Transition from practitioner to educator: A repertory grid analysis

We examined the process of transition from being a practitioner in a field to becoming an educator in the same field, using repertory grid technique and a longitudinal methodology. A total intake of Technical and Further Education beginning teachers was followed throughout their 2-year preparation program. At five intervals, 6 months apart, repertory grids were administered to the group, with the elements supplied relating to various roles and aspects of the self relevant to transition. Constructs elicited from the group mapped the transition process during the 2-year period and showed the changing emphasis over the course. Measurements of self-esteem and the effect of the transition on family relationships were also administered. Results showed that the nature of the transition was generally positive. The constructs elicited identified change in the transition process as experienced by the group under study. Initially constructs were general and included satisfaction, striving, and participation. They then revealed greater concern with issues of time, control, personal and professional development, and, finally, those attributes of “being qualified.” Specifically, results show the transition process to be a personal experience, and illustrate the beneficial function of proceeding through the transition process as part of a group.     

The Nature of the Co-Therapy Relationship

Termination is a complex phase in the total therapeutic process. Criteria for termination of long-term analytic group therapy encompass both intrapsychic and behavioral changes. One of the useful ways of conceptualizing the termination phase is in terms of the issues of separation-individuation. Three different kinds of termination that can occur and the techniques for working with each are described. Multiple transferences are worked with in the long-term analytic group and both real and transferential losses acknowledged. The ability to leave group therapy with a stronger, better defined sense of self is one of the goals of therapy.     

Activity Group Therapy of a Dull Boy with Severe Body EGO Problems

The presence of a time limit shapes the entire therapeutic process and culminates in the management of termination. This paper outlines a protocol for dealing with termination in time-limited psychotherapy groups: (1) Select suitable members with similar capacity to use a time-limited format; (2) use a closed group format; (3) clarify the time boundaries at the beginning; (4) reinforce the time frame during the last half of the group; (5) provide focused interventions; (6) forestall premature termination; (7) reinforce termination themes of deprivation, resentment and anger, rejection, grief and loss, responsibility for self; (8) structure the final session; and (9) plan a 4-month follow-up visit to encourage ongoing application. These guidelines provide the therapist with a general structure to ensure that major termination themes are systematically addressed. They deal with powerful concepts of maturation and self-responsibility and incorporate the principal strategies that distinguish time-limited from time-unlimited group psychotherapy.     

Special Aspects of Countertransference in Analytic Group Psychotherapy

The structure of health care delivery is in a period of rapid change. An understanding of psychotherapy service use patterns indicates the importance of time categories as well as the relevance of group techniques. Traditional interpersonal and psychodynamic group techniques may be modified for time-limited use without sacrificing basic values and with demonstrated effectiveness. Adapting to a more fiscally stringent practice environment requires the clinician to undertake a difficult process of transition. As professionals our task is to prepare ourselves for this challenge and to let the health care system know that proper practice guidelines are necessary to achieve effective treatment for our patients.     

The termination phase of combined therapy

Three different kinds of termination are described and discussed. In combined therapy the group can help to resolve and clarify the meanings of moves to terminate therapy. The role of the therapist's countertransferences in this stage of the work is important to consider, and here, too, the group is an important part of the work. The author sees termination as an important part of the treatment process. In combined therapy it may be more complex but it also allows for a fuller exploration of the relevant issues.     

Medication dynamics in group psychotherapy

The use of medications in insight-oriented groups has not been adequately investigated. We report a group in which the anxiolytic buspirone appeared to be associated with attractiveness to the group in the face of impending therapists' termination. We feel that in this group, medications became a variable associated with group cohesiveness, served as a vehicle for the expression of group dynamics, and as an indicator of regression within the group. These observations suggest that, under certain circumstances, medications may become an important variable in the process and expression of group dynamics.They would like to thank Myron Pisetsky, M.D., for reading the original draft of this paper, and are also indebted to Daniel O'Neil, Ph.D., for his input.     

Therapeutic factors in group psychotherapy: A contemporary view

This paper reviews the two major approaches to the assessment of therapeutic factors in therapy groups: 1) questionnaires administered at termination, and 2) postsession Critical Incident reports. The major categories will be discussed, and a new study utilizing Critical Incident methodology reported which replicates previous results. Suitable studies will be reanalyzed from the standpoint of the change in therapeutic factors over time as a group develops. It is recommended that the Critical Incident methodology be further refined and used in preference to the questionnaire approach.     

