Abstract
This research paper will discuss the different ethical issues within group therapy sessions. A therapist should bear particular ethical standards that are required in group therapy sessions. Importantly, counselors should uphold moral codes that guide the group agenda from the formation to the operational stages of the group. Also, this paper will analyze the distinct traits of individual and group counseling. Group counseling involves one counselor attending several clients simultaneously. On the other hand, individual counseling includes a one on one session between a client and therapist. In group counseling, the members may be shy to share their issues while in individual therapy, the client may be very open to the counselor. The last part of this paper will explore why a therapist may decide to choose group therapy over individual therapy. Among many factors, the decision of the therapist is mostly determined by the client’s condition and effectiveness of a particular treatment process.
Hot topic of ethics in groups
Therapists and clients encounter various factors if they decide to choose group therapy. The hot topics of ethics in group counseling may influence the success of the treatment. The first hot topic in group ethics is the conflict of interest. A conflict of interest may occur if the patients have a relation outside the therapy setting or the counselor has a connection with the clients outside the session setting. This ethical issue may be unimpeachable and in most cases unpreventable (Gonyea, Wright, and Earl‐Kulkosky, 2014). However, if the client and therapist have a relationship outside the session setting, they should apply particular policies and ethical factors to ensure the treatment is not impacted negatively. The patient and client should be careful to ensure their safety and concentration during therapies. In group counseling safety and protection is vital since the sessions involve numerous people (Burian & O’Connor Slimp, 2000).
Second, referring clients is an intricate issue of ethics in group counseling. The counselor might identify when a patient requires the services of a more qualified therapist. Also, a therapist should determine when a patient needs individual therapy instead of group counseling. This knowledge helps the therapist to refer their clients at the right time. Alexopoulos, Raue, and Areán, (2003), note that the counselor may recommend PST to a patient according to their condition. The client also benefits from the wise decision from a therapist to refer them to a different counselor or individual therapy. Patients and sharing is also a hot topic of ethics in group therapy. In therapy sessions, it is crucial to inform the patients that they can share all relevant issues. The therapist should also notify the clients that they can conceal any information that they do not wish to share during the therapy sessions. Further, the therapist should reveal their experience to the patients. The disclosure makes the clients comfortable and open in session settings.
Termination and follow-up is also a hot topic in group counseling. Members of a group may have related issues, but achieve healing at different times. In this case, the therapist should have the right skills and knowledge to create conducive condition for positive change (Brabender, 2006). They should also monitor the healing process in clients and determine when to terminate a certain therapy. Ideally, if a therapist failures to end the treatment at the right time, the patient might be impacted adversely. Upon termination of therapy, the therapist should identify and plan follow-up counseling programs. Clients tend to respond slowly to certain treatments administered to help them regain their normal status. Hence, a good follow-up program by the therapist helps them recover fully. The knowledge and qualities of the therapist is also a contemporary topic.
The person to lead a group therapy should have appropriate training since they will be at the forefront during sessions. Even though any individual can lead a group session, there are specific traits that are required in a therapist. Agreeableness and dutifulness are two essential qualities that a therapist should exhibit. Each therapist should show certain ethical standards that allow them to interact with the clients freely without inflicting any harm. The moral standard also enables the leader to show empathy and compassion to the patient for the sessions to proceed smoothly (Bruns, and Frewer, 2011). Planning and organizing also help the leaders to design efficient and engaging counseling sessions. Good understanding of the topics of a certain therapy session is crucial since it helps the therapist to respond to challenging and contradicting questions that arise during treatments. Apart from contemporary knowledge about certain topics, the counselor should also be aware of the theoretical background of specific issues. This experience helps the therapist to have a solid foundation and expertise of the discussion topics.
Ethical issues unique to group therapy
Importantly, all participants in groups counseling wish to achieve personal development. The counselor creates a setting that allows the members to share their issues openly and honestly. Group counseling has different ethical issues that arise in the course of the therapies. Confidentiality is one of the primary ethical issues in group counseling. In a group therapy, the therapist cannot enforce privacy since members share their problems openly. Thus, participants are not guaranteed that their information will remain concealed. Misuse of power can also happen in group counseling. The team leaders’ have authority over the clients which determines the success of the therapy.
Another key ethical issue of group therapy is involuntary participants in the group. A therapist should counsel the patients of their liberties and roles and share with them about any possible problem that they may experience if they decide to undergo the therapy. Barros-Bailey and Saunders (2010), states that informed consent is very vital if patients have to adopt a particular treatment. Ideally, therapists, psychiatrists and counselors should strive to establish an informed consent before initiating a group therapy. Consent indicates that the clienteles know all the procedures, effects, and outcomes of a particular treatment. Involuntary patients may impact the therapy sessions adversely.
