Essay Grade

13 Ending the Group’s Work
Learning Outcomes
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Explain the factors that influence group endings
Compare the variables that affect planned and unplanned terminations
Identify the techniques for ending group meetings
Describe the steps involved in ending the group as a whole
Chapter Outline
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6.
Factors that Influence Group Endings 395
The Process of Ending 396
Planned and Unplanned Termination
Ending Group Meetings
Ending the Group as a Whole
Summary
The ending stage, a critical part of group work practice, has been given little attention in the
literature since a special issue of the International Journal of Group Psychotherapy was published
in 1996. The skills workers use in the ending stage determine, in part, the success of the entire
group experience. In this stage, workers and members form their lasting impressions of the
group. An otherwise satisfying and effective group can be ruined by a worker who is not skillful
at ending the group’s work. During the ending stage, the group’s work is consolidated. In task
groups, the decisions, reports, recommendations, and other products of the group as a whole are
completed, and consideration is given to how the results of the work can best be implemented. In
treatment groups, the changes made by individual group members are stabilized, and plans are
made for maintaining these gains after the group ends. In groups in which members’ selfdisclosure has been high, it is necessary to help members work through their feelings about
terminating their relationships with the worker and with each other. It is also a time when
workers confront their own feelings regarding ending their work with a particular group. This
chapter examines the tasks and skills involved in ending individual group meetings and ending
the work of the group as a whole.
1. Factors That Influence Group Endings
Endings vary depending on whether a group has an open or closed membership policy.
In closed groups, unless there are unplanned terminations, all members end at the
same time. In these groups, the worker can help all members to deal with common
issues and feelings that arise as the group draws to a close. Open groups present a
more difficult challenge for the worker. Some members may be experiencing reactions
to termination, but others may experience reactions common to the beginning stage of
the group. In open groups, the worker should individualize work with each member.
However, because each member will eventually experience disengagement from the
group, the worker can use the reactions of members who are terminating to help
members who will experience similar reactions in the future.
Endings also vary according to the attraction of the group for its members. In groups
that members find attractive, endings may not be viewed as a positive event.
Conversely, if group meetings are viewed as something to be endured, news of the last
meeting may be received with relief.
In addition, endings vary depending on whether the group is a treatment group or a task
group. In many therapy groups and support groups, for example, members reveal
intimate details of their personal lives. They let down their defenses and become
vulnerable as they share concerns and issues that are important to them. In these types
of groups, mutual aid and support develop as members deepen relationships with one
another and the worker. They come to trust each other and to rely on the therapeutic
advice and suggestions given by the worker and fellow members.
2.The Process of Ending
In therapy, support, and growth groups, termination may be accompanied by strong
emotional reactions. However, in educational and socialization groups, termination
rarely results in the expression of strong emotional reactions.
Terminating the relationships that may have influenced the members of treatment
groups is quite different from terminating the relationships formed in task groups. In task
groups, members’ self-disclosure is generally at a relatively low level. Because the
focus of these groups is on a product, such as a report or the development of a plan of
action, members often look forward to the end of a group with a sense of
accomplishment or with relief that their work is finished. Because they have not let down
their defenses or shared their personal concerns to any great extent, there is rarely an
intense emotional reaction to ending. Also, members of task groups may work together
again on other committees, teams, or councils. Therefore, the endings of task groups do
not have the same sense of finality as do endings of treatment groups.
In the task group literature, the focus is on the skills the leader uses to end individual
group meetings rather than on how the leader ends the entire group experience
(Tropman, 2014). This focus contrasts sharply with treatment group literature that
generally focuses on ending work with the group rather than ending work in a particular
meeting.
Arranging transportation to and from the group may also help. At other times, workers
may find that there are ways they can improve their own skills to prevent members from
dropping out of the group. For example, they may learn to be more gentle or tentative
when they use confrontation methods. A survey of 275 workers who were members of
the American Group Psychotherapy Association engaged in long-term group work found
that the top reason for unplanned termination was that the member was asked to leave
because of disruptive behavior (33 percent). This was followed by 29 percent being
asked to leave the group because there was a poor fit or match between the group and
a member. Other reasons included client threatening to the group (20 percent), member
not committed to the group (19 percent), disruptive dual relationships with another
member of the group (16 percent), and the group was not appropriate for the member
(18 percent). It should be noted that these figures are based on a low response rate to
the survey (11 percent), and over half of the respondents being in private practice and
leading mostly long-term groups (Mangione, Forti, & Iacuzzi, 2007).
