Ethical Issues Unique to Group Therapy

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Introduction

Psychiatric therapy refers to a form of treatment whereby a therapist (an expert who deals with mental and emotional disorders) holds session(s) with a single patient or a group with the same problem(s) in a bid to help them overcome such stresses.

Group therapy on the other hand refers to a situation whereby a set of patients seeking counseling, normally ranging from four to ten in number, sit with the psychotherapist and share their experiences with the aim of learning from one another and from the psychotherapist on how to overcome their challenges (Marino, 1994, p. 5). It is usually a chatting treatment and seeks to raise a person’s or group sense of their own welfare.

Psychiatric therapists make use of a variety of procedures founded on pragmatic association development, discussion, communiqué and conduct transformation all which are aimed at perking up the rational wellbeing of a customer(s), or to get better group associations, for instance in a family unit.

The unrelenting progress of the use of group method of therapy that involves physical or electrical therapeutic treatment in the psychological health line of work has resulted in quite a number of prospective tough situations that relate in particular to group work.

As qualified therapy providers are required to direct the course of increasing groups as time goes by, it is imperative that a comprehensive foundation in the ethical standards that relate to group therapy is set up. This is not only aimed at ensuring the protection of each and every customer, it also makes certain that the psychotherapist and the line of work are also secured (Charles, Kraus, DeEsch & Geroski, 2001, p. 31).

As a result of the extensive use of group work in the psychological health sector, various bodies have made out sets of conventional principles that lay down anticipated ethical conduct when guiding groups. These entities consist of the American Psychological Association (APA), American Counseling Association (ACA), and Association for Specialists in

Group Work (ASGW)

The major ethical matters and principles connected with group work are recognized in two most important parts; the ones falling under the grouping members’ civil liberties and those under the psychotherapist’s duty.

Knowledge of the ethical principles founded and well-known for group therapy by the APA, ACA, and ASGW gets counselors geared up for the potentially multifaceted ethical matter and catch-22 situations that always pop up in group work.

The intrinsic power of remedial groups to result in individual change for members has experienced growing acknowledgment in modern times in the psychological health profession. In the past, though, personal therapy was perceived to be the most effectual type of healing with group therapy being seen as less enlightened.

There exists quite substantial evidence that group therapy is as effectual as individual therapy in resolving psychosomatic crises (Asay and Michael, 1999, p. 23). With increasing importance of group therapy, it has become vital that psychoanalysts come up with a firm groundwork in the general moral matters that are bound to pop up in group psychoanalysis.

Establishing Guidelines

The foundation of ethical leading principles adhered to in group psychoanalysis in the psychological health line of work were set up by the bodies mentioned earlier. American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct of 2002, the Association for Specialists in Group Work’s Ethical Guidelines for Group Counselors of 1989, and the American Counseling Association’s Code of Ethics of 2005.

The Ethical Guidelines of ASGW were in particular set up to prop up superior group guidance, performance and investigation by way of augmenting the knowledge of ethical matters linked with groups.

As stated by ASGW group work is a wide-ranging specialized practice concerning the appliance of information and expertise in group facilitation to lend a hand to a mutually dependent group of people to attain their shared aspirations which may be intrapersonal, social, or job-related.

It thus, involves both the group associates and the lead experts (Corey, Williams & Moline, 1995, p. 161). Discrepancy in group therapy has kept on growing with time and has necessitated the need for comprehensible ethical courses of action.

Rights of group members

As a result of the various sorts of groups, situations of group intercession, and group head guidance, understanding of group affiliates’ interest(s) possessed by law or custom is as important as ever. Therefore, those who are thinking about joining a psychotherapy grouping need to be aware of their fundamental rights as group associates and their tasks.

Selection, predilection and informed consent

Group associates ought to have the guarantee that other affiliates are suitable for the group’s echelon of operation. It is the members’ right that a testing of potential associates prior to them joining the group is carried out in order to establish whether they possess the characteristics being sought (Glass, 1998, p. 95).

What’s more, when the would-be affiliate is clued-up of the deep-seated rudiments of the group at both the test and the early session, the partaker are usually further apt in reacting in a much superior way to the group set-up.

Group affiliates also have the right to be on familiar terms with the intention of the group, an explanation of the group arrangement, the credentials of the grouping person in charge, the charges and any other operating costs of linking with the group, and comprehension of the state of affairs in which discretion ought to be breached as a result of lawful, ethical or expert grounds before he or she gets to join the group.

