In which phase of group therapy should the nurse plan to first address termination?

Choice A reason: The orientation phase focuses on establishing group norms, trust, and goals, not addressing termination. Discussing endings at this stage could disrupt group cohesion and engagement, as members are building relationships, making this choice incorrect for introducing termination.

Choice B reason: The working phase emphasizes active therapeutic work, such as addressing conflicts and goals. Termination is not the focus, as members are engaged in processing issues. Introducing termination here could distract from ongoing work, making this choice incorrect.

Choice C reason: The termination phase is designed to address group closure, reviewing progress and preparing for separation. Discussing termination aligns with this phase’s focus on processing endings and transitioning, a key aspect of group therapy dynamics, making this the correct choice.

Choice D reason: The pre-group phase involves planning and recruitment, not therapeutic activities like addressing termination. This phase sets the stage for group formation, not closure, making it inappropriate for discussing termination, rendering this choice incorrect.

Choice A reason: Command hallucinations directing harmful actions, like throwing a plate, indicate a severe psychotic state posing imminent danger to others. This meets criteria for emergency or involuntary admission to ensure safety and stabilize the mental illness, making this the correct choice.

Choice B reason: Staying in their room during outpatient therapy suggests withdrawal but not imminent danger. Outpatient settings allow autonomy, and this behavior does not warrant emergency admission unless accompanied by severe risk, making this choice incorrect for involuntary intervention.

Choice C reason: Requesting to speak with a nurse indicates engagement with care, not a crisis requiring emergency admission. It reflects a desire for support, not danger to self or others, making this choice inappropriate for involuntary hospitalization in mental health settings.

Choice D reason: Playing cards alone during group therapy suggests social withdrawal, not an acute crisis. This behavior does not indicate imminent danger or severe mental instability requiring emergency admission, making it incorrect compared to violent actions driven by hallucinations.