In this case, the therapist should tailor the sessions to suit the unwitting client who may hinder the direction of the therapies. Also, the entire group may be impacted negatively by an involuntary client. Another ethical issue in group therapy pertains right of refusal and confrontations during sessions. Some individuals have a legal and clinical ability to decline a particular care. These people may reject an absolute care regardless of the thoughts of others. Notably, some therapists tend to reject working with clients due to their insurance covers. While some insurance firms decline to reimburse certain treatments others may take a therapist to court for incompetence. Therapists also encounter patients who do not contribute during therapy sessions. These clients may be too shy to talk or mentally disturbed to participate in group therapy.
Administering therapy session that does not work well in group settings is also an ethical issue. Conflicts of cultural values also present a challenge in group counseling. Cultural values are ethical issues since some communities do not support sharing of information openly. For instance, in family counseling, a parent may not share their problems openly in the presence of their children. However, ethics offer policies and guidelines for premier behaviors in family counseling (Southern, Smith, and Oliver, 2005).
Negligence might also occur in group counseling. The counselor can breach their role of offering what is identified by other professionals as the standard practice. Evidently, neglect and misuse of therapy sessions may lead to failure. Personal relationships between the clients may also present an ethical issue in group counseling. Close relationship between group members may influence the therapy sessions either positively or adversely. Psychological risks of a group are also an ethical issue in therapy. Members of a group may be psychologically impacted by issues of colleagues or by the treatments suggested by the therapist.
How ethical issues within groups compare to those from individual counseling
The ethical issues in individual and group counseling exhibit some differences and similarities. The problem of dual relationship may occur in both individual and group therapies. Just like in group setting, the client and therapist in individual counseling may have a personal relationship outside the session setting. Also, some patients may be reluctant to adopt some treatments proposed by the counselor which raises the issue of involuntary. Confidentiality may be more practiced in individual counseling than in group therapy. Ideally, in individual counseling, the client shares their concerns directly with the therapist without involving a third party. Hence, there are high chances that the information will be held between the patient and their therapist.
Another ethical issue that is prone to individual counseling is sexual abuse. Therapists tend to take advantage of the clients in individual therapy setting. A patient may experience adverse outcomes in case they are involved in a sexual relationship with the therapist. Evidently, these similarities and distinctions between individual and group therapies impact the results differently. It is notable that these two treatments work effectively for different people. While some patients achieve positive results from group therapies, others find group counseling useful.
Why a therapist would choose group therapy
Group counseling offers various benefits to the therapist and client. In a group setting, the counselor has a chance to attend to several clients concurrently. Thus, the therapist will determine how the patients' are faring with the therapy. A therapist may also choose group counseling since they get substantial income per session and minimize miscellaneous expenditure. On their part, the clients can minimize their spending due to cost sharing. Group therapies are time saving and allow the therapist to plan their schedules. For instance, a therapist can attend to ten clients in only one hour. Conversely, if the therapist serves a single client for one hour each, they would take ten hours to handle all patients.
Additionally, members of a group get different viewpoints of the issue that they are experiencing. The patients understand that most other people are also facing similar problem which shortens the time of the therapy. Individuals experiencing similar problems have an opportunity to share their experiences. Thus, people with comparable issues learn how to cope with their problems. Other clients require a sense of belonging which is only possible in group therapy. People also acquire new skills through group therapies and adopt the right behavior to apply the skills in real life. Group participation offers the participants an opportunity to get collective feedbacks compared to a single feedback that they receive from an individual therapy. Further, group therapy allows patients to learn from each other indirectly by paying attention to the issues of they have in common.
Therapists also believe that it is effective to develop therapy categories that can suit many individuals. The counselors offer information about a particular issue to many patients simultaneously which relieves their workload. Therapists presume that group counseling is more structured since patients get accurate categories or modules to discuss and study. Counselors also suppose that offering group therapy helps members to gain experience which supports the healing process.
Therapists believe that group counseling that involves families contributes to determining how they interact and assists them to feel comfortable in sharing problems. The counselors develop a succinct plan for the entire group (Vinella, 2013).A clear goal for the team helps the therapist to put efforts to achieving the objective. Therapist may also choose a group therapy based on the conditions for the patients. Evidently, the counselors analyze the requirements of the clients before recommending a particular treatment. Patients who have minor issues can suit in group therapy effectively. The therapists tend to group clients who have similar or related matters together to ease the therapy process.
Why therapist may choose individual therapy
The primary factor that makes a therapist prefer individual therapy is the condition of the client. Importantly, some patients cannot perceive positive outcomes from group therapy. In case a client is uncomfortable with group therapy, a therapist may choose individual therapy. At times, a patient may be unwilling to share their secrets and issues in a group. Also, a patient may be reluctant to share their problems openly if a group consists of close relatives. Some patients may be very shy and not ready to open up when sharing a forum with their family members. In a group therapy, patients may not get sufficient time to interact with the therapist. This aspect may be a shortcoming if a client requires more attention from the counselor. People with severe mental illness may find individual therapy more appropriate (Bolier, Haverman, Westerhof, Riper, Smit and Bohlmeijer, 2013). Individuals with severe psychiatric problems cannot fit in a group setting.
