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ABSTRACT
Endings in group psychotherapy are suffused with complexity and potential conflict, some of which entail ethical quandaries. Ethical issues attending endings in group therapy are explored through a discussion of informed consent, time and role boundaries, privacy and confidentiality, unplanned endings, therapist-initiated termination, and competence. Findings from an exploratory survey of members of the American Group Psychotherapy Association and clinical-ethical vignettes are presented to highlight these issues. Clinicians need to develop and maintain ethical fitness and awareness, including attunement to personal responses, to endings and loss.
Endings in group psychotherapy can be charged and complicated events, many entailing ethical quandaries. In this paper, we explore the interface of endings and ethics in group therapy, focusing on several areas of possible ethical conflict: informed consent, time and role boundaries, privacy and confidentiality, unplanned endings, therapist-initiated termination, finances, and competence. In each of these realms, we explicate problematic concerns as well as point toward ethical practice, incorporating findings from our survey of group therapists on ethics and endings. Finally, we offer examples of ethical dilemmas and suggest an ethical fitness model for life-long practicing of ethics.
A FRAMEWORK FOR ETHICS AND ENDINGS: A CULTURAL CONTEXT
Two sets of factors potentially contribute to the conflict-fraught character of many endings in group therapy. Clinicians and clients tend to share a cultural milieu about endings. Living in a postmodern, pluralistic society, we lack a shared perspective on death and loss as well as the rituals and observances that other cultures have invoked previously to deal with such endings. In our clinical work and teaching, particularly around short-term groups, we have often talked about our "under-ritualized" culture and how it is difficult to be wholly present to the experience of loss and endings. Schafer (1973, p. 142) writes that "progress is almost a state religion" in the United States; if we compulsively have to make progress, it is hard to say it is time for a group or an individual to end therapy, and to do so graciously.
Clients often come into treatment with poignant disruptions, disappointments, and tragic endings in their lives-abandonment, divorce, deaths of family and friends, loss of dreams, loss of childhood. As therapists, we hear a deluge of endings and leavings that are unprocessed and...