The Present Status of Group Therapy in United States Correctional Institutions

A time-limited group treatment program focusing on mothers of toddlers with a borderline personality disorder is reported. The project involved two intersecting groups—the toddler group and the mother group. The focus of the work with the children was to promote their social interests and skills to an expanded world beyond the maternal dyad. The focus of the work with the mothers was on their difficulties with emotional separation-individuation and on strengthening their ego functioning, particularly in the area of mothering so that they could participate positively in their child's separation-individuation phase.

Representative group process is presented as it organized around three distinct phases. The initial phase was marked by intense resistance, and ambivalence. During the middle phase, group cohesion developed around shared feelings and issues. The termination phase focused insistently on issues of separation. Conclusions drawn from the project include the utility of a group approach in influencing maternal behavior.     

A Principal Reflects on Shame and School Bullying

This article considers the contribution that consideration of the moment-to-moment process in psychoanalysis can make to an understanding of termination. Information on moment-to-moment interactions related to termination is developed from videotape microanalysis of termination discussions—focusing on a child analysis, but including an example from an adult analysis—as viewed through the structure of a developmental model (Tronick's dyadic expansion of consciousness model) that is consistent with dynamic systems theory. The theory emphasizes the co-creation of meaning that occurs in an analysis, as indicated by verbal, as well as nonverbal, interactions that are apparent in the videotape. The insights from this approach can enrich the traditional psychoanalytic views on termination by emphasizing the ongoing developmental process, with termination more of an important step in this process than a specific ending.     

Premature termination: A risk in eating disorder groups

This study examines the influence of combined vs. conjoint psychotherapy on the phenomenon of premature termination in eating disorder groups. Thirty-eight women with a diagnosis of anorexia nervosa or bulimia enrolled in group psychotherapy were designated as group completers or premature terminators using individually defined treatment objectives. Those eating disorder patients in combined group and individual psychotherapy showed a lower frequency of premature termination than patients in conjoint group and individual psychotherapy.     

Group Session Rating Scale: Preliminary psychometrics in substance abuse group interventions

Background: Although ultra‐brief outcome and process measures have been developed for individual therapy, currently there are no ultra‐brief alliance measures for group therapy. Method: The current study examined 105 clients in group therapy for issues related to substance abuse or with issues related to the substance abuse of a significant other. We tested whether a newly developed group therapy alliance measure – the Group Session Rating Scale would be related to other commonly used group process measures (Working Alliance Inventory, Group Cohesion, Group Climate) and early change (change over the first four sessions of group therapy). Results: The findings provided support for reliability based on Cronbach alphas and test‐retest coefficients. Additionally, the GSRS was a one‐factor measure that was related to other group process measures as well as predicted early change. Discussion: Clinical implications for how to utilise ultra‐brief outcome and alliance measures are provided.     

Terminations

Whether the person leaving the group is a group member or a group therapist, the basic dynamics of separation are the same, involving the separation process as well as mourning. Terminations evoke ambivalent feelings of both separation-pain and hope. Group members and the departing person experience a loss, which reminds them of other losses, and the departing person (group member or therapist) may also experience some guilt. Any termination will have an effect on the-group-as-a-whole, as well as on the individual members, and must be dealt with prior to the actual leaving, as well as after the termination.     

Penetrating the boundaries of latent conflict

The psychotherapeutic process has customarily been divided into an opening phase, a working-through phase, and a termination phase. Beyond recognition of these stages, few theorists have offered criteria for tracking the transition from one phase to the next. A related problem affecting each of these stages has been whether dynamically-oriented psychotherapy can predict latent conflict before it becomes manifest. Developmental principles derived from the early life relationship between caregiver and infant may provide therapists with a viable approach for handling these issues. By applying these principles analogously to the therapeutic situation, therapists may be able to better predict the transitions between stages, as well as to identify latent conflict before it is manifested. Moreover, these principles may also provide criteria for determining when treatment should be terminated.     

