Legal and Ethical Considerations for Group and Family Therapy Essay Paper

Legal and Ethical Considerations for Group and Family Therapy Essay Paper Legal and Ethical Considerations for Group and Family Therapy Essay Paper Group counseling offers multiple relationships to assist an individual in growth and problem solving. Groups are an excellent treatment choice for numerous intrapersonal and interpersonal issues, and in helping people to change. Groups provide a sense of community to its members allowing them to see that they are not alone. In group therapy sessions, members are encouraged to discuss the issues that brought them to therapy openly and honestly. It is the responsibility of the counselor to work to create an atmosphere of trust and acceptance that encourages members to support one another. Legal and Ethical Considerations for Group and Family Therapy Essay Paper It is the responsibility of the counselor to respect the basic rights of all members. Because of this responsibility, counselors must carefully select members and hold individual consultations with each member to discuss informed consent. This dialogue must also include the risks and benefits of group work (Israel, 2002). During this time it is important for the counselor to stress the importance of confidentiality within the group. A counselor cannot prevent a group member from speaking out during their personal lives, however a counselor must stress the importance of maintaining confidentiality as a way of demonstrating respect for protecting the disclosures of others in the group (Corey et al., 2010). It is a difficult task for the therapist to uphold the legal rights of each individual within the group especially since they have no control over the activities of members outside of the group. Therapists also may interact with group members away from the group setting and have to toe the line of what is and is not appropriate to discuss outside of the group setting (Israel, 2002).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Permalink: https://nursingpaperessays.com/ legal-and-ethica…rapy-essay-paper / ? Ethical issues in a counseling practice lay the foundation of a therapist in practice. Ethics are at the center of how the counseling process functions and operates in a successful manner for the clients who seek help in such a setting. In order for the counseling profession to be ethical and hold professional recognition, there are many facets that need to be examined and outlined to make sure all counselors and practitioners are functioning at the highest level and withholding their duties required by the counseling profession. The first introduction so to speak of the area of ethics also happens to be one of the first steps in counseling, which is the informed consent. The informed consent provides the basis of what happens or will be Why is this important in counseling? The informed consent process involves establishing the basic framework between a therapist and their client that serves as an ethical and legal requirement as well as the formation of a basic working partnership between a therapist and their client. The informed consent is essentially an informational exchange between a therapist and a client that outlines the process of therapy. It also allows the client to be informed of their rights in order to make conscientious and thoughtful decisions related to their therapy. An interesting fact about informed consent is that is it can be provided in written and oral form, or a combination of the two (Corey, 2013). If done orally, the counselor must document what was addressed in the informed consent. The information that must be presented to clients, first and foremost, are their rights and responsibilities as a client working with a particular therapist. Beyond this, an informed consent should outline the goals of the counseling relationship, the responsibilities of the client as well as the therapist, expectations of the client, limitations of the counseling relationships, fees involved Legal and Ethical Considerations for Group and Family Therapy Essay Paper The purpose of this paper is to discuss and evaluate what ethical requirements that are current “hot topics” therapists must employ when working in group and individual settings, respectively. There are subtle differences in ethical considerations but at the same time, there are many similarities. For the purpose, these ethical considerations have been narrowed down to conflict of interest (dual roles), when to refer clients to group or individual counseling or even to another more qualified therapist and when clients need to share and when they don’t. In addition, the discussion of what a therapist must share about the group; what the group is about, what rules are necessary for a successful outcome and the rational of the group – why they are there.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Couple and family therapists arguably face more ethical challenges than individually oriented therapists, yet codes of conduct and ethics have not always been of direct assistance. Often it seems that the principles lack the specificity to really attend to the issues at hand. Further, couple and family therapy presents challenges which are often erroneously assumed to be covered under general principles about counselling and psychotherapy. A significant values difference between couple and family therapy and other mental health services is an appreciation of context, which is grounded in the foundational premise of the family as a system. This means that it is the relationship that is the focus of study, and all relationships are seen to exist within multiple other systems, including the therapeutic system (Wilcoxon et al., 2007).