Maintaining Confidentiality in Group Therapy

Introduction

Confidentiality has been a fundamental factor in healthy therapeutic relationships based on ethical principles of fidelity and autonomy. Confidentiality is based on the assumption that a client or a patient has the right to decide who they want to share their information with. It also assumes respect for the choice of the patients regarding the information they want to disclose. Fidelity, in this case, refers to the faithfulness of the psychologist and loyalty to keep his or her promises to the client, including not disclosing the information that the client revealed.

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Confidentiality in therapy needs to be taken with much concern, since it builds self-confidence in both the therapist and the patient, thus leading to a healthy working environment (Association for Specialists in Group Work, 2007). The aim of this essay is therefore to address the aspect of confidentiality and other ethical issues that are unique to group therapy while bearing in mind how they differ from those of individual counseling as well as discuss why a therapist would choose group therapy over individual counseling.

There are several ethical issues that are unique to group therapy. Group therapy refers to a form of counseling that incorporates a small group of people converging together under a trained therapist. The trained therapist has the duty of giving encouragement to the group members to help each of them to overcome their challenges. In most cases, the group members are peers facing the same kind of problem, such as anxiety, depression, etc. The ethical issues that are unique to group therapy are as follows (Laing, 2012).

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Group Therapy and Confidentiality

Confidentiality, which may be described in other words as the right to privacy, becomes the center of all the activities that are undertaken in group therapy. Confidentiality is the ethical duty of every trained therapist to uphold the privacy of the patient’s information, and this has become a constitutional right for every citizen. In group therapy, the practice of secrecy should be upheld because of the number of individuals involved in the group.

The therapist has the task and the duty of notifying his or her patients that confidentiality is not only ethical but also a legal requirement. The therapist is also obliged to review the requirements pertaining to confidentiality at the beginning of the meeting for the aspect of internalization within the group, and at any time, there is an individual who comes to join the group (Association for Specialists in Group Work, 2007).

The issues of confidentiality are often believed to be complex. The American Psychological Association (APA) states that therapists always find themselves in a dilemma when they have to deal with confidentiality issues. Therefore, the American Psychological Association (APA) provides an ethical guideline on the question of secrecy in group therapy. This guideline states that a therapist or a psychologist is obliged to protect confidential information and recognize the limits of information disclosure (Amato, Blase & Paley, 2001).

However, the guidelines provided by the American Psychological Association provide little specificity about confidentiality in group therapy. For this reason, another organization meant to deal with the aspects of group work that came to be. The Association for Specialists in Group Work developed more definitive guidelines in the year 2007, which found their wider use in group therapy. The association explicitly stated that group workers are obliged to define confidentiality and its limits in the way they behave when undertaking the discussion in a group setting. It also took into consideration the legal aspect of confidentiality (Amato, Blas? & Paley, 2001).

The association further stated that group therapists have the responsibility and the task to inform the group members about the essence of confidentiality in a group setup. Similarly, it is their role to educate the members on the repercussions of breaching confidentiality, as well as to inform about the fact that the legal privilege does not necessarily apply unless provided by state statute (Amato, Blas? & Paley, 2001).

It is clear that group psychotherapy has been a powerful therapeutic method of psychological treatment, but the issue of confidentiality has become an issue of concern (Forsyth, 2014). In comparison with individual therapy, in most group therapies, it is not the therapist only who is legible to get the information, but other group members are also in the position of knowing what their counterparts are undergoing. Thus, most people do not understand how confidentiality can be practiced. The specialists in group work boldly state that the clients need to be in the position of assuming all the aspects of privacy in detail. Thus, the information on privacy matters needs to be channeled to the group members immediately they enter the group (Laing, 2012).

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First-time education on the aspects of privacy before a member enters the group will enable them to better understand the issue of confidentiality in group therapy. Regarding the aspect of the informed consent, the practice of confidentiality has not become a legal requirement, but it becomes part and parcel of the member participation in a group, that will enhance the privacy of the latter (Kaminer, 2005).

In maintaining confidentiality in group therapy, group members should be encouraged all the time to embrace the aspect of confidentiality in the group and make it one of the group norms. This means that they should openly discuss the issue of secrecy amongst themselves. Also, the constraints that constitute the breach of secrecy should be clearly and thoroughly defined in the context of group discussions, and the consequences should be well understood in the study. There is a common phrase that has been in use in therapeutic groups, “what is said in the group stays in the group”.

To some extent, the expression has played a significant role in maintaining confidentiality in group therapy in that issues that are discussed amongst the panel members are not carried elsewhere. Therefore, a therapist needs to explain their responsibilities to the group members and keep on reminding them about their commitment to keeping their group members’ information private, and that no other party may have knowledge of the discussion (Durr, 2007).

The other ethical issue that relates to group therapy is upholding professionalism. A therapist needs to establish a clear group therapy boundary. This would enable him or her to extensively define and maintain their professionalism. This implies that there are patients who may surpass the limits, which would result in a significant challenge for the therapist in delegating their duties per the anticipation of the group. There are specific techniques that can be employed by the therapist in case such a challenge occurs in the group.

