Ethical and Legal Issues in Group Counseling

Topics to be discussed
Introduction: A Brief History of Ethics in Psychology Ethical Issues in Group Membership Confidentiality The Use and Abuse of Group Techniques The Role of the Leaders Values in Group Leadership Ethical Issues in Group Work with Diverse Populations Ethical Issues in Technology and Group Work Competence and Training Issues Guidelines for Ethical and Legal Practice Conclusion: Ethics and Law in Group Counseling

Introduction: A Brief History of Ethics in Psychology

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Main Objectives of Presentation Highlight ethical issues faced by group workers Briefly overview how established ethics codes are applied to various dilemmas BRIEF HISTORY Hippocratic Oath* Over 2,000 years old, written by Hippocrates, considered the foundation of modern ethics. Based on the concept of ethos, a Greek word closely associated with character. Do no harm. Prohibits exploitation (financial, emotional, sexual, etc.) Rights and responsibilities of both the professional and the customer/patient/client the right of one party is the responsibility of the other.

Introduction
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First APA Code of Ethics* Private psychology and social work practitioners increased after WWII. The need arose for a shared ethical code to boost credibility. This would be the first of its kind. APA produced the first draft in the early 1950s, in consultation with the Hippocratic Oath. Many amendments and changes have been made since then. Changes in society are reflected in the changing ethics code i.e. what was considered ethical years ago in the practice of psychology may be considered unethical today (and vice versa).

Introduction
Ethical Decision-making - Personal and professional consciousness know the laws and regulations governing your conduct and your profession. - Personal integrity be willing to follow through on what you say you will do. Keep your word, do not make false promises or reassurances.

Factors in Ethical Decision-making (1) Consultation with colleagues. (2) Supervision and training. (3) Keeping up with trends, new developments within the field. (4) Attend relevant conferences and workshops

Introduction
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Codes of Ethics Used in Psychology Today Code of Ethics and Standards of Practice (American Counseling Association, 1995) Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2002) American Association for Marriage and Family Therapy Code of Ethics (AAMFT, 2000) Code of Ethics for National Association of Social Workers (NASW, 1999) Ethics codes within psychology differ according to: (1) National/state laws. (2) The types of groups involved (e.g. families, teenagers, etc.) (3) The type of therapy undertaken (e.g. psychoanalysis, counseling, etc.)

Ethical Issues in Group Management 1. Informed Consent

Is information on nature, purpose and goal of the group. An individual is provided with all information that might influence their willingness to participate Getting an informed consent means that the individual must understand their options, be capable of a competent decision and independently agree to the option
Failure to obtain informed consent can result in civil liability

Ethical Issues in Group Management 2. Involuntary membership

Members unwilling to take part but in some way are required to e.g. by court order
Most effort is placed in informing members on:
Nature Procedures Rights Benefits

Members should also be asked why they do not wish to participate In case of getting a consent members may be explored by leaders during screening or orientation

Ethical Issues in Group Management 2. Involuntary membership

Options of dropping out is not encouraged but leaders could give support and debriefing
Leaders should not conclude that it is a mandatory group and members would be involuntary and unwilling to participate

Ethical Issues in Group Management 3. Freedom to withdraw from a group

Procedures for leaving a group needs to be explained to all members before the session begins, when they are given consent
Although members have the right to leave they should give notice in advance and not encouraged to do so. Members should also give reasons to leave If a member has decided to leave the leader nor any other group member must not interfere with the decision made

Ethical Issues in Group Management 3. Freedom to withdraw from a group

If a person leaves without putting much thought in consequences could be negative for the remaining members.
Person leaving could have unsolved issues Withdrawal should not be encouraged, if members have any doubts about anything the best thing to do is to stay and talk Member withdrawal could be reduced through preparation and screening

Ethical Issues in Group Management 4. Psychological risks for members

Leaders should be responsible enough to see that this does not happen
Psychological risks could be reduced by the following:
Knowing members limits Respecting their requests, Developing an invitational style Avoiding assaulting verbal confrontations Describing behaviors rather than making judgments

