Discussion: Legal and Ethical Considerations for Group and Family Therapy

Discussion: Legal and Ethical Considerations for Group and Family Therapy

Considering the Health Insurance Portability and Accountability Act (HIPPA), the idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential. Discussion: Legal and Ethical Considerations for Group and Family Therapy. For this Discussion, consider how limited confidentiality and other legal and ethical considerations might impact therapeutic approaches for clients in group and family therapy.

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Learning Objectives

Students will:

  • Compare legal and ethical considerations for group and family therapy to legal and ethical considerations for individual therapy
  • Analyze the impact of legal and ethical considerations on therapeutic approaches for clients in group and family therapy
  • Recommend strategies to address legal and ethical considerations for group and family therapy

To prepare:

  • Review this week’s Learning Resources and consider the insights they provide on group and family therapy.
  • View the media, Legal and Ethical Issues for Mental Health Professions, Volume I, and reflect on legal and ethical considerations for group and family therapy and individual therapy. Discussion: Legal and Ethical Considerations for Group and Family Therapy

QUESTION

Post an explanation of how legal and ethical considerations for group and family therapy differ from those for individual therapy. Then, explain how these differences might impact your therapeutic approaches for clients in group and family therapy. Support your rationale with evidence-based literature.

 

NOTE

  1. ALL REFERENCES SHOULD BE 5 YEARS OR LESS
  2. INCLUDE THE TWO TEXT BOOKS AS ADDITIONAL REFERENCES BUT NOT COUNTED AS THE NUMBER OF 3 OR MORE EVIDENCED –BASED REFERENCES,

The Group Psychologist | April 2011

Group Psychotherapy Column

Procedures and guidelines for group therapy

Detailed procedures and rules members of group therapy must adhere to.

By John Breeskin, PhD, ABPP

  1. Confidentiality

Anything said between any two or more group members at any time is part of the group and is confidential. I understand that everything said in group is confidential. I agree to keep secret the names of other members of the group and what is said in the group. I agree to keep secret anything which occurs between or among group members. I understand that there is an exception to this confidentiality which applies to the group leader. Discussion: Legal and Ethical Considerations for Group and Family Therapy. If the group leader believes that someone is in danger, the leader has a professional obligation to take direct action in order to keep everyone safe.

I agree not to keep secret from the group anything which occurs within the group. Anything which occurs between or among any members is part of the group is kept secret from anyone outside of the group but is not kept secret from the group. This also applies to any individual meetings you may have with a group leader. Discussion: Legal and Ethical Considerations for Group and Family Therapy. I understand that if I violate this confidentiality I could be removed from the group.

  1. Privacy (The Stop Rule)

No group member is ever required to answer any question, to participate in any activity, or to tell anything. If I am asked questions or asked to participate in an activity which makes me feel uncomfortable, I understand that I have the right to pass, that is, the right to refuse. I agree that will never pressure other group members to participate in any discussion or activity after the member has passed or refused. I understand that the group leader is obliged to protect this right. .Discussion: Legal and Ethical Considerations for Group and Family Therapy I also understand that I will benefit more from group the more I am able to take risks in sharing and participating.

  1. Dignity

No group member is ever humiliated, hazed, or abused in any way. I agree to avoid this destructive behavior.

  1. Violence or intimidation

Violence or intimidation toward other group members is never tolerated. I understand that I must never be violent or intimidating toward other group members and that if I threaten to harm persons or property I will be asked to leave the group.

  1. Alcohol and Other Drugs

Group members cannot participate in the group under the influence of alcohol or other mind altering drugs. When under the influence of chemicals, persons do not have access to their emotions and have less control over their behavior. Discussion: Legal and Ethical Considerations for Group and Family Therapy. I understand that if the leader believes that I am under the influence of alcohol or other drugs, I will be asked to leave the group.

  1. Exclusive relationships

Dating and other exclusive relationships between or among group members are not a good idea. The relationships can make other group members feel left out. When a couple breaks up, for example, this can be most painful and may make it impossible for these people to continue in the group. Since anything which occurs between or among group members is part of the group, members who are dating or in very exclusive relationships may be embarrassed when their intimate moments are discussed in the group.Discussion: Legal and Ethical Considerations for Group and Family Therapy

  1. Gossip

Gossip and secret grudges can be very destructive in a group. I agree that if I have something to say to another group member, I will try to say it to the member directly rather than talk about him/ her behind his/her back.

  1. Attendance

I agree that I will attend every meeting unless an emergency arises. If an emergency should arise I will notify the group leader prior to the meeting to tell him or her that I will be unable to attend. I understand that the group leader will tell the group what has happened. I understand that if I have three unexcused absences, my continued group membership will be discussed.