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Relationship issues and the values we hold about relationships are completely entwined with their social and historical context. We are constantly exposed to theories about effective relationships and relationship pathology, whether they be evidence-based or common folklore. We cannot help but be influenced by these ideas, nor by our own experience of relationships. New and emerging issues such as internet pornography, surrogacy, same-sex parenting and working with perpetrators of abuse, offer groundbreaking moments in the therapy room. Couple and family therapists have a unique view into the complexities such circumstances bring and need to be able to respond effectively … or to know when and who to report matters when it all goes belly up. Without an awareness of the potential ethical challenges in the work, psychologists can be insufficiently prepared to face them. This article provides an overview of some of the significant practice issues couple and family therapists face, and outlines some of the considerations required for ethical reflection and decision making. Ethics are a set of moral principles or rules of conduct for an individual or group. The term ethics comes from the Greek ethos meaning custom, habit or character. Ethics determine choices made. In counselling, ethics underpin the nature and course of actions taken by the counsellor. Counsellors and others in helping professions are expected to behave in an ethical manner.Legal and Ethical Considerations for Group and Family Therapy Essay Paper We believe it is important to become familiar with the basic ethical guidelines that therapists should follow before you begin therapy with a new therapist, and we encourage you to do so. Unfortunately, media portrayals of therapy do not always provide examples of ethical, effective therapy experiences and many myths about therapy persist. Although all the therapists and counselors listed in GoodTherapy.org certify that the therapy they provide accords in orientation and attitude to the Elements of Good Therapy, GoodTherapy.org does not provide a specific code of ethics for therapists to follow. However, ethical codes have been developed by mental health associations for the purpose of setting professional standards for appropriate behavior, defining professional expectations, and preventing harm to people who go to therapy. Mental health professionals have an obligation to be familiar with their professional code of ethics and its application to their professional services.Legal and Ethical Considerations for Group and Family Therapy Essay Paper We provide links to ethical codes below because we feel it is important for consumers of psychotherapy to know the difference between ethical and unethical behavior. Most therapists intend to “do no harm” and strictly follow ethical guidelines. Overall, mental health professionals are a good bunch. However, not only do good therapists make mistakes, there are some providers who, unfortunately, are careless and unaware of the importance and purpose of some ethical guidelines. We believe it is in everyone’s best interest to become familiar with basic ethical guidelines before beginning psychotherapy. By nature of the profession, counsellors are to act in the best interest of their client, promoting client goals, protecting client rights, maximising good and minimizing harm (Stein, 1990). This expectation broadens due to the inherent power of the relationship between client and counsellor. Ethics including ethical codes and principles aim to balance the power and ensure that the counsellor operates for the good of the client and not for self.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Primarily, counsellors’ duty of care is to their clients. When making ethical choices, counsellors must consider not only themselves, but also the agency or organisation (if not self-employed), their profession and the greater community (Axten, 2002). Counselling does not occur in a vacuum therefore it is important that counsellors acknowledge all facets of their practice both internally and externally. Ross (2002) draws on this further by asking counselors to look at ethics from a holistic perspective — body (the environment, structures, systems, policies, laws, regulations, moral codes, and societal norms), mind (ethical thinking, philosophy), heart (relationships, emotions, values) and spirit (unknowing, unconscious). A complete awareness of the ethics of a situation can occur when all are taken into consideration.