As a component of associate grounding, it is always fine to incorporate a talk of the standards and confines of groups, the psychosomatic threats drawn in group sharing and means of playing down these threats (Glass, 1998, p. 97). All the above stated measures seek to offer a suitable bond between the grouping and the character and are the single prime pre-emptive measure to steer clear of additional ethical tricky situations.

Participation

It is always worthwhile to be conscious of the ethical tight spots relating to involvement n group therapy. In particular, these tight spots might take account of involuntary involvement matters, the participants’ principles of justice to depart from the group, and compulsory chipping in a range of goings-on that go on in the course of group work.

Instances are always reported by therapists of customers who get into it unwillingly, or due to a number of grounds, are unenthusiastic to play a part.

This calls for counselors to make every effort to make certain that up to date approval for the participants even though they are in it against their will. High opinion for the independence of each and every member is always vital as coherence among the participants comes out in the course of the group progression.

Person(s) in charge of a group need to look after participants’ principles of justice against corporeal intimidation, compulsion and unwarranted pressure by one’s peers, especially to conform, as far as is practically feasible.

After all, the function of a group is to assist its members hit upon their own solution(s) or understanding as opposed to oppressing them into partaking in what the group deems is the proper path (Markus & King, 2003, p. 203). At times, participants may begin to feel pressurized into making known personal, possibly detrimental information if they are not clued-up and guarded.

Lessening the possibility of compulsion in group therapy is vital to the chipping in principles of justice of the group affiliates and permits the restorative driving force contained by the group course to work its wonder.

Discretion and advantaged communication

Maintaining group affiliates’ information off the record in group rehabilitation is one of those for the most part not easy facets of group psychotherapy. In accordance to the ASGW Code of 1989, the group psychotherapist has got to take steps to look after members by means of describing discretion and would-be inadequacies of keeping it up in group work (Bemak & Chung, 2004, p. 32).

Despite the fact that it is the psychotherapist’s sense of obligation to form a confidential ambiance in which privacy is upheld, it is over and over again easier said than done as a result of authority and regulations presiding over their area.

Confidential communication is a lawful aspect making it certain to customers that individual information made known in the therapeutic exercise will not be made accessible by the psychotherapist in charge in any lawful proceeding(s).

On the other hand, the idea of confidential communication, which is normally endowed to personal therapy associations, does not become appropriate to group therapy reason being that the other participants act as a third party. In legal proceedings, the group psychotherapist may be let off from being a witness but any third party may be compelled to give evidence.

Confidential communication was not initially planned to care for interactions made inside groups, and regrettably does not at all times be relevant to group work in the court of justice. Two regions in the United States have set up regulations to fight discretion violations.

These are Illinois and Washington, D.C. the Illinois regulation, referred to as The Illinois Mental Health and Disabilities Confidentiality Act enhanced confidential contact to any person who gets to take notice of revelations made by clients to counselors at some stage in psychological healthiness healing.

The District of Columbia holds a regulation that unambiguously makes it illegal for group affiliates to reveal to outside parties information gotten about each other in the group. The above illustrations show the struggle for affiliates’ principles of justice to secrecy and discretion while in group therapy (Markus & King, 2003, p. 205).

On the other hand, confidentiality remains one of those mainly easier said than done ethical standards to maintain. This intricacy came out in the 1985 case involving the State and Ortiz. This was in Arizona and the court disagreed with advantage communication to group work by affirming that affiliates can have no prospect of discretion in a group situation.

Leader responsibilities

The greater part of ethical aspects relating to group work arises from the mind-sets, duties, and measures of the group leader, as opposed from the group itself.

One of the most challenging elements of group headship is the capability of the group person in charge to act in response to disagreement or tricky occurrences in the group (Paradise & Kirby, 1990, p. 114). It is always advisable that the ethical principles spelled out by the ASGW, ACA, and APA be adhered to so that group leaders are in a position to respond to their affiliates in an ethical manner.

Training principles

With finely tuned ethical understanding in group therapy in the present day, educating proficient and knowledgeable persons in charge has turned out to be the most vital distinctive feature of psychotherapy graduate syllabuses. The ASGW put in place a foremost focus on the significance of educating group persons in charge as illustrated in the Professional Standards for the Training of Group Workers of 2000.

During the same year, ASGW’s Training Standards put forward a number of detailed proficiency capabilities (Paradise & Kirby, 1990, p. 115).

These consisted of capacity to open and wrap up group sittings, reproduce suitable conduct for group associates, slot in suitable self revelation in the group, offer and be given reaction, be of assistance to members in giving sense to their experience, and lend a hand to associates in assisting them incorporate and put into practice their knowledge.