The experience and skills of a therapist ensure patients get sufficient professional help at a personal level. Ethical decision-making in individual therapy leads to a power shift. Unlike in group setting, in individual therapy the patient has more control over their treatment. The clients can establish the kind of treatment they require. The counselor offers the patient multiple choices and lets them decide the best therapy. This aspect provides the therapist the opportunity to identify a treatment that works for the client and one that does not work. Concentration tends to be high during an individual counseling since interruptions come from only two parties, the client and therapist. In individual therapy, a counselor avoids issues of cultural and religious variables are associated with group counseling (Cornish, Wade, Tucker and Post, 2014). The therapist can determine when they want to meet their clients for sessions without inconveniencing a large group. Therapists may also choose individual counseling since managing a single person is simple. The counselor will not have to deal with contradicting ideas raised in group therapies. A therapist also believes that convincing an individual client to adopt a particular treatment is easier that convincing a group.
Conclusion
Group and individual therapies present various ethical issues regarding the behavior, relationship and interactions between the therapists and clients. The ethical standards observed in these therapy approaches are also different. In both counseling methods, the therapist should consider conflicting interests, dual relationships and refer clients if they require advanced treatment. The hot topics in group counseling mainly revolve around the session settings, conduct of the counselor and involvement of many members in a group. Various factors determine the kind of therapy the therapist would choose. In a case where the patient requires more attention, is shy or has a severe psychological disorder, the therapist may prefer individual therapy. Conversely, when people have minor related issues and want to cost share the charges of the therapy, the counselor will most likely choose group therapy.
References
Alexopoulos, G. S., Raue, P., & Arean, P. (2003). Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. The American Journal of Geriatric Psychiatry, 11(1), 46-52. Retrieved from http://ezproxy.liberty.edu:2048/login?url=http://search.proquest.com/docview/195982648?accountid=12085
Barros-Bailey, M., & Saunders, J. L. (2010). Ethics and the use of technology in rehabilitation counseling. Journal of Applied Rehabilitation Counseling, 41(2), 60-64. Retrieved from http://ezproxy.liberty.edu:2048/login?url=http://search.proquest.com/docview/577388539?accountid=12085
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health, 13, 119. Retrieved from http://callisto.ggsrv.com/imgsrv/FastFetch/UBER1/5QAT_1471-2458-13-119-p?dl=Positive_psychology_interventi.PDF
Brabender, V. (2006). The ethical group psychotherapist. International Journal of Group Psychotherapy, 56(4), 395-414. Retrieved from http://ezproxy.liberty.edu:2048/login?url=http://search.proquest.com/docview/194771302?accountid=12085
Bruns, F. & Frewer, A. (2011). Ethics consultation and empathy. HEC Forum, 23(4), 247. Retrieved from http://search.proquest.com.ezproxy.liberty.edu:2048/docview/916008452?pq-origsite=summon
Burian, B. K., & O’Connor Slimp, A. (2000). Social dual-role relationships during internship: A decision-making model. Professional Psychology: Research and Practice, 31(3), 332-338. Retrieved from http://psycnet.apa.org.ezproxy.liberty.edu:2048/journals/pro/31/3/332.pdf
Cornish, M. A., Wade, N. G., Tucker, J. R., & Post, B. C. (2014). When religion enters the counseling group: Multiculturalism, group processes, and social justice. The Counseling Psychologist, 42(5), 578-600. Retrieved from http://tcp.sagepub.com.ezproxy.liberty.edu:2048/content/42/5/578.full.pdf
Gonyea, J. L. J., Wright, D. W., & Earl-Kulkosky, T. (2014). NAVIGATING DUAL RELATIONSHIPS IN RURAL COMMUNITIES. Journal of Marital and Family Therapy, 40(1), 125-36. Retrieved from http://ezproxy.liberty.edu:2048/login?url=http://search.proquest.com/docview/1501475688?accountid=12085
Southern, S., Smith, R. L., & Oliver, M. (2005). Marriage and family counseling: Ethics in context. The Family Journal, 13(4), 459–466. Retrieved from http://tfj.sagepub.com.ezproxy.liberty.edu:2048/content/13/4/459.full.pdf
Vinella, P. (2013). Transactional analysis counseling groups: Theory, practice, and how they differ from other TA groups. Transactional Analysis Journal, 43(1), 68-79. Retrieved from http://search.proquest.com.ezproxy.liberty.edu:2048/docview/1659760854?pq-origsite=summon
