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MASTERPIECE2019

PPT On Group Information Dependence Problem

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The summary should only be a brief summary of the paper with new information should be located in the body of the paper. The abstract should only be one paragraph from 150 to 250 words. An abstract rarely contains citations (Chapter 2, 2.04, p. 26). The text should not be cited. Ten research articles are required.

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Ethical Issues Unique to Group Therapy

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Abstract

Ethics is one of the contested issues in almost all aspects of human life. In the counseling arena, there are ethical codes that are put in place that guides the process of service delivery by psychiatrist. It is notable thereapeutical services are delivered either in individual or group sessions. In individual sessions, a psychiatrist serves a single patient at a time. On the other hand, group therapy involves  several patients that are attended in a single set up. In group therapy, flexibility is also enhanced from practitioners perspective since a big number of clients can be served at the same time thus creating a unique learning advantage.

However, group therapy also have unique ethical issues that are not observed in individual therapy. For instance,there is a  general dissatisfaction that  is observed concerning challenges in  ethical codes in group therapy set up. In  this perspective, it is important to identify and address all potential areas of concern that creates ethical issues. As a result, an examination of all factors that makes group therapy unique is conducted.This paper examines ethical issues unique to group therapy before comparing them with those prevailing in individual counseling. Also, the paper provides reasons supported with facts on why a therapist would prefer group therapy to individual counseling.

Key words: ethics, issues, confidentiality, dependence

Ethical Issues Unique to Group Therapy

Compromise of Personal Interest

Individual patients who form a group therapy usually have different problems that require psychiatric care. However, to ensure that the primary objectives of a group are achieved, therapists often find themselves in a situation whereby individual interests must be compromised. In this regard, evaluating issues related to beneficence and nonmalfeasance that touches individual and the entire group usually lead to ethical dilemmas. The psychiatrist has to establish a fragile balance of help and dissatisfaction among people and other group members (Doughtery, 1992). For instance, a therapist may find him/herself in a scenario where the response to the emotional demands of an individual member is postponed to serve other members. A rule of thumb is to assess the benefits and liabilities regarding the decision in hand from both individual and group perspectives. Managing the pace and intensity related to emotional issues to ensure uniform positive results remain an ethical issue unique to group therapy.

Confidentiality

Maintaining confidentiality in group therapy is always prone to jeopardy (Mangione, Licsw, & Iacuzzi, 2007). Since group therapy is social in nature, there is always a higher risk of private information to leak. The situation is worsened in case every group member has an individual session to attend which is headed by the same therapist. In the counseling field, confidentiality refers to a legal obligation of revealing private information regarding patient’s treatment. As a result, there is an urge to stipulate roles and duties of every party involved in a group therapy as well as confidentiality limits. Moreover, it is also important to educate group members on the possible dilemma regarding confidentiality and how to safeguard personal and other members’ privacy. Rules to guard privacy in group therapy also need to be set up with sanctions and punishments for perpetrators elaborated.

Managing Complex Personal Behaviors: Alcoholism

Some of the conditions that require psychiatric care are so complicated, especially in a group therapy setting. They hinder a meaningful interaction among group members making hard to a have a serene environment. A good example of a complex patient’s condition is alcoholism. Clients suffering from alcohol problems are observed to be reluctant to deal with while they are in a group therapy (Michael, 1989). The tendency to uptake alcohol encourages individuals to disregard the honest problem-solving approaches. Having a meaningful communication with group members who are alcoholic is also a challenging as the majority of them tends to be skeptical. Based on expectancy theory, alcoholics tend to have fake positive expectations regarding alcohol such as more confidence, optimism among others (Crespi, 2009). Changing such perspectives in an individual therapy is easier compared to a group therapy. Since it is easier for alcoholics to influence their peers, alcoholism remains an ethical issue in a group therapy setting.

Dependence

Dependence is one of the controversial ethical issues in the field of psychotherapy. Patients tend to develop a notion of having a parent/child relationship with the therapists rather a helper guide/helper relationship. Development of a dependence tendency is preferred by some psychiatrists as it strengthens the therapeutic bond and makes transference easy where necessary. In a group therapy set up, a sense of dependency can be lethal as it derails a sense of direction among the members (Haen & Weil, 2010). The group cohesiveness and interpersonal interactions might also be at stake. In this regard, it is important to have an open discussion with all members involved in a group concerning shortcomings of dependence traits in a group. The group leader should address the issue both in an individual and collective manner to ensure that members understand the seriousness of the subject.

Managing Group Social Power

The aspect of social power prevalent in the group therapy makes it more efficient compared to individual counseling. However, social power has been observed to be detrimental towards some individual members if it’s not well monitored. Extreme social pressure is considered harmful, especially where members are forced to conform to the established norms of a group. Such pressures negatively affect individuals in the group to make sound and rational decisions. In this regards, it is group leaders’ obligation to ensure there is a moderate group pressure towards members, thus enhancing the effectiveness of therapeutic care while diluting potential harms (Childs, 2001). It is notable that some member’s potential increases while subjected to pressure. However, it is advisable for the therapist to ensure that members are not overwhelmed. Open communication should be encouraged where clients are free to ask for help in a scenario where group pressures appear threatening.