Premature termination: A clinical study

Ten patients who terminated prematurely from 10 different therapy groups were interviewed using a semistructured interview protocol. Half the subjects were patients in private therapy groups; the other half were patients in clinic therapy groups. Among the issues inquired about were subjects' initial attitudes about group treatment; the nature of the preparation process; subjects' experience of the group therapist, other group members, and the group process; their reasons for leaving their groups; and the nature of the termination process. The findings reported focus on patients' perceptions of therapists' motives; the importance of establishing appropriate treatment goals; the handling of negative feelings about the group and/or the group therapist; the issue of narcissistic injury; the experience of the balance between giving and receiving; the difficulties caused by unresolved conflicts within groups; and the problems posed by inadequate preparation for the group experience. Guidelines for practices aimed at minimizing premature terminations are offered.     

Symbolization of experience in the process of group development

This paper applies some of the concepts of the theory of experiencing (as developed within the client-centered school of thought) to psychotherapy process in the small group. The ideas of Rogers and Gendlin regarding how change occurs in psychotherapy are applied to the process of development in the group-as-a-whole. The role of perception and symbolization of experience in the process of group development is examined. A case example from group psychotherapy is used to illustrate the process of formation, the change of shared perceptions among the group members, and the importance of these perceptions to the functioning of the group.     

Building bridges for disengagement: The transition process for individuals and teams

Abstract

A general dircwion for understanding the process and impact of disengagement and uansition on individual athletes and teams is presented. Disengagement is presented as a process within athlete and team development. The disengagement of athletes from a team and the impact on the team ue examined. Two models of change are described as is a model of group development. Examples of a team in transition are provided and suggestions for sports psychologists' work with athletes and teams in transition an offered. The focus of these suggestions is on work with teams.     

The Cultural Adaptation of a Transition Program for Latino Families of Youth with Autism Spectrum Disorder

During the transition to adulthood, effective and culturally relevant supports are critical for families of youth with autism spectrum disorder (ASD). There is a dearth of documented program development and research on supports for Spanish-speaking Latino families during this life stage. The present work describes the cultural adaptation process of an evidence-based transition program for Latino families of youth with ASD. A model of the actions necessary to meaningfully conduct a cultural adaptation in this context is described. After implementing the culturally adapted program titled Juntos en la Transición with five Spanish-speaking families, parents reported high social validity of the program through surveys and interviews. The cultural adaptation process followed in this work is important for the further development of programs that address the transition needs of Latino youth with ASD and their families. Our impressions may also be useful to those who aim to develop culturally sensitive and ecologically valid multifamily group intervention programs for families from cultural and linguistic minority groups.     

The Relationship Between Dropout and Outcome in Naturalistic Cognitive Behavior Therapy

Dropout from psychotherapy is frequent and limits the benefits patients can receive from treatment. The study of factors associated with dropout has the potential to yield strategies to reduce it. This study analyzed data from a large sample of adults (N = 1,092) receiving naturalistic cognitive behavioral therapy (CBT) to test the hypotheses that dropouts, as compared to completers, had (1) higher symptom severity at treatment termination, (2) a slower rate of symptom change during treatment, and (3) a higher odds that the therapist rated treatment as ending for reasons related to poor outcome. Results showed that although dropouts ended treatment with higher symptom severity than completers, dropouts and completers did not differ in their rate of symptom change during treatment, suggesting that dropouts had higher symptom severity at termination because they received fewer sessions of treatment, not because their symptoms changed at a slower rate. Dropout was also associated with a higher odds of having a therapist-rated termination reason indicating a poor outcome, suggesting that dropout is more likely if patients are dissatisfied with some aspect of the therapy outcome or process. These findings suggest that strategies for monitoring and enhancing patient satisfaction with the process and outcome of treatment may help patients stay in treatment longer and end treatment with fewer symptoms than if they had dropped out.     

Co-leader termination in an outpatient alcohol treatment group

The termination of a co-leader from a long-term therapy group for alcoholic outpatients is described over a seven-week period from the initial termination announcement to the first week following the co-leader's departure. The authors highlight salient themes and defensive maneuvers that appear as the group struggles with the difficult task of termination. Attempting initially to flee from the impending loss, the group defends with pseudomature responses and veiled hostility. These are followed by themes of abandonment and loss. The group leaders' initial collusion with the group's denial of loss is described, along with leader tactics to facilitate the group's termination work. Finally, the meaning of a group farewell gift is discussed in terms of both its implicit communications and as a form of resistance.