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Code of Ethics The concept of ethics relates to moral consideration. The challenge lies in what is considered moral or ethical. Each counsellor comes to the profession with their own set of values and standards. Individual principles and how they were used to interpret dilemmas would be universally different. Therefore, a Code of Ethics — a general standard that counsellors and therapists adhere to and use co jointly with legal standards to provide ethical practice and work through ethical dilemmas — is required. Ethical codes offer counsellors an outline of what are considered acceptable and unacceptable behaviours. In a region (such as Australia) where counselling is not regulated through licensing, ethical codes provide a valuable tool for developing and maintaining ethical conduct. Numerous professional associations have developed their own Code of Conduct and Ethics. Codes may adopt similar principles whilst also covering behaviours specific to an area of counselling. Professional counselling organisations provide Codes of Conduct and Ethics to members and the inability to stick to these Codes may result in removal of membership.Legal and Ethical Considerations for Group and Family Therapy Essay Paper A professional may belong to more than one organisation and thus have access to additional ethical codes. When faced with an ethical dilemma, a counsellor is to consider all available and applicable codes. It is counsellors’ responsibility to familiarise themselves with relevant codes and regulations governing their area of practice. Clarkson (2001) contends that all members of a professional association subscribe (at least in principle) to their profession’s Code of Ethics for the sake of protecting the public. The degree to which this ‘protection’ occurs is based on four factors: Client awareness and knowledge of the Code of Ethics and the complaints procedure The degree to which the client feels they can discuss his or her feelings about a violation with the counselor The fairness of the Codes The client’s ability to manage the Code or gain assistance in negotiation Legal and Ethical Considerations for Group and Family Therapy Essay Paper A core ethical responsibility to clients is the promotion of beneficence: doing good on the client’s behalf. This is reflected in a number of professional areas, but starts with the therapist’s competence to practise. Interestingly, couple and family therapy is quite commonly practised by therapists with little or no specific training. It seems to be thought that if one is individually trained, then it is not a great stretch to see other family members (Shaw, 2001). Nothing could be further from the truth. Issues surrounding relationships (violence and abuse, family law matters, sexual concerns, infidelity and other betrayals, severe attachment disruptions) all render this work highly complex and specialised. Without core training, duty of care is potentially breached (refer to the professional standards of the Australian Association of Relationship Counsellors and the Australian Family Therapy Association). If you were seeking assistance for your own relationship, what qualifications would you seek in your therapist? We often provide less for our clients than we would require for ourselves.Legal and Ethical Considerations for Group and Family Therapy Essay Paper The very act of asking the initial caller to gather other family members for an appointment raises questions about the forms of ‘social coercion’ that this might involve (Wilcoxon et al., 2007; Ramisch, 2010). There are different levels of power and opportunity in families. One member can decide for the group, while others can be unfairly excluded from key decision making. How the therapist is positioned within this is crucial to consider. Further, there are complexities around informed consent with people across ages and circumstances, and about how one might consider sending therapeutic letters or other communications. Are the adults always the best gatekeepers for other family members? Not uncommonly, I have had children say to me that they have ‘no idea’ about why they are in my room, despite my parental preparation. Arranging for individual consultations within relational work raises a myriad of difficulties. While it can be important for assessing dynamics such as abuse, it also provides opportunities for disclosures that will significantly shape the work ahead. Further, issues of confidentiality and privacy are often confused, and therapists can find themselves unwittingly silenced and compromised through promises they have made in good faith. There are certain principles about moving between individual and couple or family sessions, but these are not articulated within accessible guidelines, leaving therapists to work things out on their own. It is not uncommon for well intentioned therapists to find themselves in breach of confidentiality by juggling too many agendas and finding themselves the ‘fall guy’.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Frequently couples will ask for assistance when on a covert level they want a referee or a judgment about the behaviour of the other. Individual sessions and phone calls can be invitations to take sides, and neutrality can be called into question. There are complex issues around being engaged to ‘save relationships’ and then having notes subpoenaed for divorce proceedings. Besides the feelings this can evoke for the therapist, there are invitations into conflicting roles, e.g., couple/family therapist versus advocate in court. Working with relationships involves managing multiple alliances. It is not always possible to have everyone on side at the one time. Members of the family may have conflicting or competing needs which they want equally acknowledged. Even trying to develop a focus for the work is fraught with challenges, as you question: whose voice will prevail? Improvement for one member must not occur at the expense of another.