Transference

The process of transference can complicate therapeutic group treatment. Since transference is a vital process in psychotherapy field, it is advisable for the group therapists to ensure that the whole exercise is done in a careful manner. As an ethical issue, the resulting concepts highly determine the success of the entire therapy process. From a group perspective, transference may alter the relationship between the clients and the treatment at an individual level. A rule of thumb is to ensure that all clients in group therapy are treated equally while personal objectives are still taken care of (Gershon & Rodriguez, 2013). Treating some members as special creates a competitive environment within the group. As a result, the approach taken by the therapist to address the issue highly manifests his/her competency.

Possessing Traits of an Ethical Leader

In individual therapy, only a single therapist is involved who assumes all leadership the roles. However, in group therapy, numerous therapists may be involved, thus, there must be a leader who oversees the entire process. While it is possible for any person to be a leader in a group therapy, the selected individual must possess unique ethical traits to lead the group in an efficient manner. According to Corey, Corey, & Callan (2007), a moral leader in group therapy must possess the characters of agreeableness and conscientiousness. This trait enables the administrator to assess risk and benefit regarding compromises to ensure that the primary objectives of a group are attained. Apart from the usual prerequisite leadership qualities, the group leader must also have empathy for the clients.

A Comparison of Ethical Issues Unique to Individual and Group Studies

Offering therapeutic care in an individual makes it easy for the psychotherapist to understand the requirements and personal objectives of a client. The sense of mutual understanding between the client and the therapist makes it easy to alter personal interests of the patients without detailed consultation. On the other hand, group therapy involves individuals who seek objectives that are related. However, there is a higher chance member’s whose personal goals do not match. In this context, compromising private interests becomes the only option for the group to realize the projected outcomes. To achieve uniform positive results for every group, the group leader must strike a balance between benefits and possible risks before altering interests of individual members (Gershon & Rodriguez, 2013). In other words, the procedure for compromising individual members’ interests in individual therapy is easy compared to group therapy.

Maintaining confidentiality is paramount either to the person or group therapy. From personal therapy perspectives, information regarding the clients’ condition and his/her progress is shared only between the therapist and the patient. This makes it difficult for sensitive information regarding individual therapeutic procedures to leak (Crespi, 2009). In contrast, group therapy involves a lot of socialization among individual group members. As a result, protecting individual members’ privacy rights can be challenging. In most cases, group therapy rarely receives legal protection as it is observed in individual therapy. For instance, it is found that the majority of psychotherapists tends to give examples that were experienced by their individual clients in previous sessions (Berg et al, 2013). Such scenarios are facilitated by the tendency to combine individual and group therapy. In short, the threats to confidentiality are higher in group therapy compared to individual therapy.

The social power factor plays a crucial role in enhancing the effectiveness of group therapy. Such power comes at a cost as some members may end up feeling overwhelmed by the pressure to conform with established group norms increases. In most cases, some members may find themselves making decisions that contradict with their personal principles. While such stands may induce a positive change, they might also end up initiating a feeling of being exhausted among some members (Travaglini et al., 2012). In contrast, the pressure to conform to some the treatment norms is minimal in individual therapy. The communication between the therapist and the client is better thus both parties usually understand each other. Moreover, individuals who are shy to express themselves in public will not have problems in stating their capability limits. In this regards, the prevalent social pressure is minimal in individual therapies compared to group therapies.

Dependency is a controversial subject both in individual and group therapy. In individual therapy, there are higher chances for the client to develop a sense of dependency compared to group therapy. The clients attending an individual therapy session receive undivided attention compared to those in group therapy. As a result, the chances of developing a sense of parent/child relationship are higher. In contrast, the tendency to divide attention among members makes it hard for clients to develop a sense of dependency. However, it is important to note that overcoming dependence in individual therapy is easier compared to group therapy (Doughtery, 1992). It is respected members in group therapy tend to copy each other behaviors. This makes it easy for members to borrow negative traits such as dependency. The complexity of communication in the group therapy makes it challenging for the therapist to address the issue.

The leadership qualities regarding ethics in group therapy are more demanding compared to individual therapy. The leader in a group therapy is expected to balance between the individual members’ interests and the interests of the entire group (Klontz, 2004). In this context, the leader is supposed to ensure that all members are treated equally to create a healthy working environment. In contrast, an individual therapy does not involve division of attention among different members. As a result, the leadership is simple, and the concept of malfeasance and beneficence is not challenging to determine.

The Rationale for Choosing Group Therapy Over Individual Counseling by a Therapist

Therapy sessions where persons with related goals are brought together in a group are gaining more attention in the modern psychotherapy field. Despite distinct ethical issues associated with this approach, many therapists are preferring group therapy to individual therapy. Firstly, the group therapy is more flexible compared to individual therapy. For instance, a single therapist can attend to more clients at the same time. In this perspective, the number of customers benefiting from therapeutic services increases compared to an individual therapy where every customer is served in a separate session (Childs, 2001). Flexibility in group therapy is also observed regarding sessions scheduling. In individual therapy, a psychiatrist has to divide his/her day into smaller sessions to serve clients. Such scheduling is not only tedious, but also inefficient.

