Group Therapy Ethics Essay
Ethics in group counseling is a topic that needs to be looked at by today’s practicing counselors. There are many different agencies and organizations that are promoting ethics in counseling. Each organization has different views on what is needed. This report will highlight some points by a few different organizations and give their takes on what they feel is important. The report will also talk about the need for education on the reasons people need therapy. People who need therapy may not be getting the help they need because of lack of education. It is important to remember that the members of the group need to be able to look up to the people that are leading them. Without ethics, this will not happen.
Ethical Issues and Group Therapy
There are many issues associated with group therapy that can provide troubles for a counselor and group. The American Counseling Association (ACA) is a group that has put out ethic guidelines for counseling in hopes of helping to eliminate some of these issues. The ACA come out with the ACA Code of Ethics (2005). This code goes into detail on many aspects of counseling from confidentiality to training and research to resolving ethical issues that come up. Section B.of the ACA Code of Ethics (2005) talks about specific areas that need to be taken into consideration in group and family therapy.
Section B.4.a goes further into group work. It states that counselors need to be able to clearly explain parameters and the importance of confidentiality in a group setting. Sense group therapy differs from individual therapy; assuring confidentiality is needed in order to have trust with the group members. In group therapy, members are encouraged to discuss their problems openly and honestly with the other group members (Bates, ND). Because there are more people involved in a group session, special consideration needs to be taken in order to protect the individuals in the group.
Getting the members to trust each other is something that the leader needs to be aware of. Since there can be different people from different circumstances and walks of life, the leader of the group needs to recognize differences of the individuals. A leader needs to find common bonds with the group members in order for them to feel accepted and be able to effectively work as a team and achieve their goals. Confidentiality is something that can be more difficult in a group therapy session than in an individual session. Because there are more people involved in the session than just the
Ethical Issues and Group Therapy 4 Counselor, gaining trust is harder. Not only do the members need to trust the leader with confidential information, they also need to trust the other members as well. In a group counseling session there is a greater risk run of breaches in confidentiality because the group members are not bound by a professional obligation to keep what is said during the session private (Simmerman, 2007) . According to the ACA Code of Ethics (2005), a leader needs to pick members for the group who have similar goals, will not impede the group process.
In screening the members, the leader can have a bit of control over who is in the group. The leader can use the screening process in order to determine the fit of the members with each other and their goals. When the group meets, there could be a better chance the group will mess well with each other. This will build the confidence of the group from the start. It is not always feasible for the group leader to screen members before a group begins. This can lead to problems in forming trust within a group. There are many different types of group sessions that deal with different situations.
One type of group that does not have the opportunity to screen members is open group sessions. In many circumstances, a person is forced to attend open meetings by courts or goes to meetings to make someone else happy and do not want to really be there. An example of this is an open alcoholic anonymous meeting. A court could order someone to attend a series of A.A. meetings or risk jail time and loss of driver’s license. In this case, the member may be resentful that they have to be in the session and cause problems for the group. This can make other group members uncomfortable. The members would not trust each other and meaningful work would not take place due to this.
Ethical Issues and Group Therapy 5 In order for a counselor and group to be affective, there needs to be a bond between the group and counselor. This bonding process is easier to achieve when there is only the counselor is involved. There can be a greater fear of rejection when interacting with more than one individual at a time (Simmerman, 2007). That is why this process can be a challenge in a group setting. In Group Counseling, Strategies and Skills, by Jacobs (2009), Jacob talks about different exercises and how to use them in order to help in different situations.
One of these situational exercise types he talks about are exercises that help to increase the members comfort levels (pg. 206). Due to many members having great anxiety in a group counseling session, getting acquainted exercises can be a good tool to use in order to help ease the anxiousness. There are many exercises that can be used. A few are dyads, rounds, and trust exercises. The effective use of exercises will help in gaining trust within the group. The American Association of Christian Counselors (AACC) is an organization that an association that bases their counseling on Christian principals. The AACC came out with their own set of guidelines for Christian Counselors.
The mission of the AACC Code of Ethics (2004) is to (1) help advance the central mission of the AACC—to bring honor to Jesus Christ and promote excellence and unity in Christian counseling; (2) promote the welfare and protect the dignity and fundamental rights of all individuals, families, groups, churches, schools, agencies, ministries, and other organizations with whom Christian counselors work; (3) provide standards of ethical conduct in Christian counseling that are to be advocated and applied by the AACC (and ABCC and CCN) and that can be respected by other professionals and institutions.
