Respond to at least two of your colleagues by suggesting strategies to address the legal and ethical considerations your colleagues discussed. Support your responses with evidence-based literature with at least two references.
Colleagues #: 1
Family or group therapy and individual therapy are unique in their individual approach to treatment and a way of understanding human behaviors. Both forms of therapy have their advantages and disadvantages. (Michael P. Nichols, 2020). With individual therapy, people feel more at ease and open to discuss their issues unlike family or group therapy where people at times are restrained and afraid of been judged by family or group members for sharing their issues. Also, the therapist will have a clearer picture of the problem in a group or family therapy and have a better approach to the family issue when everyone is present. According to (Imran S. Khawaja, 2011), Group psychotherapy is highly efficacious, and virtually all research comparing it to individual treatment indicates that it is, at the very least, equal to individual therapy as a treatment modality. Group psychotherapy contains a vitality and energy not often seen in individual treatment. Group and family therapy offers a unique sense of community and support that may not be achieved through other therapeutic approaches (Baltimore, MD) . Despite these advantages, therapy can be anxiety provoking to both the clients and the therapist. At the beginning of therapy, therapists are complete strangers and the clients are supposed to share their innermost secrets. As a result, therapists are likely to encounter clients who, at their initial consultation, are confused, anxious, needy, and vulnerable and sometimes, downright hostile and negative. It is almost inevitable, then, that complex ethical and legal issues will arise in these settings.
Groups and individual therapy poses some legal and ethical issues which can hinder the progress of the therapy. Ethically, confidentiality remains a big problem with both forms of psychotherapy. According to (Gottlieb, 2008), confidentiality is based on the assumption that clients will only reveal personal information if they have a reasonable expectation that it will remain private and under their control. As a result, confidentiality remains the core of all mental health treatment and most ethic codes are clear regarding how and under what circumstances information may be disclosed to third parties. The ability of the therapist to explain and obtaining consent forms is also a critical step as it relates to ethics in psychotherapy. The therapist explains his/her ethical and legal obligations in maintaining confidentiality to the client/group before initiation of therapy. Unfortunately, group therapy presents more challenges with regards to confidentiality of information discussed in groups compared to individual therapy.
Violation of the confidentiality and privacy in group or individual psychotherapy may present some legal challenges. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides consumers with important privacy rights and protections with respect to their health information, including important controls over how their health information is used and disclosed by health plans and health care providers. Ensuring strong privacy protections is critical to maintaining individuals’ trust in their health care providers and willingness to obtain needed health care services. This also will help as a shield for the therapist in preventing unwanted legal issues.
According to (Wheeler, 2014), Peplau stressed the need for self-awareness in the nurse-patient relationship , and understanding one’s own functioning will determine the extent to which he/she can come to understand the situation confronting the patient and the way he/she sees it. Understanding the full bearing of these ethical and legal implications of psychotherapy together with self-awareness of the conditions will help me to approach therapy sessions with my clients with open mind and in a holistic manner. Treating a client with respect and dignity irrespective of their disease state, conveys caring and empathy and helps solidifies the clinician /patient relationship. This invariably leads to the client been more engaged in therapy which results in positive outcomes for the client. I will also be more inclined in group therapy in the sense that it gives me a clearer picture of the issue/situation. Having all the group members together gives the clinician a better opportunity of addressing the issue and reaching a resolution faster than in an individual therapy session.
Colleagues #: 2
Group versus Individual Therapy
The legal and ethical considerations surrounding group and family therapy are somewhat different than with individual treatment. When a client enters therapy, they expect a certain level of privacy. The foundation of effective treatment is the understanding that what is discussed in therapy will remain private (McClanahan, 2014). The client participating in individual therapy will have a greater feeling of this privacy, unlike the client in a group setting where several people that are not professional therapists will hear what is being said. Confidentiality must be maintained in a group setting. This can be accomplished by having the participants sign an agreement to keep all things discussed private. Group members must understand that anything discussed between two or more members must be kept secret from anyone that is not a part of the group (Breeskin, 2011). It should be made clear that when participating in group therapy that no one is required to do or say anything, they do not wish to (Breeskin, 2011). Group and family therapy can be a powerful tool for the clients involved as long as the participants feel at ease to discuss the issues for which they sought out therapy in the first place. It seems that group therapy could create a lot of anxiety for some clients due to the possibility of exposure and feelings of lack of confidentiality, and some would seek individual counseling instead. Individual counseling is not a guarantee that the private counseling sessions would never be exposed, however.
There are certain instances when what is discussed in an individual session could be shared with others. These situations include authorization, in which the client authorizes information to be released (Sommers, Feldman, & Knowlton, 2008). Information could be mandated to be revealed, which is when it is necessary to warn or report potential harm to others, or when the court orders/subpoenas the release of information (Sommers, Feldman, & Knowlton, 2008). Permission is the last and most significant way that information could be released from private sessions as it includes consent that is granted federally under HIPAA guidelines, including information for treatment, payment, or healthcare operations (Sommers, Feldman, & Knowlton, 2008). The state you are in can also grant permission to release information to prisons, police, fire departments when the person is not conscious or in the case of death information can be given to the coroner if there is an investigation (Sommers, Feldman, & Knowlton, 2008). Of course, there are certain exceptions to every rule, and it is beneficial to know the exact rules for the state in which you practice. One thing is certain that there are no absolutes when it comes to privacy.
My approach to group therapy would differ from individual therapy due to the differences in privacy and exposure of the patient to sensitive topics. With the individual therapy, a bond can form with the counselor and cause the patient to feel at ease when speaking, even if there is the possibility that privacy could be breached in the future. When counseling a group, there would be less privacy, but there are a lot of benefits to group therapy. There are, of course, the apparent benefits of being able to help several people at one time. Still, there are benefits to groups and families seeking therapy together that could not be accomplished out of the group setting. Treatment in a group or as a family will change all of the members involved and create a lasting change due to all members have changed and not just the individual (Nichols & Davis, 2020).
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