Occasionally, an entire group may end prematurely. Just as there are many reasons for
the premature termination of individuals, there are also many reasons for the premature
termination of groups. A group that begins with a small number of members may lose
several members and thus be unable to continue functioning effectively. Groups may
not receive sufficient support from their sponsoring agencies to continue functioning, or
groups may be unable or unwilling to respond to external pressure to change their
functioning.
Groups may also end prematurely as a result of internal dysfunction. For example,
communication and interaction patterns may be poorly distributed and cause
subgrouping, scapegoating, or domination by a few members. The group may lack
sufficient attraction for its members and, therefore, may fail to coalesce or function as a
cohesive unit. Social controls, such as norms, roles, status hierarchies, and power, may
cause severe tension and conflict when some members rebel against the control of the
worker or other members. Lack of appropriate social controls may cause chaos or an
aimless drift that eventually leads to dissolution of the group as a whole. Members may
also have great difficulty deciding on common values, preferences, ways of working
together, or other aspects of the group’s culture.
Whenever workers confront the possibility that a group may end prematurely, they
should carefully examine the factors that are contributing to the problem. It is often
possible to trace a group’s dysfunction back to the planning stage. Careful examination
of the factors that contributed to a group’s demise can help workers avoid such pitfalls
in future groups.
3.Planned and Unplanned Termination
At the beginning of closed, time-limited groups, workers and members decide how
many times the group will meet. At the beginning of other groups where there is no fixed
number of meetings, terminations can result from a variety of factors that are not under
workers’ control, such as when a person leaves an inpatient or residential setting. In
other situations, the worker should discuss with members how termination should occur.
For example, the worker may ask for a two-meeting notice. The extra week can be used
to integrate the changes that are made and to plan for the future. It also discourages
members from ending without notice.
Member Termination
Sometimes members stop attending before the planned ending date. Unplanned
termination of membership is a relatively common experience. Review studies have
found unplanned termination rates of about 30 percent (Barlow, 2013; Burlingame,
Strauss, & Joyce, 2013).
Case Example Premature Termination
In a group for separated and divorced persons, three people did not return to the second group
meeting. When they were contacted, it was found that one person lived 40 miles from where the
group met and, after driving home on foggy rural roads after the first group meeting, had decided
not to return. Another member’s job had unexpectedly changed and required the person to be at
work during the group’s meeting times. It was learned from the third person’s employer that one
of his children had experienced a serious accident. The member called two weeks later to explain
that “I have been running between the hospital and my responsibilities to the other two
[children].”
Research-Informed Practice
Behavior:
Use and translate research evidence to inform and improve practice, policy, and service delivery
Critical Thinking Question:
1. Members often drop out of groups. What do research findings suggest about how the
group worker might prevent premature termination?
In treatment groups in which participation is voluntary, a reduction in membership
sometimes occurs after the first or second meeting of a group. After the initial drop,
groups often develop a stable core of members who continue until the group ends.
When leading groups, workers sometimes find themselves asking rhetorically, “What
have I done to cause members to fail to return to the group?” In follow-up contacts with
members who terminated prematurely, many workers find they did not cause premature
termination.
There is also empirical data that indicates that workers may not be responsible for some
unplanned terminations. For example, when evaluating a smoking-cessation group
treatment program, it was found that members left treatment prematurely for a variety of
reasons (Toseland, Kabat, & Kemp, 1983). Several were dissatisfied with their group or
their group’s leader, but others left for reasons unrelated to their treatment experience.