Ethical Issues and Group Therapy
Section 1-330 of the AACC Code of Ethics (p. 11) talks about the proper way for Christian Counselors to go about bring up spiritual content in a counseling session. Although the association is for Christian counselors, the counselor has to remember that not everyone they see will have the same views as them. A counselor needs to be able to get consent from the client and respect the fact if they are not comfortable with brining up spiritual things if they so choose. Obtaining this consent in a group counseling session could cause problems. In a group, there may be members who do not mind spirituality in the session and some members who may be against spirituality in sessions. If this is the case, it puts the counselor and the members in a difficult situation.
A counselor may see how prayer and a deeper look into the Bible will help a member, but if one member of the group is against spirituality, the counselor has to be careful to respect their decision even in a group setting. One way to help alleviate the problems that may be associated with different spiritual views goes back to screening of members. Section 1-540 through 542 of the AACC Code of Ethics goes more into depth on the role of a Christian in a group setting. Specifically, section 1-541 (pp. 14-15) talks about the counselor needing to be fair and unbiased.
This is an issue associated with group counseling that is not relevant in individual counseling. It can be hard at times not to show bias towards someone who the counselor may mesh better with. If a member of the group feels like there is a bias being shown against them in a group it will cause conflict, mistrust, and resentment in the group. These feelings will cause the group to struggle to reach their goals as individuals and as a group as a whole. There are many different types of clients that present themselves in a group setting. Many of the types of clients that present will be a challenge for the counselor.
However, some of these Ethical Issues and Group Therapy Patients may not purposefully cause challenges. One such group that may be difficult is special needs groups. This is especially evident in groups of special needs children. These children can experience difficulties due to hyperactivity, distractibility, impulsivity, anxiety, emotionally, low self esteem, aggressive behaviors, difficulty recognizing emotions of others, and many other socially unacceptable behaviors (Stephens, D., et. al., 2010). Group counseling is not often used with special need children in a school setting. However, using group sessions may be what special needs children would benefit most from. The counselors’ ability to meet the needs of larger numbers of students is significantly enhanced by the use of group counseling techniques (Cook ; Weldon, 2006).
Johnson and Johnson (2005) claim that group counseling is one way that has been shown by research to be effective in school settings, and needs to be implemented more often. There are many reasons why group counseling is considered to be very effective for special needs. Livneh, Wilson, and Pullo (2004) say the group therapy process give’s individuals the opportunity to learn from one another, and a chance to generate solutions together. While learning from others in a group setting can be a positive aspect of group counseling, there are also down falls as well.
Often times the most outspoken person in a group will emerge as the group leader. Others may try to follow the leader’s views or start to act like them even if their thoughts and actions are incorrect. Another problem associated with group counseling is adding new members to a group that has already bonded. A counselor needs to pay close attention to the timing of introducing new members in to a group. This is a problem that is not present in individual counseling sessions.
Ethical Issues and Group Therapy
There are many reasons why a group may need to add more members. Although not set in stone for all groups, Jacobs (2009) states that for most groups the ideal size is between five to eight members (p. 41). If a group falls below this level, it may be time for the leader to look at trying to add more members. The leader has to be aware of when a good time to add the new members to the group are. A group that is in crisis suddenly entered into a new stage of development may not favor the addition of new members (Yalom, ; Leszcz, 2005). The group needs to be ready to accept new members.
If a group falls below the ideal number of group members, but is in a stage that is not conducive to adding new members, the leader must be aware of that and ultimately do what is best for the group. Phobias also can be a problem that presents itself in a group therapy session. There are many different types of fears that people have. Social phobias are fears that could affect group session. Some of these social phobias are fear of people, speaking in front of others, anxiety, and performing in front of other people. Because of these fears, some people are turning to a new tread.
Cyber counseling is a relatively new tool that some people are using instead of the traditional individual or group counseling sessions. This type of counseling has is pro’s and con’s. Many people refuse to attend regular counseling sessions be it group or individual. Their phobia’s or just lack of willingness to see someone face to face can prevent individuals from getting help that they need. A pro of cyber counseling is that an individual may be more likely to seek help. This is because they will not need to actually see another person face to face. This will make the individuals feel safer and more comfortable. Another pro to cyber counseling is that a person seeking help can get help very quickly in emergencies.