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Commonly relationship therapists will think it might be a good idea to offer individual therapy to one family member, and may well be pursued to do so by the client. This is not considered good practice, but it can be tempting to do. Really good relational work can be brought asunder by selecting/engaging in work with one member. What might be defendable reasons (not justifications) to take on individual work in this context? Working with systems means being able to hold the relationship in mind over and above individual contributions: the notion that the sum is more than its parts. However, one still has to attend to:Legal and Ethical Considerations for Group and Family Therapy Essay Paper Individual responsibilities for pain and suffering, and for the stressors of addiction, mental health or family of origin trauma for example. How to address this in a relational context without pathologising one member and getting them off-side can be tricky. Perceived inequities in the tasks for therapy. For example, perpetrators of hurt have different tasks and responsibilities than those who have been hurt. Different ages and life stages Ensuring that safety is attended to, and knowing how to take a position when necessary, for example with mandatory reporting. Further important issues in the field which involve specialised ethical and practice considerations include: The perennial question of working with whoever can come to sessions or insisting that all must attend sessions Working effectively and respectfully with culturally diverse clients and communities Working with gay and lesbian clients and same-sex parents (Negash & Hecker, 2010).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Ethics Checklist Are you trained in couple/family intervention? What is your role going to be? Individual or relationship therapist, not both. How are you going to communicate effectively with all family members? How are you going to obtain informed consent? What is your plan to manage multiple alliances and diverse needs? Have you organised specialised professional development to support your work, especially on emerging social issues for families? How often do you take ethical issues to supervision? Couple and family therapy has advanced different models of practice. Over time, therapeutic strategies (e.g., use of paradox, strategic manoeuvres, prescriptions, triangulation) have been critically analysed in terms of how much stress is acceptable in achieving change (Wilcoxon et al., 2007) and a post modern framework has been adopted as more respectful. In terms of our role, while we may have preferences for therapeutic intervention, we have to be prepared to also be advocates, to take positions (on abuse and violence for example) and to be strategic in our case management. We need to enhance growth and positive relationships, not act as social control agents or gatekeepers of community values not in keeping with the client’s own (notwithstanding where people are at risk).Legal and Ethical Considerations for Group and Family Therapy Essay Paper As is evident, ethics is as much about critical and responsible reflection as it is about compliance with a professional code. Reason, intuition and experience all play a role in developing effective and justifiable responses (Shaw, in press). Finding opportunities for professional development and rigorous debate about ethical issues in practice is crucial. Ask yourself: how often do I reflect on ethical challenges in supervision? There are some valuable decision making models for therapists (e.g., Gilligan (1982) in Newfield et al., 2000; Kitchener, 1984; Hecker, 2010). It behoves effective therapists to establish frameworks to support their practice ahead of needing them! Finally, our best work will occur when we are also in the best possible shape. Self care is foundational to good ethical practice, and something we can tend to under emphasise.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Ethical considerations in group counseling Ethics are parameters by which professionals in different fields use (Jacobs, Masson, Harvill, & Schimmel, 2012). They are, in a sense, the rules that professionals follow to be fair to their clients, their profession and to themselves. While not all ethical considerations are the same for every profession, there are similarities. This also holds true for different situations in counseling. The scope of this paper is to discuss the “hot topics” of ethical considerations for group therapy and individual therapy; and to compare them accordingly. Also, to answer why a therapist may choose individual counseling over group therapy or vice versa.Legal and Ethical Considerations for Group and Family Therapy Essay Paper There are many ethical considerations for therapists who choose to counsel on an individual and group basis. For this context however, the focus is on the conflict of interest, when to refer clients on to other professionals or from individual counseling to group counseling and whether forcing clients to share their deepest, darkest sorrows and secrets are ethical. A conflict of interest