Although it is commonly assumed that dropouts are treatment failures, in evaluating
eight smoking-cessation groups, it was found that one of seven dropouts left treatment
prematurely because he had stopped smoking and believed he no longer needed
treatment. Another dropout quit smoking before a follow-up evaluation. Thus, it is
important to realize that unplanned termination of members may be the result of their
lack of interest or motivation, particular life circumstances, or other factors beyond the
control of the worker that have little or nothing to do with a worker’s leadership
skills. Toseland and colleagues (1997), for example, found that attendance at group
meetings by older adults in nursing homes was greatly affected by their health status.
Yalom (2005) lists nine factors that may cause group members to drop out of treatment
prematurely. Yalom points out that some members leave because of faulty selection
processes and others as the result of flawed therapeutic techniques (Yalom, 2005).
These factors are presented in the following list.
Factors Leading to Termination
• External factors, such as scheduling conflicts and changes in geographical location
• Group deviancy, such as being the richest group member, the only unmarried
member, and the like
• Problems in developing intimate relationships
• Fear of emotional contagion
• Inability to share the worker’s time
• Complications arising from concurrent individual and group therapy
• Early provocateurs
• Inadequate orientation to therapy
• Complications arising from subgrouping
However, sometimes members do drop out as a result of their dissatisfaction with the
group or its leader. For example, in therapy and growth-oriented groups in which
confrontation is used as a therapeutic technique, members occasionally become so
angry when confronted with an emotionally charged issue that they threaten to
terminate. To prevent premature termination, Barlow (2013) and Walsh (2010) suggest
using a careful pregroup screening interview to select members who have the capacity
to benefit from the group. It is not always possible, however, to screen out members
whose defensiveness, anger, and impulsivity may cause them to abruptly leave a group.
Therefore, some workers also specify in the initial contract that members must give two
weeks’ notice before leaving the group so that members have a chance to rethink their
decisions.
Pregroup training has also been found to be an effective way to prevent premature
dropouts from therapy groups (Barlow, 2013; Burlingame, Strauss, & Joyce,
2013; Mangione, Forti, & Lacuzzi, 2007). The most common form of pregroup training
is for the worker to meet with individual members to thoroughly review group
procedures and processes (see also Chapter6). Pregroup training can also take many
other forms, such as listening to or viewing recordings of similar groups, sitting-in on a
group, and talking with members or the worker about where the group is in its
developmental stage. Piper, Debbane, Bienvenu, and Garant (1982) found a
reduction of 13 percent to 30 percent in the dropout rate attributed to the successful
management of anxiety and the development of interpersonal bonds that resulted from
a pregroup training program. Many other studies have been conducted over the past 20
years about the benefits of pregroup training, which seems to work by reducing the
ambiguity and uncertainty in beginning group meetings. For a summary of these
studies, and the findings from them, see Barlow (2013) or Mangione, Forti, and
Lacuzzi (2007).
When workers take the time to explore members’ reasons for terminating, the data
gathered can help reduce premature terminations in subsequent groups. Sometimes,
for example, workers learn that arranging for child care while the group is in session
helps reduce the number of dropouts. Arranging transportation to and from the group
may also help. At other times, workers may find that there are ways they can improve
their own skills to prevent members from dropping out of the group. For example, they
may learn to be more gentle or tentative when they use confrontation methods. A
survey of 275 workers who were members of the American Group Psychotherapy
Association engaged in long-term group work found that the top reason for unplanned
termination was that the member was asked to leave because of disruptive behavior (33
percent). This was followed by 29 percent being asked to leave the group because
there was a poor fit or match between the group and a member. Other reasons included
client threatening to the group (20 percent), member not committed to the group (19
percent), disruptive dual relationships with another member of the group (16 percent),
and the group was not appropriate for the member (18 percent). It should be noted that
these figures are based on a low response rate to the survey (11 percent), and over half
of the respondents being in private practice and leading mostly long-term groups
(Mangione, Forti, & Iacuzzi, 2007).
Occasionally, an entire group may end prematurely. Just as there are many reasons for
the premature termination of individuals, there are also many reasons for the premature
termination of groups. A group that begins with a small number of members may lose
several members and thus be unable to continue functioning effectively. Groups may
not receive sufficient support from their sponsoring agencies to continue functioning, or
groups may be unable or unwilling to respond to external pressure to change their
functioning.