Secondly, group therapy has a higher social power compared to individual therapy. As opposed to individual therapy where a single client discusses their issues with the therapists, group therapy creates a safe environment where sharing feelings and ideas are possible. In this regard, individual members of a group can improve their social skills in the long run. Moreover, socialization acts as a source of motivation that might be having low self-esteem or feeling demotivated as a result of their condition. Thirdly, group therapy usually makes the work of psychotherapist easy. For instance, patients in the same group may benchmark their performance to determine each’s level of progress. From this perspective, clients may receive positive feedback from their colleagues. It is also possible to analyze issues that appear complicated at the individual level in diverse views eventually getting a way out (Gershon & Rodriguez, 2013). Such approaches end up making the work psychiatrists more easy which not only saves time but also minimizes resources to be used in the entire process.

Group therapy also creates an environment that enables clients to learn new things. The clients are challenged to get out of their comfort zones by extending their capabilities. The tendency to raise the bar for the clients’ potential has been criticized in terms creating unnecessary pressures (Crespi, 2009). However, a sense expecting higher results instilled on members by the group leaders has been observed to cultivate a sense of positive attitude during the therapy session. As a result, many patients have been found to perform better in group therapy compared to individual therapy.

Fifthly, group therapy creates a win-win situation both for the clients and the care provider. From the clients perspectives, the social power associated with the group therapy increases the rate of recovery as sharing of thoughts and ideas is encouraged. Higher recovery rates reduce the number of treatment sessions that a single individual needs to attend. Charging fees per session are also minimal for the group therapy compared to individual therapy (Mangione, Licsw, & Iacuzzi, 2007). This is due to result simplification of the entire process that is observed in group therapy. From the caregiver perspective, organizing group therapy sessions enable them attend to a higher number of clients in a day compared to individual therapy. The amount of resources required in a group therapy is also minimal. For instance, it is easy for patients to share leaflets and other vital documents during a group discussion. This enhances cohesiveness while reducing paperwork. Simplified schedules in group therapy also enable the therapists to get rid of extra activities which strengthen the efficiency of the entire process.

Conclusion

The above discussion clearly shows that group therapy as a mode of offering therapeutic care has unique ethical issues that are not present in individual therapy platform. The rationale behind the formation of group therapy psychotherapy field is that clients usually have related personal goals. The paper uncovers seven unique ethical issues that are prevalent in group therapy. These are the compromise of individual interests, confidentiality, an aspect of social power, dependence, transference, managing complex personal behavior such as alcoholism and ethical leadership traits. For instance, the threat to confidentiality is higher in group therapy compared to individual therapy. It is easier to safeguard privacy rights of the clients in individual therapy compared to group therapy.

Ethical issues unique to group therapy also vary to individual therapy. For instance, in individual therapy, there is less pressure on the clients to conform to certain requirements during treatment. However, the pressure to conform to group norms may end up exalting pressure on members. In this context, the social power that is prevalent in group therapy can be detrimental to the entire process if not well monitored. Nevertheless, group therapy appears the most feasible mode therapeutic care from both clients and therapist perspectives. For example, the clients using group therapy can improve on their social skills. This is because group therapy supports the exchange of feelings and ideas. Moreover, group therapy is cost effective to the clients. From a caregiver perspective, group therapy is more flexible as it enables therapists to serve numerous clients at the same time. Group therapy also creates a higher revenue to the caregiver as they can serve a larger number of customers daily.

References

Childs, J. (2001). Interprofessional approach to ethical issues. Theory in Practice, 46(2), 125-131.

Berg, R., Landreth, G., & Fall, K. (2013). Group counselling: Concepts and procedures. New York :Routledge.

Crespi, T. (2009). Group counseling in the schools: legal, ethical, and treatment issues in school practice. Psychology in the Schools, 46(3), 273-282.

Doughtery, M. (1992). ethical issues in consultation. Elementary School Guidance & Counseling, 26(3), 214-220.

Gershon, E., & Rodriguez, N. A. (2013). New ethical issues for genetic counseling in common. Mechanisms of Psychiatric illness, 170(1), 968-976.

Haen, C., & Weil, M. (2010). Group therapy on the edge: Adolescence, creativity, and group work. Group, 34(1), 37-52.

Klontz, B. (2004). The ethical practice of experiential group psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 41(2), 172-179.

Mangione, L., Licsw, R., & Iacuzzi, C. (2007). Ethics and endings in group psychotherapy: saying good–bye and saying it well. International Journal of Group psychotherapy, 57(1), 25-41.

Michael, F. (1989). Cognitive and affective patterns of alcoholics: implications for group therapy. Group, 13(1), 31-41.

Travaglini, L., Treadwell, T., & Reisch, E. (2012). Confidentiality and cohesion in groups: Story collaborative building and telling as a means of improving the therapeutic experience. Group, 36(4), 317-331.