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Ethical Consideration for Group Therapy

Ethical Consideration for Group Therapy

Ethical Consideration for Group Therapy

QUESTION
Instructions
Based on your understanding of the ethical code of your profession and your readings, for this task, describe how you think the therapist in the following situations should respond. Refer to the specific parts of the code to support your thinking. Note any sections that may remain unclear or in which personal judgment might play a role. Please choose one of the following scenarios for your assignment.

Scenario 1: You are the group leader of a women’s group. Sue, one of the participants in the group, wants to help others get involved and invested in therapy. To show them how effective therapy can be, she reveals that a few years ago she had inappropriate sexual thoughts toward a minor. She never acted on them, but they caused her great distress. After more than a year of group therapy with other people who had similar issues, she was able to get rid of these obsessive thoughts.

After the session, Meg, another member of the group, comes up to you for advice. Sue’s daughter and Meg’s nephew are in the same class at school. Her nephew has recently been invited to a sleepover at Sue’s house. Now she wonders if she should advise her brother against letting his son attend the sleepover. She knows it is wrong to reveal anything that was discussed in the group outside the session but doesn’t feel comfortable having her nephew at Sue’s house in a sleepover situation. She asks for your advice.

What ethical principles are involved here?
Is it appropriate for you to discuss Sue outside of the therapy group?
How much of what occurs in the session can Meg share with her brother in this situation?
Does it make a difference that Sue says she never acted on her inappropriate thoughts?
How would you deal with this situation and observe ethical principles at the same time?
Scenario 2: Lena has been placed in group therapy as part of a court order. She must attend the therapy sessions or enter a detention facility. She shows little interest in the session and even less interest in sharing anything personal or doing any work on herself. Another group member, Becca, comes into the group one day, obviously distressed and distraught. She reveals that her father beat her in an alcoholic outburst. She further adds that this is not a rare occurrence for her. After the session, you find Lena taunting Becca in the schoolyard, mocking her about her father in front of other girls.

How would you, as a group leader, react to this scenario?
What type of rules would you have put in effect for someone like Lena (who is an adolescent and forced to attend)?
Would you expel Lena from the group for this behavior? Why or why not?
What other steps might you take?
What are your ethical responsibilities toward Lena?
What are your ethical responsibilities toward Becca?
In a paper, address the questions in both of the scenarios listed above.

Support your analysis with at least three articles published in peer-reviewed journals in the past five years.

Length: 4 pages for the entire paper (2 pages for each scenario).

References: Include a minimum of four scholarly resources.

Part 2: For this week’s reflection, consider the following points:
Reflect on your experience with this week’s readings and Assignment 1. (Assignment 1 focused on evaluating group developmental actors and stages).
Examine what therapy approaches were reviewed from this week’s readings, and name one and a population it might be useful as a therapeutic intervention and why.
Include any questions you may have for your professor.
Length: 1 pages
Ethical Consideration for Group Therapy