Groups may also end prematurely as a result of internal dysfunction. For example,
communication and interaction patterns may be poorly distributed and cause
subgrouping, scapegoating, or domination by a few members. The group may lack
sufficient attraction for its members and, therefore, may fail to coalesce or function as a
cohesive unit. Social controls, such as norms, roles, status hierarchies, and power, may
cause severe tension and conflict when some members rebel against the control of the
worker or other members. Lack of appropriate social controls may cause chaos or an
aimless drift that eventually leads to dissolution of the group as a whole. Members may
also have great difficulty deciding on common values, preferences, ways of working
together, or other aspects of the group’s culture.
Whenever workers confront the possibility that a group may end prematurely, they
should carefully examine the factors that are contributing to the problem. It is often
possible to trace a group’s dysfunction back to the planning stage. Careful examination
of the factors that contributed to a group’s demise can help workers avoid such pitfalls
in future groups.
Worker Termination
Ethical and Professional Behavior
Behavior:
Make ethical decisions by applying the standards of the NASW Code of Ethics, relevant laws
and regulations, models for ethical decision-making, ethical conduct of research, and additional
codes of ethics as appropriate to context
Critical Thinking Question:
1. Group workers sometimes leave their groups. What ethical issues should be considered
when a worker starts the termination process?
Although rarely mentioned in the literature, there are times when workers have to
terminate their work with a group. Probably the most common reason for worker
termination is that students leave at the end of their field placements, but change of
employment or shifting job responsibilities also lead to worker termination. In a study of
two groups in which workers terminated their participation, Long, Pendleton, and
Winter (1988) found that the termination of the worker led to testing of the new worker
and to a reorganization of the group’s processes and structures.
Several steps can be taken to reduce the disruption that can be caused by worker
termination in an ongoing group.
Steps to Reduce Disruption
• Group members should be told as early as possible when termination will occur.
• The reasons for termination should be shared with the group, and members should be
encouraged to discuss their feelings frankly.
• Unfinished business should be completed.
• The new worker should be introduced to the group and, if possible, co-lead the group for a
while with the terminating worker.
4. Ending Group Meetings
Scheidel and Crowell (1979) list four generic worker tasks in ending group meetings:
(1) closing the group’s work, (2) arranging another meeting, (3) preparing a summary or
report of the group’s work, and (4) planning future group actions. In preparing to close,
the worker should help the group keep to its agenda. The worker should ensure that all
items of business and all members’ concerns are given sufficient attention, but the
group should not be allowed to spend too much time discussing one item of business or
one member’s concerns. To move the group along, the worker can do the following:
• Keep members focused on the topic of discussion.
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Limit the time that each member has to discuss an issue.
Summarize what has been said.
Obtain closure on each issue or concern as it is discussed.
In closing the group’s work, the worker should avoid bringing up new issues, concerns,
or items of business. Instead, the ending of a session is a good time to engage in a
process of reflection. This process entails (1) focusing on the session, (2) looking back
on what transpired to see what it meant for members, (3) analyzing the significance of
what occurred, and (4) examining what members can take away from the discussions
and put into practice in their own lives. It is also a good time to identify unfinished work
and to think about work that should be accomplished in future sessions (Birnbaum &
Cicchetti, 2000). A discussion of what was accomplished and what needs to be done in
future sessions lends continuity to the group. Enabling members to have a role in
setting the agenda for future sessions and to give feedback about the group experience
empowers them (Birnbaum, Mason, & Cicchetti, 2002). It provides an opportunity for
members to express their satisfaction and sense of accomplishment with what occurred
in the meetings, as well as any concerns they have about how the group is
functioning. Birnbaum and Cicchetti (2000) point out that it is helpful for group leaders
to invite members to raise discrepant points of view during ending discussions. Leaders
who solicit discrepant viewpoints and feelings about how the group is going can help
group members to express and resolve conflicts before they can become inflamed. At
the same time, soliciting different points of view can help members to discuss group
processes as well as the content of group meetings. In this way, members of the group
take increasing responsibility for both the content and the process of future group
meetings.