An example of this would Ethical Issues and Group Therapy
Be an individual that thought of harming themselves. If an individual got a negative thought in their mind in the middle of the night, they would find it much easier to find a person to help them online than if they started calling around to different counselors in the middle of the night. However getting help at all hours is a pro to cyber counseling it is also a con. Although a person can find someone to help them fast, an individual cannot actually know the qualifications of the counselor.
That can be a problem because the counselor may not even be trained at all and is giving out bad advice. Botella et el (2009) authored a report on the cyber therapy and its advantages, disadvantages, and limitations, and ethical issues. In the report they stated cyber counseling us “simulates reality while providing a new possibility: the user has the illusion of being in the computer generated environment interacting with the virtual objects. This is a unique feature that is relevant for applications in clinical psychology (p. 84).” This is the case because it can create a safe environment for the members of a group.
The authors believe that the feeling of being safe is important for the members in a group therapy session. Creating a virtual person to represent a member helps to protect the individuals in the group while still being able to share information because no one knows who they really are. Botella et el (2009) gave some good information on why cyber counseling is productive. They also had many legitimate negative aspects of this type of counseling as well. They have concerns that cyber therapy and virtual reality therapy is not an effective tool for all types of counseling. They believe this type of therapy may actually cause more harm than good in some patients.
They were concerned that people with severe anxiety disorders, such as posttraumatic stress disorder (PTSD) or panic disorder with agoraphobia will actually have negative effects Ethical Issues and Group Therapy from this type of treatment (p. 87). They state that therapy for this group should be focused on desensitization. This type of treatment could actual more sensitization. There are also ethical considerations to consider in the case of cyber counseling. Alston (2010) created a list of possible ethical considerations for cyber counselors. The list includes (1) is the clients confidentiality protected? Without proper encryption, information may be in jeopardy, (2) does the counselor have back up plans in place if the individual needs to see someone immediately due to being in danger to self or others, (3) is the counselor in violation of any laws for counseling someone who may be from out of state due to not being licensed in that state?, (4) does the provider have a modified ethical codes to include cyber counseling. These are all very good ethical questions about cyber counseling.
There are many cyber counselors that have already shut down business online because there are still so many unanswered questions about them (Alston, 2010). Ronald Fernandez is a consultant to Center on Rehabilitation Synergy at the University at Buffalo. He gave a presentation on Ethical Issues Related to Counseling and Rehabilitation in the Cyber Age (2010). Fernandez (2010) stated the question; how is Counseling via a computer link different than sitting in an office with a person across from you with the door closed and no distractions? There are obviously many differences between the two.
But with the differences, is there a way to still conduct counseling via the computer while still holding the high ethical values that a counselor needs to have? Fernandez goes on to state there are six ethical principles for rehabilitation counselors. These principles are (1) Autonomy, which is respecting the clients rights to be self governing within their own social and cultural framework, (2) beneficence, which is to do good and promote well being in the clients, (3) fidelity, which is to be faithful, Ethical Issues and Group Therapy 11
Keeping your promises and honor, (4) justice, which is to be fair, providing all appropriate services, (5) nonmaleficence, which is to do no harm, and (6) veracity, which is to be honest. Achieving these principles in a conventional group therapy session or individual session is much easier that doing so in a group cyber setting. It can be done, but there are many variables that could ultimately affect the way the principles are carried out. Neace (2010) wrote an article titled Why Should Christian Counselors Care about Ethics Research? This article discusses why looking into ethical issues from the past is needed in the counseling field.
Neace states that Ethics research allows us to look back over time and see what ethical issues counselors have struggled with most. Looking back at past ethical issues make it easier to predict possible issue that may come up in a group counseling session now. It also helps us to see the mistakes that were made in the past. This can lead to new and more meaningful standards to be created.
Another reason ethics research is important for counselors, especially Christian counselors is that it helps them better understand when spiritual intervention is responsible and when it may not be a good time to bring up (Neace, 2010). It helps the counselor to understand the difference between using spirituality in a counseling session and spirituality in personal life. Counselors are in the profession of helping others. Counselors are known by their clients as very professional. However, there are many people who are hesitant to seek out group counseling because of the stigma that is associated with counseling. People with mental health issues really have a hard time dealing with social stigma.
Social stigma associated with seeking mental health services is the perception that a person who seeks psychological treatment or is diagnosed with a mental health concern, such as depression, is undesirable or socially Ethical Issues and Group Therapy 12 unacceptable (Hobson, 2008). These stigmas lead to stereotyping of people with mental health issues. If a person feels they will be made fun of and labeled a social outcast, they are less likely to seek out the counseling they need. The self esteem issues caused by stigma are great. These people will feel bad about them, feel alone, and feel like they are not worth anything.
