, it can be helpful to use some instrument to evaluate the clients’ current status. For instance, combat veterans with PTSD can complete the Mississippi Scale for Combat-Related PTSD, which will help in identifying the severity of their health issue. This tool addresses people’s feelings regarding their present life and the level of integration into society. Another important evaluation measure is the participants’ feedback concerning the therapy. Veterans can reflect on it during a session or can write their thoughts out and share some of the most crucial ideas with the group.
During the last sessions of the therapy, the leader should provide some follow-up to the members of the group. Veterans should be invited to discuss the way they interact with their close ones and other people. It is essential to focus on feelings and ways to ensure a positive attitude. The leader can also provide a set of checkup lists that can help veterans to cope with negative ideas and emotions. It is also possible to give clients a booklet containing resources that can be helpful for the members of the group.
Summary
In conclusion, it is possible to note that the consolidation stage is the period to draw conclusions, consolidate, and help the members of the group to prepare themselves for life without the therapy. Some people may find it easy to part with the group leader and peers, but some patients can fail to cope with this experience. Therefore, the leader should continuously mention that the therapy has certain goals and it will be terminated at a specific period of time.
Transparency is the key to effective consolidation, and it is essential to concentrate on the established goals and the level of their attainment. Another important point to remember is the identification of each client’s progress or the absence of any positive changes. The leader should share this information with clients so that the latter could understand what they achieved and what is yet to be attained.
References
Corey, G. (2015). Theory and practice of group counseling (9th ed.). Boston, MA: Cengage Learning.
Donovan, A. (1988). Transparency and termination in group psychotherapy: A resident’s perspective. Jefferson Journal of Psychiatry, 6(2), 46–53. Web.
Maples, J. L., & Walker, R. L. (2014). Consolidation rather than termination: Rethinking how psychologists label and conceptualize the final phase of psychological treatment. Professional Psychology: Research and Practice, 45(2), 104-110. Web.