Despite efforts to structure the agenda to ensure that there is enough time to discuss
important issues at the end of a meeting, Shulman (2016)points out that members
occasionally raise “doorknob” issues just before ending. If consideration of these issues
can be postponed, they are best handled during the next meeting when they can be
given fuller consideration. When discussion of an important issue cannot be postponed,
the worker should ask group members whether they prefer to continue the discussion
for a brief period. If not, the issue may be taken up outside the group by the worker and
any interested members.
In closing the group’s work, the worker should also help members resolve any
remaining conflicts. Resolving conflicts helps members to work in harmony for the
decisions reached by the group as a whole. In addition, the worker may want to discuss
the strengths and weaknesses of the working relationship that has developed among
members during the group meeting, particularly if the group will work together in the
future.
During the ending minutes, the worker should help the group plan for future meetings.
When considering whether to meet again, it is helpful to review and summarize the
group’s work. A summary of the group’s activities during the meeting clarifies issues
that have been resolved and points out issues that remain unresolved. A clear summary
of the group’s progress is a prerequisite for arranging another meeting. Summaries also
remind members of the activities or tasks they have agreed to work on between
meetings and help the worker become aware of items that should be included in the
agenda for the next meeting.
If a group has completed action on a particular task, the final minutes can also be used
to ensure that all members understand and agree to the oral or written information that
will be presented at the conclusion of a group’s work. Some task forces may prepare
extensive written reports of their findings and conclusions. In these groups, it is not
productive to prepare the report during the group meeting. The closing minutes can be
used to formulate and highlight the major conclusions to be enumerated in the report, to
assign members responsibility for preparing major sections of the report, and to develop
a mechanism for obtaining approval from members before disseminating the report.
The endings of group meetings can also be used to plan future group actions. However,
because planning action steps is time-consuming, plans are usually developed during
the middle of a group meeting. At the ending of a meeting, plans are summarized, and
members select (or are assigned) tasks to carry out.
The worker should help members maintain their motivation, commitment, and
responsibility to implement and carry out the tasks they have agreed to complete
between meetings. To help members maintain their motivation, the worker should
praise members for their work in the group and for their willingness to commit
themselves to tasks outside the meeting. The worker may also want to mention any
benefits that will accrue to members for maintaining their commitment to the plans and
activities they have agreed to complete.
5. Ending the Group as a Whole
A variety of tasks are associated with ending a group as a whole:
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Learning from members
Maintaining and generalizing change efforts
Reducing group attraction and promoting the independent functioning of individual
members
Helping members deal with their feelings about ending
Planning for the future
Making referrals
Evaluating the work of the group
With the exception of evaluating the work of the group, which is discussed
in Chapter 14, the remaining portion of this chapter examines each ending task and the
skills and techniques the worker can use to facilitate the effective ending of a group.
Many of these tasks may be carried out simultaneously. The specific order in which
each task is completed depends on the group the worker is leading.
Learning from Members
In the last session of a group, in addition to any formal evaluation procedures, workers should
give members a chance to describe what it was like for them to be in the group. One way to do
this is a final group go-round where each member gets a chance to say what they enjoyed about
the group, what they learned, and how they will use what they learned in the future. Members
should be encouraged to talk about what they think could be improved in future groups. All
members should also have a discussion of what they learned from one another. It is also an
important time to give individual members a chance to give some final feedback to other
members whom they would especially like to thank for their contributions to the group. Workers
can make a statement about what they learned from individual members and what individual
members contributed to the group. Workers should also give positive but realistic feedback about
what each member accomplished and what each member should remember about their resiliency
and strengths, and how they can use them in the future to work on any issues that arise after the
group ends. If there are no follow-up group sessions planned, it can also be useful to schedule
individual follow-up meetings with members a month or two after the group ends to get
additional feedback from them about the group experience, to praise them for any changes in
their lives that they have started or sustained, and to help them with any problems or issues that
may have arisen since the last group meeting.