Leaders should deal with any concerns members have after a group session Rushed decisions should not be made by group members after just a few sessions of group work

Ethical Issues in Group Management 4. Psychological risks for members

Its not the leaders responsibility to get in the way of a members decision but leaders could give advice and give better options
Risks are to be identified and dealt with at the beginning And its the members who decide how far they should go to Possible risk of group work
Self disclosure Maintaining confidentiality Scapegoat Confrontation

To reduce psychological risk there should be a contract where leaders state their responsibility and members state commitment

Confidentiality
General Guidelines - Discussed during individual screening process of group members, before entering into actual therapy. - A written contract, read, understood and signed by group members is a wise policy. Aspects of Confidentiality - (1) Therapist must keep group members confidence. - (2) Group members must keep each others confidence. Leaders are responsible for ensuring that members maintain confidentiality within the group. - This can mean enforcing some type of sanction on an offending member.
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Confidentiality
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ACA Code of Ethics (1995) Counselors must: (1) Clearly define confidentiality to clients. (2) Explain its importance. (3) Discuss difficulties. (4) Communicate to members that confidentiality cannot be guaranteed it has its limits.

Limits of Confidentiality Confidence must be maintained unless: (1) Clients are likely to harm themselves/others, and/or physical property. (2) Abuse of children/elderly is suspected. (3) There is a court order to provide the information. (4) They are being supervised in a supervisory relationship. (5) Specific written permission is given by group members. Strictly only relevant information is shared. Members should be informed if information about them is shared

Confidentiality
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Confidentiality of Minors Cooperation and written permission from parents/guardians is a wise policy. Use simple, easily understandable vocabulary. Discuss the minors concerns. Discuss the limits of confidentiality.

People are not going to reveal facts about their personal lives unless they feel quite sure they can trust both the leader and the members to respect their confidences. (Corey & Corey, 2006)

Use and abuse of group techniques

Group techniques are leaders interventions aimed at facilitating movement within a group
Group techniques includes:
Suggesting good behavior Being silent Inviting members to deal with a conflict Offering feedback

Techniques should not be used to cover up leaders discomfort

Techniques used in consideration with members background

Use and abuse of group techniques

Techniques left if not effective
Techniques must be invited not ordered Group techniques could be abused by group members at times of involuntary memberships

Effective Group Leadership

The Role of the Leaders Values in Group Leadership

(1) Self-awareness in terms of your own values. (2) Awareness of the direct and indirect ways you may influence members of the group. (3) Keep in mind it may be necessary to refer members to someone else if a conflict in values affects your objectivity. (4) Your views must be expressed in a non-judgmental manner if you cannot do so, it may be inappropriate to reply. (5) Leaders must avoid imposing their values on clients (ACA, 1995). The key point is that it is not your role as leader to make this mans decision for him, even if he asks you to do so. (Corey and Corey, 2006) Group leaders must encourage members to explore alternatives and decide for themselves. Members must be challenged to do whats right for THEM, as opposed to what YOU think is right.

Ethical issues in group work with diversity

When we look at a diverse group we could be looking at a wide range of diversity
Diverse population includes diversity in culture, gender, race, religion and so on. Here we would be dealing with cultural and gender diversity

Ethical issues in group work with diversity 1. Values and working with Diversity
If leaders ignore some basic difference in people they can hardly be doing what is in the best interest of their clients Ethical practice requires that leaders become aware of the multicultural context in a group There could be some group norms that do not go hand and hand with cultural norms

Ethical issues in group work with diverse population 1. Values and working with Diversity
Looking at our own group diversity what are some of the cultural norms that do not go hand in hand with group norms
Although some techniques are designed to assist members to talk openly some may find this offensive

Cultural diversity affects the issues that members bring to a group and the ways in which they might be either ready or reluctant to explore these issues
As group leader you should become aware of the clues given by the members indicating to issues they may not be comfortable to talk about They should also modify their interventions to suit the members cultural and ethical background

Ethical issues in group work with diversity 2. Ethics and standards of preparation and practice
Counselors should not only consider the members cultural view but should also consider his own personal cultural and the impact it has on the counseling process The code of ethics suggest that:
Acknowledge ethically and cultural influence behavior Should have knowledge and skills to work with diverse range of members Inform members about groups values

counselors should not make assumption about a person just because he is of a particular background.