ANSWER
Ethical Consideration for Group Therapy
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Ethical Consideration for Group Therapy
Introduction
Group therapy is a popular mode of psychological treatment designed to alleviate psychological problems and improve psychological growth. The approach involves logic and emotional interaction between group members and the therapist and also among clients. The modality provides a cheaper alternative to psychotherapy to a large number of clients. Group therapy seeks to effect psychological wellness to members. However, the efficacy of group therapy is limited to negative outcomes when ethical issues that involve the group leader or group members arise. Ethical issues arise when the therapist is not skillful or well trained in handling confidential issues of each member of the group or the group as a whole. Group therapists should be mental health professionals with specialized and specific group therapy training to minimize ethical issues that result in negative outcomes. The paper focuses on the ethical issues that group therapists and group members face regarding patient confidentiality among members and the consequences they face once they breach these agreements.
Ethical Dilemas
To understand the ethical issues involved in group therapy sessions, two scenarios are discussed in depth. The first scenario is that of Sue. She is one of the participants in a women’s group therapy. One day she testifies how effective group therapy has been to her life. She discloses that some years back, she had unappropriate sexual desires towards small boys. Although Sue claimed to have never acted on them, she admitted that the thoughts caused her abundant pain. After interacting with people with the same issues for more than a year, she successfully got rid of the thoughts and desires for small boys. Meg, another group member, after the session comes for advice. Her nephew and Sue’s daughter attend the same class in school.
She learns that her nephew has just been invited to a sleepover at Sue’s home. She is now confused whether she should advise her brother against letting her nephew attend the sleepover.
She understands that it is wrong to expose anything discussed in the group to the session but she is uncomfortable to letting her nephew at Sue’s house.
Ethical Principles in Group Therapy
As a group therapist, one of the expected ethical principles is to value equality and tolerance between people and enable friendly solutions to conflicts between individuals. The case has two implications. On one other hand, if Meg decides to advise her brother against allowing the children’s sleepovers, she would have prevented her nephew’s potential sexual molestation. Assuming that Sue is still susceptible to her sexual desires towards minors, she could attempt to move on to them. On the other hand, Sue could have completely had a change of sexual desires in children. If Meg decides to advise her brother against her nephew’s sleepover at Sue’s house, the conflict will arise, and Sue’s confidential testaments will be revealed. This will lead to conflict and lack of trust to sue towards the therapist and the whole group. Meg should take Sue by her word that she changed and has no sexual interests in minors anymore. The best decision to take as a group therapist is to remind Meg to stick to her part of the confidentiality agreement as Sue claimed to have never acted on her feelings towards minors. Meg and Sue should be encouraged to continue with their group psychotherapy participation only so long as appropriate to the patient’s needs. Sue’s confession should not create animosity between Meg and sue or any other member related to a minor.
Issue of Confidentiality
Discussion of other members While offering Meg advice, avoid discussion of Sue’s confession with Meg. Focus on the consequences of Meg opening up to her brother. Meg should also be guided on the importance of safeguarding fellow group members’ privacy, not only Sue’s but also other group members. Meg should be encouraged to embrace the concept of confidentiality and not share anything with her brother regarding Sue or any other group member. This will not only prevent problems of lack of trust among Meg and other group members, but it will also uphold Sue’s dignity and integrity. The consequences of breaching confidentiality should be clarified and explained to her.
The fact that Sue did not act on her inappropriate thoughts should not be a factor for the therapist to stop offering therapy. However, since the issue involves minors, Sue should be interrogated further to avoid any case of child molestation. Encourage her to continue with the therapy sessions to be fully free from the inappropriate thoughts.
The situation should be handled diligently. The group leaders should do proper screening to identify the group members’ rights, compatibility for the group, and if the group is an appropriate fit for the client. The screening process is initially conducted in the first session and is a continuous process throughout the clients’ journey. Clients are expected to be supportive and active if they are conversant with the process. The leader who does this as a matter of policy demonstrates honesty and respect for the members and fosters
Conflicts in Group Therapy
The second scenario is the case of Lena. She is an adolescent girl that has been directed by the court to attend group therapy. Lena has to choose either attend the therapy session or be detained in a government facility. Lena has no interest in the group therapy shows no interest in sharing personal issues or even taking part in group activity. Becca, another group member one days shares her personal story of how she has been physicaly assaulted by her father. She adds that her father is an alcoholic and is used to beating her. Later after the session, lena taunts Becca in the schoolyard about her father beating her in the presence of other girls.
Ethical Consideration for Group Therapy

Steps in Conflict Resolution
The first step in handling the conflicting situation is to stop the outburst. Separate Lena from the group and have an individual discussion on her behavior. The next step would be to dismantle subgroups existing within the group therapy. Subgroups tend to undermine group cohesion and increase member drop out.
Rules and Consequences of Rule Breaching
The establishment of rules and guidelines for group sessions is a vital element of group therapy’s success for all participants. Rules put in place to deal with adolescents such as Lena would include; all participants are expected to keep other members confessions confidential at all times, group members must answer not all questions as one can opt to pass a question or activity, violence and intimidation towards another group member are unacceptable, compulsory attendance of group meetings unless an emergency arises. Members should not attend group therapy under the influence of drugs.
Precautions should be taken against group members who defy group therapy rules. Several precautions should be taken against Lena to avoid similar mistakes from other group members. Meaning-Attribution should be applied to Lena. Meaning attribution would involve Lena to understand herself, other group members, and people outside the group. This will enable her to stop taking out her anger and insecurities on others. The approach is a better method of dealing with Lena as opposed to terminating her therapy session.
Emotional Stimulation should be offered to Becca after the altercation. Emotional stimulation uncovers and encourages the expression of feelings, values, and personal attitudes (). This will enable her to uncover her recent attitude towards Becca. Encourage her to forgive and accept Lena as part of the group therapy.
Ethical Responsibilities of Therapists
Several ethical responsibilities should be extended towards Lena and Becca. They include trustworthiness. Trust is the distinctive ethical dimension of group therapy. Trust will enable Lena to achieve her aspirations and foster quality interaction between Lena and other members of the group. Developing trust will enable Lena to tell the truth as she understands it without holding information. Autonomy is another ethical responsibility of therapists. The responsibility emphasizes the importance of increasing a clients’ capability to be self-directing within therapy and other aspects of life.
Beneficence is one of the ethical responsibilities that should be practiced by Becca. The ethical responsibility stipulates that all the actions and activities are in the client’s best interest based on professional assessment. The therapist is obligated to use regular supervision to enhance the quality of the services provided.