The principles also delineated the foundational group work proficiencies. These comprise of trait and characteristics of application, evaluation of group affiliates and the societal frameworks in which they subsist and work, setting up group intercessions, execution of group intercessions, headship and co-headship, and multiplicity proficient carry outs.

Practicable session set-ups for various complications have been established over time and need to e adhered to in order to achieve the desired results. There is requirement for augmented alertness to these touchstones in a research that established that pre-doctoral psychology placements by themselves did not consistently offer adequate group psychotherapy teaching.

There exist several ethical queries drawn in having the need of learners in preparation to play a part in a group development occurrence. It is important for all the players to realize that it is the program’s sense of duty to tag along the training touchstones at the same time as sticking on to other specialized guiding principles (Glass, 1998, p. 103).

In 2001, the Council for Accreditation of Counseling and Related Educational Programs, CACREP, emphasized on the magnitude of training superior group persons in charge by registering group work as one of the main program of study.

Under CACREP’s guiding principles, learners have to be endowed with the alternative to take part in group goings-on in the course of graduate training that endorses and perks up learners’ individual understanding and augments soul-searching and societal skills.

Effect of the leader’s values

Persons in charge of a group(s) hold an immense amount of influence and have to ascertain that they are not imposing their own standards on the group. The bottom line of the ethical concern in this sector entails persons in charge who utilize their group to press forward their private agenda or to realize their own objectives at the expense of the group affiliates.

Principle Seven of ASGW’s Ethical Guidelines of 1989 says that psychotherapists guiding groups need to build up a consciousness of their own ideals and requirements and the probable effect that they have on the intercessions likely to be made. It also needs to be made clear that there exists a genuine distinction between inflicting and depicting one’s standards.

Whenever persons in charge of therapy groups impress their principles they are being disrespectful if the group affiliates’ reliability. On the other hand, at selected times it may be fitting for a group leader to depict his or her own values when they clash with those of an associate (Roback, Moore, Bloch & Shelton, 1996, p. 177).

This is for the simple fact that standards form what is to be anticipated and all-encompassing part of psychiatric therapy. As a result, persons in charge of groups need not to compel their own ideals upon the group, but have got to make every effort to craft a ground of value dialogue and investigation at the same time as keeping up high opinion for the varied ideals contained by the group.

Adoption of a multicultural standpoint

This is one of those most imperative ethical issues surrounding group work and it is the responsibility of the person in charge to ensure it is built up. As the outlook of the social order changes toward a more varied populace, group intercessions have to find their feet to meet the requirements of these transformations and this also rests with the group leader (Forester-Miller & Duncan, 1990, p. 88).

ASGW drew out in detail the ethical principles for a multicultural standpoint in group rehabilitation in 1998 in the Principles for Diversity-Competent Group Workers. These doctrines illustrate multiplicity-proficient knowledge of self, consciousness of group associates’ worldview, and multiplicity fitting intercession lines of attack.

The preface ASGW’s principles serves as a reminder that these are in place to form beginning points for group personnel to become all the time more conscious, well-informed, and dexterous in assisting groups whose memberships stand for the multiplicity of our world. Research experts have emphasized the serious requirement for psychotherapists to become multiplicity-proficient group persons in charge.

Such that group psychoanalysts turn out to be successful with all people, it is vital that they are educated to be racially proficient (Forester-Miller & Duncan, 1990, p. 90).

Hitherto, in times gone by, group psychoanalysis has not paid sustenance or methodical consideration to working across racially and ethnically varied precincts, and as a result has been for the most part based on European-American representations of psychiatric therapy and counsel.

Ethnically centered mind-sets and other preconceived notions are not easy to take out of a group setting, however, the by the work of bodies such as ASGW and reform minded persons in charge the nature of group intercessions will carry on toward a more multiplicity-proficient set-up.

Difficult group associates

It occurs at times that no matter how strict the screening actions are, some associates of a group may turn out to be troublesome and unable to get along with the group. Psychoanalysts need to be acquainted with how to make out and handle such patients in an ethical way (Bemak & Chung, 2004, p. 37).

At times, the troublesome affiliate may be facing up to the arrangement to be taken notice of or recognized by the group, or, is standing-in as an offset reliant. Offset reliant are group associates who shy away from commanding makeup such as obey the standards of a group.

Affiliates who find it hard to follow the standards of the group need to be drawn back into the group by the other affiliates. Through this they get to convert a foundation of unconstructive energy into a constructive, curative opening.

The person in charge has got to be in a position to make out if the challenge from the associate is a normal occurrence of the group progression, or if the fellow is generating a harmful setting for the other associates.

