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Southern New Hampshire University Confidentiality in Group Therapy Discussion
Discussion: Confidentiality
One of the most important concepts in clinical practice and group work is confidentiality. All members of the group sign an informed consent form in order to address the rules and parameters of the group sessions. The rules regarding confidentiality are stated in one section of the form. Although every member must sign this agreement, ensuring that all information shared in the group remains confidential can be difficult. As the group leader, the clinical social worker is responsible for developing strategies so that all members feel safe to share.
For this Discussion, review the “Working With Groups: Latino Patients Living With HIV/AIDS” case study.
By Day 3
Post strategies you might prefer to use to ensure confidentiality in a treatment group for individuals living with HIV/AIDS. Describe how informed consent addresses confidentiality in a group setting. How does confidentiality in a group differ from confidentiality in individual counseling? Also, discuss how you would address a breach of confidentiality in the group.
By Day 5
Respond to a colleague who used a different strategy in addressing the issue of confidentiality. Discuss the importance of confidentiality in treatment groups.
Colleague 1: Caneshia
Strategies for confidentiality for individuals living with HIV/AIDS
Some clients are reluctant to participate in therapeutic groups due to an overall lack of trust for group members and fear that potential group participants would disclose information to those outside the group who do not have HIV/AIDS (Olivier, 2009). Some individuals are embarrassed to have HIV/AID’s, thus are not willing and open to public exposure to treatment groups. Hence, I must first display empathy and understanding for the feelings of the patient. I would need to first ensure the patient of privacy disclosure with the patient. I would ensure the patient that their privacy is important and would be enforced. I would report to the patient of the HIPPA laws. I will express the guidelines of the HIPPA law of how personal information will not be given without their permission. As the social worker one should explain the dynamics of the group. The explanation of confidentiality would be explained via the rules for group. Understanding the dynamics of treatment groups can be an example to ensure confidentiality of a treatment group. Social goals in the group setting empower group members develop rapport with each other as it forms the milieu (Toseland & Rivas, 2017). Hence, this implies that members are experiencing similar trauma or goal. I would inform the patient that others within the social group are experiencing the same trauma experience. I lead group with my first internship, and I had a patient reluctant to participate in our treatment group. I reported to the patient of the group rules. This is also a way I would ensure the confidentiality of treatment group is via group rules. The number one rule for group is confidentiality. The group members were not allowed to search for each other on social media or interact with one another outside of group. This is to ensure the confidentiality of each group member. This would also ensure the group members are not communicating about group outside of group. Another form of ensuring confidentiality. Another group rule was to respect other group members. Hence, “do unto others as you will have them do unto you” For example, if you would dislike others to speak of your situation, we do not speak on others situation. As the group leader, confidentiality of not speaking on group issues outside of group was strictly enforced.
Informed consent addresses confidentiality
Informed consent is a means of communicating expectations to the group and allows both the participants and the facilitator to have a mutual understanding (Lasky & Riva, 2006). Informed consent via group rules was a form of addressing confidentiality for each group member. For example, of informed consent to address confidentiality, each group member would have to verbally agree to the term and conditions of group rules. The informal consent via the group rules were to refrain from communication with other group members outside of group. This informal consent was to ensure the information within group remain confidential. As the group facilitator it would be my responsibility to ensure each participant has a solid understanding of the group rules.
Group vs Individual Counseling
During group discussions the group facilitator has little to no control over what is said (Lasky & Riva, 2006). An example of how I gained control of group was via my signals. The timeout sign was one I often used. I would physically hold up this symbol so that group members understood to stop speaking. This symbol was to stop a group member from triggering another patient without other group members knowing the personal information of another group member. For example, if I had a group member who is a rape victim. Saying certain phrases can trigger that group member. Hence, without reviling that the patient is a rape victim I simply hold my timeout sign and switch topics with the group with out verbally saying reasons for the timeout sign. In individual therapy confidentiality is guaranteed, unless a client discloses, they are a risk to themselves or others or discloses abuse. As this information will be given prior to beginning of the session. Before I began anyone on one therapy I informed the patient of confidentiality, I always ended the statement of however, if you place a harm to yourself or others, I am mandated by law to report by law. In group I would also inform the group of the breach. If anyone reports a threat on themselves or others I am mandated to report by law.
Reference:
Lasky, G. B., & Riva, M. T. (2006). Confidentiality and privileged communication in group psychotherapy. International Journal of Group Psychotherapy, 56(4), 455–476.
Olivier, C. (2009). Enhancing Confidentiality within Small Groups: The Experiences of AIDS Service Organizations. Social Work with Groups, 32(4), 274–287. https://doi-org.ezp.waldenulibrary.org/10.1080/016…
Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson
Colleague 2: Stacey
Strategies for confidentiality for individuals living with HIV/AIDS
Patients living with HIV/AIDS (PLWH) can become an isolated and venerable group. Therefore, treatment groups are essential for providing security, mutual respect, and support for one another. Confidentiality is critical to any group setting and even more so with PLWS. Confidentiality is the safeguard of client information to ensure their information is not disclosed. In a group setting, one strategy I may use to promote confidentiality is education. According to Laskey & Riva (2006), group leaders should educate group members on confidentiality to ensure that everyone has the same foundation. For instance, I would employ this strategy by allowing the group to identify terms and agreements to confidentiality in which they must follow in and after each group. Another strategy I may use to ensure confidentiality in a group setting is requiring that each member sign a clause that states the information disclosed in the group cannot be disclosed outside of the group. As a social worker, I must understand that confidentiality in a group setting is different compared to an individual session.
Informed consent addresses Confidentiality
According to Laskey & Riva (2006), informed consent is the process by which clients learn about confidentiality and its limits. Informed consent allows the patient to control who has access to their private information. Informed consent is addresses confidentiality in a group setting by allowing the client to determine who much of their pertinent information they would like to disclose.
Confidentiality in a Group and Individual Setting
The nature of confidentiality is more complex in a group setting compared to individual counseling. In a group, an individual discloses information to the therapist and other group members in which there is no guarantee that the information disclosed will remain confidential. In a group setting, the facilitator has less control over the nature and depth of what is shared during the group. In contrast, in an individual session, a therapist has more control over the depth of each session and can guild the nature of the session. In a group setting, group members are not bound by confidentiality due to the third-party rule. The third-party rule states that any information disclosed in front of a third party is deemed not privilege by the court (Lasky & Riva, 2006). Thus, the third-party rule concept suggests that the disclosure in front of another individual is viewed as public (Lasky & Riva, 2006).
Breach of Confidentiality
To address the breach of confidentiality in a group setting, I would bring the issues to the group to help each member identify how the concept of trust and mutual understanding was broken. I would allow each group member to share how their trust has been broken in the past and how it is currently impacting them. As the group facilitator, I would allow the group to determine the ground rules for the breach, either removal from the group or a behavior continuum contract. In addition, I would also address the breach individually with the client to ensure that they have a complete understanding of confidentially and explain the risk of their actions.
Reference:
Lasky, G. B., & Riva, M. T. (2006). Confidentiality and privileged communication in group psychotherapy. International Journal of Group Psychotherapy, 56(4), 455–476
Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing [Vital Source e-reader].
“Working With Groups: Latino Patients Living With HIV/AIDS” (pp. 39–41)
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