Therapy Approaches Used in Group Therapy
Group therapy incorporates different approaches depending on the specific population of clients. Cognitive Behaviour Therapy (CBT) is an example of approaches used in group therapy. The approach aims to change inappropriate and unwanted behaviour through rewards, desensitization and reinforcement (Shuman, Shreeve and Corley 2020). Clients learn ways to identify and change destructive thought patterns that negatively influence their behaviour. Group leaders can apply cognitive behaviour therapy to treat drug addicts population. The approach can be used to treat Lena from the second scenario, who is a drug addict. CBT is preferred in the treatment of drug addiction; this is because it is focused on helping addicts deal with the specific underlying problem. Therapists guide addicts to identify and understand the thoughts and feelings that influence their use of drugs.
Brief cognitive group therapy is another technique used in group therapy. Individual group members take turns to describe situations that led to their depressive feeling. Clients are allowed to freely explore difficult experiences from their past, gaining insight and working through unresolved issues Group therapist can use the approach to treat clients with post-traumatic stress disorder. In this case, Becca should be counselled using a cognitive approach. Therapists try to change clients’ thoughts so that they can change how they feel and what they do.
Psychodynamic group therapy is also an approach used in group therapy. The approach stresses the importance of the unconscious and past experience in shaping current behaviour (Shuman, Shreeve and Corley 2020). Psychodynamic therapy can be used to treat clients with emotional problems resulting from past physical or and sexual abuse. Group members are asked to talk about their childhood, the relationships they had with their parents, and other significant people. The therapist then identifies the feelings the clients experienced in previous relationships. From the revelation of the feelings, the therapist encourages the development of transference, giving the client a sense of safety and acceptance.
Conclusion
Efficient group psychotherapy depends on the preparedness of group therapist, and the ability of leaders to plan the activities of the population. Keen preparation is important to the functionality of the group therapy. The process includes scrutiny of clients, selection of few and practicable number of group members with similar issues, introducing a regular place and time for the therapy session, and formulating rules and penalties. The success of group therapy is dependent on many factors. Ultimately, ethical principles and responsibilities enables the a better interaction among members leading to succss of the psychotherapy.
New meeting Brief cognitive group therapy is another technique used in group therapy. Individual group members take turns to describe situations that led to their depressive feeling. Clients are allowed to freely explore difficult experiences from their past, gaining insight and working through unresolved issues Group therapist can use the approach to treat clients with post-traumatic stress disorder. In this case, Becca should be counselled using a cognitive approach. Therapists try to change clients’ thoughts so that they can change how they feel and what they do.
Psychodynamic group therapy is also an approach used in group therapy. The approach stresses the importance of the unconscious and past experience in shaping current behaviour (Shuman, Shreeve and Corley 2020). Psychodynamic therapy can be used to treat clients with emotional problems resulting from past physical or and sexual abuse. Group members are asked to talk about their childhood, the relationships they had with their parents, and other significant people. The therapist then identifies the feelings the clients experienced in previous relationships. From the revelation of the feelings, the therapist encourages the development of transference, giving the client a sense of safety and acceptance.
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Reference
Gregory Jr, V. L. (2020). Cognitive-behavioral group therapy and buprenorphine: Balancing methodological rigor and community partner ethical concerns in efficacy-effectiveness trials. Ethics & Behavior, 30(5), 364-384.
Proctor, C. (2018). Virtue ethics in psychotherapy: A systematic review of the literature. International Journal of Existential Positive Psychology, 8(1), 22.
Schönenberg, M., Wiedemann, E., Schneidt, A., Scheeff, J., Logemann, A., Keune, P. M., & Hautzinger, M. (2017). Neurofeedback, sham neurofeedback, and cognitive-behavioral group therapy in adults with attention-deficit hyperactivity disorder: a triple-blind, randomized, controlled trial. The Lancet Psychiatry, 4(9), 673-684.
Schumann, N. R., Farmer, N. M., Shreve, M. M., & Corley, A. M. (2020). Structured peer group supervision: A safe space to grow. Journal of Psychotherapy Integration, 30(1), 108.

Ethical Consideration for Group Therapy

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