in counseling can range from too much therapist self-disclosure to having dual relationships, or relationships with clients outside of the therapy sessions (Jacobs, et al., 2012). These ethical dilemmas may be seemingly innocent enough and may, in some cases be unavoidable (i.e. in rural communities where there are not many therapists) (Gonyeah, Wright & Earl-Kulkosky, 2014; Gottlieb, 1993) but when the therapist and client are in a situation where knowing each others lives outside of the office setting, certain rules and ethical considerations come into play. Attending functions together may require a lot of thought on both sides to determine the safety of both the client and therapist. In a group therapy setting, the stakes for safety and protection are even higher because of the many lives and families involved (Burian & O’Connor Slimp, 2000).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Therapists must be aware and mindful of when a client needs to move on to other more qualified therapists or from an individual setting to a group session. Knowing the time to move on is the responsibility of the therapist as is knowing when they are not qualified to do their client justice with their own limitations (Jacobs, et al., 2012). This is when the therapist should refer the client to a more qualified therapist who has the experience required to further help the client. With groups, it is the therapist’s job to know when being in a group setting is more beneficial and will challenge the client to move on in their recovery. If the client within a group setting is struggling in the group and can’t seem to connect, it is the job of the therapist to refer them back to individual counseling or a group setting that is more suited to the clients issues.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Clients and sharing Letting clients know that they are free to share whatever they’d like, as long as it is relevant to the topic of the group (i.e. substance abuse, child abuse, anger management, etc.) is important to establish early on (Corey, Schneider-Corey, & Haynes, 2014). Letting the client know that they do not have to share anything that they are uncomfortable with is also important. For some clients, it may take more time to warm up and become comfortable but most importantly, trusting of the group enough to share what they are going through or have experienced and want to work on or heal is vital. REPORT THIS AD Therapists, according to Hartman & Zimberoff (2012), should also disclose their experience and training on a honest level; to falsify information is an ethical infraction. It is also the therapist’s job to establish to their client(s) that they are trained for this type of therapy, and that they are competent to lead the group (or single individual) effectively (Scher & Kozlowska, 2012).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Unique issues in group therapy There are several ethical standards that apply to both group and individual therapy. In looking at the list of ethical considerations in Groups in action: Evolution and challenges (Corey et al., 2014), there were many that applied to both types of therapy in one way or another. In example, the screening of clients, to ensure that they were in the right group for the topics being discussed is important in group therapy but by the same token, screening clients to ensure that they and their issues are a good fit for the therapist and their level of expertise; and experience with those issues is important. Another similarity is that of clear roles. What the roles of the clients are in direct correlation with the roles of the therapist and what the group’s rational and purpose is.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Therapist roles and client roles Therapists must know their business. They must spend time keeping up their own education and constantly evolving into better therapists and including the latest information into their knowledge base. They must also learn new techniques and theories that will aid them in understanding their clients needs, the needs of the group as a whole and what will work in advancing the healing process of their clients (Brabender, 2006). They must also believe in their clients and that change is possible (Stalker, Horton & Cait, 2012). Therapists must also know the cultural and religious variables of their clients and know how those variables will affect each client within the group setting (Cornish, Wade, Tucker & Post, 2014; Henrikson, Polonyi, Bornsheuer-Boswell, Greger & Watts, 2015; Ibrahim & Dykeman, 2012). Therapists must also know how to show empathy for their clients and while not making the client feel awkward, the therapist must give emotional support throughout the group experience; this is especially true of young adolescents (Bruns & Frewer, 2011; Yamuna, 2013; Scher & Kozlowska, 2012). A unique dynamic here is co-leadership of a group or “cotherapy” where two therapists share the job of co-leading a group. A study on this dynamic discovered that in order for co-leading to be effective and succeed, a healthy working relationship between the therapists must exist as well as the ‘sibling’ dynamic in the therapist’s personal life (Shapiro & Ginzberg, 2001).