Maintaining and Generalizing Change Efforts
After treatment plans have been developed and carried out, workers should ensure that
the changes that have been achieved are maintained and generalized to other
important aspects of members’ lives. Evaluations of results of therapeutic interventions
suggest that positive changes are often difficult to maintain over time. For example, in
an evaluation of two different group intervention programs for caregivers of the frail
elderly, it was found that some of the positive changes found immediately after group
intervention were not sustained at one year (Labrecque, Peak, & Toseland,
1992; Toseland, 1990).
Positive changes are even harder to maintain in group treatment programs that are
focused on individuals with addictive disorders. For example, in an evaluation of a group
treatment program for smokers, it was found that although more than 60 percent of
members who attended the program initially stopped smoking, the cessation rate had
dropped to 36 percent after three months (Toseland, Kabat, & Kemp, 1983). Results
obtained for a variety of other addictive disorders, such as narcotics use, alcohol use,
and overeating, show similarly high relapse rates (Boyd-Franklin, Cleek, Wofsy, &
Mundy, 2013; Chiauzzi, 1991; Marlatt, 1996; Marlatt & Barrett, 1994; Vaillant, 1995).
Maintenance is also difficult to achieve in working with antisocial group members, such
as juvenile delinquents, and in working with group members who have severe
psychological disorders.
Both novice and experienced workers often mistakenly believe that changes in specific
behaviors can be taken as a sign of generalized improvement in a member’s level of
functioning. These workers do little to ensure that specific behavior changes generalize
to related, but untreated, behaviors. Results of a variety of different treatment programs
have shown, however, that therapeutic changes occurring in specific behaviors do not
always generalize to similar behaviors performed by a member in other contexts
(Masters, Burish, Hollon, & Rimm, 1987). For example, a parent may learn how to
reduce a child’s temper tantrums, but this success may not affect the parent’s ability to
help the child play cooperatively with other children.
Although some people seek group treatment only for changes in specific behaviors,
most people enter group treatment with the expectation that there will be a generalized
improvement in their life situations. Therefore, it is important for workers to help
members generalize changes achieved in specific behaviors and performed in particular
situations to related behaviors performed in other contexts. With the notable exception
of Rose (1989, 1998), little has been written about these topics in group work. Almost
all the theoretical and clinical work on maintenance and generalization of change has
come from the literature on behavior modification and learning theory. The literature
suggests several things workers can do to help members maintain and generalize the
changes they have achieved.
Maintaining and Generalizing Changes
• Helping members work on relevant situations
• Helping members develop confidence in their abilities
• Using a variety of different situations and settings in helping members learn new
behaviors
• Using a variety of naturally occurring consequences
• Extending treatment through follow-up sessions
• Preventing setbacks in an unsympathetic environment
• Helping members solve problems independently by providing a framework for
organizing data and solving problems that can be used in many different situations
Relevant Situations
To achieve long-lasting changes that will generalize to similar situations in members’
lives, the concerns and issues worked on in the group should be a relevant and
realistic sample of concerns and issues experienced by members in their daily lives.
Sometimes members become distracted by issues that are not central to their concerns,
a possible sign that the members are avoiding difficult issues and the changes they
necessitate. The worker can help by drawing members’ attention back to the central
concerns that brought them together as a group.
In other cases, the situations discussed may be highly specific and individual. Although
it is important to be as specific and concrete as possible when developing treatment
plans, it is also important to ensure that situations that are relevant to all group
members are included in the group’s work so that members are prepared for situations
they are likely to encounter in the future.
Although group meetings should provide a protected environment in which members
receive support, encouragement, and understanding, the group should also be a place
in which members can get honest feedback about how their behavior is likely to be seen
outside the group. Members should be encouraged to try out new behaviors in the
group, but they should not be misled into thinking they will receive the same level of
support and encouragement for trying new behaviors outside the group. In short,
although the group should provide a supportive and caring atmosphere in which to
work, the group should help members understand, cope with, and prepare for reactions
likely to be experienced outside the group.
Helping Members Develop Confidence
Many treatment groups spend much time discussing members’ problems and concerns
as well as their inappropriate ways of handling situations. Although ventilating thoughts
and feelings may be therapeutic, Lee (2001) points out that too much time in treatment
is often spent on th