  1. Internet Connectivity

I feel very strongly that the members of the group should form and participate in an online group limited to the group members. Of course, the same cautionary notes apply to the internet communications in terms of both confidentiality and inter-group sharing. Discussion: Legal and Ethical Considerations for Group and Family Therapy. (I have used this model very successfully, and it significantly enhances a healthy form of interconnection.)

  1. Responsibilities

I understand that it is the group leader's responsibility to enforce these procedures and guidelines. The group may, when it wishes, propose other procedures and guidelines which will be up to the group to monitor.

  1. Termination

Usually, group members decide, within the group, with the leader, when it is time to leave the group. Sometimes it is necessary for a group member to leave the group unexpectedly. This can cause group members to wonder if they have harmed the leaving member. I promise that if I must leave the group unexpectedly, I will come to a last group meeting and tell the members that I am leaving and say goodbye. Discussion: Legal and Ethical Considerations for Group and Family Therapy. I agree to announce this at the beginning of the last meeting so that the group has time to ask questions and say goodbye. If I decide to leave the group the group members may express their concerns but also respect the decision of the person wishing to leave.

I have read the procedures and guidelines for group and agree to be bound by them while I am a member of the group

_____________________         ____________
Group Member                         Date

I promise to faithfully enforce procedures and guidelines for this group.

____________
Date

J
Group Leader

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.Discussion: Legal and Ethical Considerations for Group and Family Therapy

  • Chapter 11, “Group Therapy” (pp. 407–428)

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

  • Chapter 1, “The Foundations of Family Therapy” (pp. 1–6)
  • Chapter 2, “The Evolution of Family Therapy” (pp. 7–28)

Breeskin, J. (2011). Procedures and guidelines for group therapy. The Group Psychologist, 21(1). Retrieved from http://www.apadivisions.org/division-49/publications/newsletter/group-psychologist/2011/04/group-procedures.aspx

 

Khawaja, I. S., Pollock, K., & Westermeyer, J. J. (2011). The diminishing role of psychiatry in group psychotherapy: A commentary and recommendations for change. Innovations in Clinical Neuroscience, 8(11), 20–23. Retrieved from http://innovationscns.com/

Note: You will access this article from the Walden Library databases.

Koukourikos, K., & Pasmatzi, E. (2014). Group therapy in psychotic inpatients. Health Science Journal, 8(3), 400–408. Retrieved from http://www.hsj.gr/medicine/group-therapy-in-psychotic-inpatients.php?aid=2644

Note: You will access this article from the Walden Library databases.

Lego, S. (1998). The application of Peplau's theory to group psychotherapy. Journal of Psychiatric & Mental Health Nursing, 5(3), 193–196. doi:10.1046/j.1365-2850.1998.00129.x

Note: You will access this article from the Walden Library databases.Discussion: Legal and Ethical Considerations for Group and Family Therapy

McClanahan, K. K. (2014). Can confidentiality be maintained in group therapy? Retrieved from http://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html

U.S. Department of Health & Human Services. (2014). HIPAA privacy rule and sharing information related to mental health. Retrieved from http://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/special/mhguidancepdf.pdf

Document: Practicum Journal Template (Word document)

Document: Midterm Exam Study Guide (Word document)

Document: Final Exam Study Guide (Word document)

Discussion: Legal and Ethical Considerations for Group and Family Therapy

Required Media

Laureate Education (Producer). (2015). Microskills: Family counseling techniques 1 [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 32 minutes.

 

Laureate Education (Producer). (2015). Microskills: Family counseling techniques 2 [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 32 minutes.

 

Laureate Education (Producer). (2015). Microskills: Family counseling techniques 3 [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 24 minutes.

Discussion: Legal and Ethical Considerations for Group and Family Therapy

Sommers, G., Feldman, S., & Knowlton, K. (Producers). (2008a). Legal and ethical issues for mental health professionals, volume 1: Confidentiality, privilege, reporting, and duty to warn [Video file]. Mill Valley, CA: Psychotherapy.net.

 

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 140 minutes.

Optional Resources

Sommers, G., Feldman, S., & Knowlton, K. (Producers). (2008b). Legal and ethical issues for mental health professionals, volume 2: Dual relationships, boundaries, standards of care and termination [Video file]. Mill Valley, CA: Psychotherapy.net.Discussion: Legal and Ethical Considerations for Group and Family Therapy

 

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 191 minutes.

HIPAA_Privacy_Rule_and_Sharing_Information_Related_to_Mental_Health_

Discussion: Legal and Ethical Considerations for Group and Family Therapy