Ethical issues unique to individual counseling

Individual counseling offers patients an opportunity to confidentially address whatever issues that are afflicting them with the help of a psychotherapist. As opposed to group therapy, patients are provided with the chance to face up to matters that are exceptionally theirs.

In the course of an individual therapy sitting, psychotherapists help patients with meting out familiarities and ways of thinking about the matters raised in the treatment setting (Glass, 1998, p. 121).

The psychotherapist in this case needs to bear in mind that his or her patient may not be in a stable position mentally. The patient has issues that are troubling him or her and these are what they need to bring out so that the therapist may assist in countering them. As a result, the patient needs to be allowed to time to speak out their mind. At first, the therapist needs not to sound opinionated or has drawn a conclusion already.

Once the patient is through with his or her narration a dialogue between the therapist and the patient should ensue. What needs to be avoided at all costs is the appearance that the therapist is lecturing his or her patient (Corey, Williams & Moline, 1995, p. 179).

In seeking solutions and chatting the way forward, both the psychotherapist and the patient have to come up with suggestions and fully deliberate on them. More importantly, the therapist needs to guide the patient and make him or her give the way forward. Solutions need to come from or if not so seem to come from the patient himself or herself.

The information given out by the patient needs to be treated confidentially as the case in group therapy.

Therapist’s preference of group therapy over individual therapy

The work of a psychotherapist becomes much easier when he or she is dealing with a group as compared to an individual. The reason for this is that whenever patients get to meet other individuals who also have problems of one kind or another; it offers them a broader point of view of their own problems.

This serves to first make them feel at home and then help them come up with solutions or ways out of their tight spots. Again, by patients paying attention to others it helps them become wary that they can analyze and deal with problems in several ways (Paradise & Kirby, 1990, p. 117). This is the most effective way of conducting counseling and thus the therapist will have an easy time.

With group therapy, encouragement and emotional prop up is available for every member. Therefore the therapist’s work is always maintained on the right track. Therapists are at several times confronted with patient problems concerning communication with other persons. In such cases, group therapy comes in handy as interactions within the group help deal with shyness.

Group therapy stands on a higher ground as compared to individual therapy when talking about building up fresh conducts that without a doubt put across their requirements and be of assistance in achieving accomplishment in the actuality (Asay and Michael, 1999, p. 55).

Group therapy mulls over the main facets of what the associates are after and what will improve their life, what they need to do in a bid to realize whatever that they want and the way in which they are able to make substitute alternatives and establish a mutual plan.

Conclusion

The fact that psychotherapy is important for the persons is not debatable. What has been debated about over time is the most effective form of therapy between group and individual therapies.

Sufficient research and conclusions have been made and facts established. Individual psychotherapy sittings by themselves are not appropriate to assist a patient go through a speedy recovery (Asay and Michael, 1999, p. 55). Group therapy has been found to be more effective. Other than it being faster and effective, it is less expensive as compared to its counterpart.

Reference list

Asay, P., and Michael, J. (1999). The Empirical Case for the Common Factors in Therapy: Quantitative Findings. In Hubble, Duncan, Miller (Eds), The Heart and Soul of Change (pp. 23–55)

Bemak, F., & Chung, R. (2004). Teaching multicultural group counseling: perspectives for a new era. The Journal for Specialists in Group Work, 29, 31-41.

Charles, C., Kraus, K., DeEsch, J., & Geroski, A. (2001). Stop avoiding challenging situations in group counseling. The Journal for Specialists in Group Work, 26, 31- 47.

Corey, G., Williams, G., & Moline, M. (1995). Ethical and legal issues in group counseling. Ethics & Behavior, 5(2), 161-183.

Forester-Miller, H., & Duncan, J. (1990). The ethics of dual relationships in the training of group counselors. The Journal for Specialists in Group Work, 16 (2), 88-93.

Glass, T. (1998). Ethical issues in group therapy. In R.M. Anderson, T.L. Needels, & H.V. Halls (Eds.), Avoiding Ethical Misconduct In Psychology Specialty Areas (pp. 95-126).

Marino, T. (1994). Nowhere to run, no one to talk to. American Counseling Association: Guidepost, 37 (2), 5-8.

Markus, H., & King, D. (2003). A survey of group psychotherapy training during predoctoral psychology internship. Professional Psychology: Research and Practice, 34 (2), 203-209.

Paradise, L., & Kirby, P. (1990). Some perspectives on the legal liability of group counseling in private practice. The Journal for Specialists in Group Work, 15 (2), 114-118.

Roback, H., Moore, R., Bloch, F., & Shelton, M. (1996). Confidentiality in group psychotherapy: empirical findings and the law. International Journal of Group Psychotherapy, 46 (1), 177-133.

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