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Clients must come to a place in which they want to change for the better (Stalker, et. al., 2015). Clients must also come to a place where they become honest with themselves, their role in their issues and problems as well as the role that others played in those problems. They need to understand that therapy is hard work that can result in a painful but hopefully, a cathartic and healing journey (Jacobs, et al., 2012). The client has a responsibility to keep working toward healing or the process outcome will be limited (Corey, et al., 2014). Group rational and purpose Establishing the group’s purpose and why the clients are there is vitally important to the success of the group. This information gives the group a clear direction and knowledge of what to expect throughout the process and what to think about bringing to the table as others talk about their own experiences and emotions. When the group knows the parameters and begins to share with one another, they often can identify with more than one person (i.e. the therapist) (Forsyth, 2014). There are more perspectives with a collective life experience to draw from.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Therapists must also have a clear plan for the group (Vinella, 2013). Corey, Corey and Haynes (2014) reiterate this need of a plan for a successful group. Knowing what is needed to be achieved on the first day to the last day (assuming there is an end) but also what events will happen from the start to the finish of the group session. Aversions to group therapy REPORT THIS AD Some clients may come into the session already upset and uptight over having to ‘be there.’ This is more likely the case with court-mandated therapy where clients have no choice but to attend (i.e. drug and alcohol counseling, anger management, parenting classes, etc.). Some clients may have preconceived notions of what group therapy is all about and not want to open up out of embarrassment, fear of judgment, ridicule, bias, rejection and speaking in a group forum rather than one on one (Jacobs et al., 2012). The lack of privacy in a group setting may also scare clients into silence. This is where the therapist needs to establish from the beginning that confidentiality is vital to the group and the more others open up and share, the more likely the fearful client will also relax and begin to share and join in the conversations and dialogs (Barros-Bailey & Saunders, 2010; Hartman & Zimberoff, 2012). Clients may have had bad experiences in the past with other therapy programs so knowing about these experiences and what the client expects to gain or lose in a group session or even an individual setting is important to furthering their growth (Garzon, Worthington & Tan, 2009).Legal and Ethical Considerations for Group and Family Therapy Essay Paper This statement, Ethics for Counselling and Psychotherapy, unifies and replaces all the earlier codes for counsellors, trainers and supervisors. It is intended to guide the practice of counselling and psychotherapy by all members of the British Association for Counselling and Psychotherapy (BACP) and inform the practice of closely related roles that are delivered in association with counselling and psychotherapy or as part of the infrastructure to deliver these services. Being ethically mindful and willing to be accountable for the ethical basis of practice are essential requirements of membership of this Association. In this statement the term ‘practitioner’ is used generically to refer to anyone with responsibility for the provision of counselling or psychotherapy-related services. ‘Practitioner’ includes anyone undertaking the role(s) of counsellor, psychotherapist, trainers and educators for these roles, providers of coaching and mentoring in association with counselling and psychotherapy, supervisors, and practitioner researchers. Members of this Association who are providers of services using counselling skills, embedded counsellors, managers and researchers of therapeutic services, are required to be accountable in accordance with the Ethical Framework in ways appropriate to their role and to communicate appropriately the basis of their ethical accountability and expectations. The term ‘client’ is used as a generic term to refer to the recipient of any of these services. The client may be an individual, couple, family, group, organisation or other specifiable social unit. Alternative names may be substituted for ‘practitioner’ and ‘client’ in the practice setting, according to custom and context. Legal and Ethical Considerations for Group and Family Therapy Essay Paper Ethical Issues Unique to Group Therapy Group therapy is a form of counseling that involves a small group of people coming together under one trained therapist who helps them and encourages them to help one another to overcome their challenges. The group members are usually peers facing the same kind of problem for example, anxiety (Forti, et al., 2007). This therapy has been in use for over fifty years and it has produced tremendous results in the lives of the group members. The group members not only learn from personal experiences of other members, but also gain different viewpoints and ideas on the issues they are facing. Like individual therapy, group therapy very powerfully influences growth and change and helps those involved to increase their self-awareness and gain sup

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