Ethical issues in group work with diversity 3. special issues pertaining to sexual orientation
The ethics codes states that discrimination on the basis of minority status be it race, ethnicity, gender or sexual orientation - is unethical and un acceptable. Leaders have the responsibility to understand the gay, lesbian and bisexual peoples special concern and develop techniques to suit their background

Technology and Group Work

Online Groups - Increasing popularity of online group counseling/therapy - Research on effectiveness is still in its early stages. - This indicates the need for group leaders of online groups to work closely with researchers to build a foundation for ethical guidelines for online groups. Difficulties with Online Group Work - Informed consent is difficult to explain and obtain online. - Confidentiality issues are rife (e.g. what if passwords are shared, accounts hacked into, etc.?) - Less computer-literate members may have difficulties interacting.

Technology and Group Work

Impacts on Teaching, Training and Supervision of Group Workers - Video and computer simulations can complement group workers training (e.g. video-taping mock sessions for later critiquing.). - Potential enhancement to modeling and behavioural research (e.g. computer simulations of group ratings can be used to assess performance

Competence and training issues

Competence refers to the capacity to use the information provided to adequately weigh risks and benefits associated with participating in treatment and research According to the ethical principles, psychologist are to provide only those services and techniques for which they are qualified by training and experience. They are to represent with accuracy their education, training, experience and competence.

Competence and training issues 1. The issue of leader competence

Several factors like:
Group type Licenses, degrees and credentials Leaders recognizing their limitations

determines the level of competence in a leader Professional competence is not arrived at once.
Some general suggestions to increase the level of competence are:
Increase knowledge be open when you yourself have issues TAKE PROFESSIONAL ASSISTANCE Try to learn more about the group

Competence and training issues 1. The issue of leader competence

A competent leader know their techniques really well. Are able to explain to their client the theory Are able to tell the goals in simple language

Competence and training issues 2. Professional training standards for group counselors
The revised professional standards for the training of group workers specify two levels of competency and related training.
Core knowledge competencies (qualifications)

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Skill competency (experience)

= specialized training

Training of group leaders focus on learning group process by becoming involved in supervised experiences

Competence and training issues 3. Training and personal experience

Personal experience and training is important The three types of experience which go together with training are:
Personal psycho therapy for group leaders Self exploration group leaders Training groups for group leaders

Competence and training issues 4. Ethical issues in training group counselors

Sample informed consent statement on experimental learning Managing multiple roles as an educator Benefits to experiential training

Guidelines for Ethical and Legal Practice

Awareness - Know the standards of your surrounding community and the possible effects/consequences of not following those standards. - Know the laws and regulations of your state/country regarding your profession. - Be well-versed in basic issues such as: (1) Confidentiality (2) Parental and informed consent (3) Record keeping (4) Patient welfare protection (5) Civil rights of institutionalized patients - Be aware of your legal rights and responsibilities both personally and professionally.

Guidelines for Ethical and Legal Practice

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Potential Sources of Civil Action Sexual misconduct. Violation of confidentiality. Failure to obtain/document informed consent. Misdiagnosis. Practicing beyond the scope of competency. Abandonment of a client. Failure to refer a client upon realization that they need intervention beyond your level of skill. Inadequate record keeping. Departing from established therapeutic practices.

Guidelines for Ethical and Legal Practice

Legal Safeguards (1) Practice good client care (always keep the welfare of the patient in mind). (2) Carefully screen potential participants. (Potential problems can be minimized by referring potential members to other group workers if deemed in their best interests.) (3) Provide all the information members need to make informed choices (e.g. limits of confidentiality, risks involved in group work, dealing with intense emotions, etc.) (4) Be alert to situations where you must break confidentiality. Discuss it with the member involved and obtain a written release. (5) Keep an open line of communication inform members of your availability outside of the group. Can you think of any other safeguards?

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