These feelings can lead to these individuals having feelings of wanting to harm themselves or others. Knowing that there are individuals that need help but are reluctant to seek it is something that counseling professionals take very seriously. Ethically, counselors need to take action in order to help reduce social stigma and encourage people who need help to see it out. In the case increase intentions to seek mental health services (Hobson, 2008). Education is something that can be given by professionals in order to reduce the stigma towards counseling. Programs that work to decrease stigma will often help reduce attitudes and behaviors that might be barriers to seeking mental health services (Corrigan, 2004).
There are many different kinds of people who are in the counseling profession. Each professional has their own unique style and way they prefer to lead the groups they conduct. There are also many attributes that an effective counselor will display. Jacobs (2009) states that some of these attributes include being caring, open, flexibility, warmth, objectivity, trustworthy, honesty, strength, patience, and sensitivity (p. 25). Along with these attributes there are many character traits that will exhibit by effective counselors. Some of these traits are experience with a diverse group of individuals, experienced with groups, good planning and organizational skills, knowledge of the topic being discussed in the group, also having a good understanding of basic human conflicts and dilemma, and a good understanding of group theory (pg 25-26).
Ethical Issues and Group Therapy 13 As a soon to be new grad in the human services field, it will be essential for me to be able to gain knowledge and strive to obtain the attributes and traits that were listed. Some of these I believe I have a better handle on than others. I believe some of my strong points at this time are that I am a warm person. People tend to feel comfortable around me quickly. Also I believe that my patience is something that will help me in the human service field.
This comes from my laidback and calm personality. My strength and flexibility are also areas that will help me in this field. These strengths that I feel I have will help me in many ways, especially when dealing with ethics and promoting awareness of the positive aspects of therapy and losing the stigma. I feel that because of my easy going and laid back attitude, people will see that there is nothing to be afraid of when it comes to seeking help. I think that spreading awareness is something that can be difficult and people may resist the efforts.
My attitude makes me be able to let negative things roll off my shoulders and helps me to continue towards the goal I am trying to achieve. When looking at the different traits that were listed above, I can see me being able to master many of them in a group setting. I am aware of the topics that I have knowledge in and the topics I have less a grasp on. I know my limitations and when able will choose to conduct groups that I already have knowledge of. However I know there may be times when circumstances come up where I need to conduct sessions on topics I don’t know much about. Ethically I need to learn as much as I can on the subject before the sessions start. It would not be fair to the members of the group if I went into the session unprepared. In order to maximize my effectiveness as a leader, I need to become an expert in the sessions I am leading. If I do not, it will be a disservice to the members.
Ethical Issues and Group Therapy
There are many other reasons why I believe that I would excel in the area of group therapy. One reason is based off my years of military service. Through the military I gained experience dealing with a wide variety of people. As a hospital corpsman in the Navy, I had to conduct group sessions on a variety of health topics. Although they were not therapy sessions, it gave me experience in a group session. Another way the military has help me is that it taught me to have organization skills.
Lastly, the military taught me how to deal with conflict and stay calm and objective doing so. Conflict is something that is going to come up in a group. Being able to stay calm and keep your thoughts and act accordingly is needed in a group setting. If the group members see the leader is not able to handle the situation, the members will react in a negative way and the group will not obtain the goals that were set for the group. Each counseling profession has a different approach they like to use in counseling. I like to think the approach that I use will be effective. My personality is easy going and takes things as they come. I very seldom let things get to me. I intend to try to pass this on to the people that I will counsel in the future.
Because I believe that God has given me these attributes, I intend to share God and how he has helped me into my sessions. Saying that, this project has help me realize that I just can’t dive into the topic of spirituality, but need to gain approval of the topic by the members and respect their views. I believe that I am a very ethical person. I intend to do all I can to promote the advancement of education and understanding for people who need to take advantage of professional counseling.
Ethical Issues and Group Therapy 15 The topic of ethics in group counseling is something that cannot be taken lightly. In order to help people through their problems, we need to understand that everyone at some point has had problems and was helped in some way. But by the grace of God, we could be in the same situation as the people we are counseling. Counselors need to be aware that they are there to help the members of their group. Ethically if this does not happen, they have failed their group members. It is also very important to remember that there are still negative stigmas that are associated with therapy. The counselors need to do their part in order to help rid some of these negative feelings.