For instance, the therapist has the authority to refer the patient to individual therapy. Also, it's difficult for a therapist to file and win a malpractice lawsuit. Hence, it becomes extremely significant to uphold and maintain the appropriate level of professionalism as compared to individual therapy (DeLucia-Waack, 2004).

From the above discussion, it is clear that maintaining absolute confidentiality in group therapy is unrealistic and often difficult. However, guidelines have been initiated by different associations such as the American Psychological Association (APA) and Association for Specialists in Group Work to enhance and uphold the ethical issue of confidentiality in group therapy. These associations to some extent have led to the assurance of secrecy among members in a group setting.

To ensure privacy, a therapist or a psychologist has to provide informed consent about confidentiality in detail, inform the group members about confidentiality as well as about the likelihood of breaching confidentiality among group members. This will enable the therapist to stand a chance of maintaining ethical principles regarding privacy such as autonomy and fidelity (Corey, Corey & Haynes, 2014).

When comparing the ethical issues that are unique to group therapy with those that are characteristic of individual counseling, many differences are found. In comparison with the maintenance of confidentiality in a group, the aspect of secrecy in individual counseling is more vulnerable to breaches in that the issue of secrecy is not discussed much. Further, in the context of individual counseling, the aspect of creating a boundary between the therapist and the patient is at stake. From the perspective of establishing a boundary to enhance professionalism in individual counseling, it may be violated to an extent that a therapist may express his or her feelings to the patient, which may further result in sexual attraction towards the client (Kaminer, 2005).

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Numerous studies on individual psychotherapy have concluded that a big percentage of patients have been sexually abused by their therapists, which leads to adverse outcomes as compared to group therapy. Also, group therapy in a broader perspective involves numerous members who come together with particular disorders such as depression, anxiety, etc. Through collaboration in a group, the members to a greater extent get to learn from each other’s experiences. Hence, the experience in a group context is accumulating to an extent that is beneficial for both the therapist and the patients as compared to individual therapy. However, these positive results are only possible in case the confidentiality and privacy of each group member is maintained (Brabender, Fallon & Smolar, 2004).

When comparing group therapy and individual therapy, it should be mentioned that in group therapy, a therapist should possess the skills of developing and maintaining a consistent group. If a therapist takes into account this aspect to a greater extent, it enhances the achievement of the goals of the group as anticipated by the panel members and the therapist. The other essential aspect of group therapy is introducing the group facilitator to the group’s tools and techniques to help them navigate difficult group situations.

Getting familiar with common techniques of facilitation of the group and the group’s resources also stands as one of the essentials that a group therapist should take into consideration. At this stage, the group facilitator or a therapist needs to understand what group therapy entails, including the basics of group facilitation and the goals of the panel on every meeting (Brabender, Fallon & Smolar, 2004).

There are several reasons why a therapist would opt to choose group therapy over individual therapy. The first reason is that in group therapy, there is an opportunity for interaction with individuals of different ages, coming from different families and cultural backgrounds. Thus, the therapist and the patients tend to learn some different interactional patterns throughout their counseling period. Another benefit is that in group therapy, one will get to understand that he or she is not the only one who suffers from a particular disorder, but other group members may have the same problem, and this will build encouragement (Shulman, 2010).

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The other reason why a therapist would opt for group therapy is the aspect of learning from each other in that both the therapist and the patients are the mirrors for each other. Converging with different individuals, especially with people outside the therapist’s social network, may help a therapist to develop more skills, which will, in turn, facilitate the provision of effective and efficient services to the patients (Hartman & Zimberoff, 2012).

The other reason is that group therapists might also be suffering or had suffered from particular disorders. Thus, by interacting with the group members, the therapist too will get some concepts that he or she needs to undertake to restrain from what may lead to anxiety or depression (Kaminer, 2005). Additionally, from the perspective of developing healthy social interaction skills and techniques, a therapist may also want to choose group therapy. The interaction between individuals in group therapy impacts both the therapist and the patient in that they obtain something from other members who are in the recovery process (Ford, 1992).

Humans are social beings and strive to be accountable. Group therapy, in this case, enhances accountability for the latter. For instance, responsibility in group therapy takes place in a situation when a recovering alcoholic gives a word of encouragement for the members striving to get rid of alcohol addiction. This aspect shows the highest level of development, which is termed accountability through group therapy. Group therapy provides a sense of belonging for individuals. The therapist feels a favorable atmosphere, which leads to inclusion in psychology. Lastly, a significant advantage of group therapy is that it is cheaper compared to individual counseling (Forsyth, 2014).

Conclusion

In conclusion, the paper extensively discussed the aspect of maintaining confidentiality in group therapy and other ethical issues that are unique to group therapy. The associations that deal with counseling, such as the American Psychological Association (APA) and the Specialists in Group Work, have come up with guidelines regarding the maintenance of confidentiality and privacy in the process of group therapy. The aspects of human interaction in the process of group therapy were highlighted, and the benefits it has for the participants were articulated. It may be concluded that the interaction of members during group therapy helps to develop the aspects of accountability, a sense of belonging, and creates a favorable environment for group members as well as the therapist.

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