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Sep 14, 2017 in Research
In the recent past, many therapists have preferred group therapy to individual counseling. However, the therapists have been facing numerous challenges and problems as they administer treatment to clients. This paper reviews some of the major challenges faced by therapists during group therapies. The paper starts by identifying and discussing thoroughly issues that are specific and unique to group therapy such as confidentiality and privacy of clients in group therapies, screening of members during the selection and constitution of a group and challenges of managing a group effectively during the therapy. It also provides a comprehensive comparison between group therapy and individual counseling by highlighting some of the reasons why a therapist would choose group therapy over individual counseling. Thirdly, the paper explores personal leadership qualities such as good communication and listening skills and trustworthiness that would enable me become a successful group therapist. A detailed description of my approach to group therapy is also provided. Lastly, the paper discusses some of the major ethical challenges such as discrimination and improper sexual relationships that are faced by group therapists.
Ethical Issues Unique to Group Therapy
The emergence of ethical issues in group therapies is one of the major challenges faced by therapists. This is because different people have different viewpoints on what should be considers ethical or unethical during group therapies.
Firstly, confidentiality and privacy is one of the major ethical concerns in group therapies. Confidentiality involves the act of assuring of the members of the group that any information disclosed during group meetings would not be exposed to third parties. Callanan (2012) also asserts that keeping memberâ€™s information confidential is very challenging assignment for many group therapists. Both the therapist and group members are responsible for the creation of a private environment that would provide adequate confidentiality and privacy. According to Lasky and Riva (2006), confidentiality in group therapies can be achieved through privileged communication which involves ensuring clients that information disclosed during group therapies would not be exposed in legal proceedings. However, Van and Kottler (2009) and Arnold (2002) argue that privileged communication exempts only therapists, thus group members may testify in court proceedings using the information disclosed during the group meetings. Maintenance of confidentiality occasionally is considered as a challenge in group therapy unlike individual counseling in which there are no third parties who would expose information revealed during the meetings between the therapist and the client.
Secondly, leadership roles and responsibilities in the group are also major ethical concerns. Group leaders are usually challenged with how to respond to personal clashes, conflicts and disagreements that may arise within the group. In individual counseling, there are no groups thus challenges of leadership of roles and responsibilities are not encountered. Thirdly, the adoption of a multicultural perspective is an ethical challenge in group therapies. The therapist or group leader must incorporate individuals from different socio-economic and cultural backgrounds. This makes it difficult to adopt varying viewpoints and values because of cultural differences. However, such problems do not appear in individual counseling.
Fourthly, screening the members of a group is also an ethical concern in group therapies. Screening involves careful selection of members of a group. The main purposes of screening are to determine if an individual is compatible with a particular group and to enable an individual to get to know whether the group would meet his or her needs. During the act of screening individual members must be assured that other group members are also appropriate for inclusion in the group (Carroll, 2009). This may lead to discriminations if not properly conducted. On the other hand, individual counseling does not require screening because only one person is involved in the therapy.
Lastly, difficulty of managing group members is also an ethical issue during group therapies. For example, Kraus, DeEsch and Geroski (2001) argue that despite strict screening during the selection of members, a group would still have some disruptive and incompatible members. Thus, the therapist would be challenged to pull them out of the group in order to prevent collapse of the whole group.
Spencer (2010) advises that group therapists should adopt and use the Code of Ethics provided by the American Counseling Association (2005) in order to enable them to deal with any ethical issue that may arise during therapies, for example, by withdrawing from potentially conflicting roles during therapies. It is also important to note that certain issues that may be beneficial in group therapies may be overlooked because of the need to safeguard the interests of clients or to gain professional satisfaction. Thus, adequate considerations should be given to all issues that may arise during group therapies.
Reasons for Choosing Group Therapy over Individual Counseling
Group therapy refers to a form of psychotherapy that involves interaction with two or more people facing similar challenges or problems at the same time. Group therapies are usually conducted by qualified psychotherapists, psychologists and counselors to encourage sharing of experiences among clients. On the other hand, individual counseling refers to a face-to-face discussion between the therapist and a single client.Individual therapy involves treating the patient on a one-to-one basis (Corey, 2012). The most suitable number of participants in a group therapy should range from five to ten persons. However, this number may fluctuate or change depending on the factors such as the number of clients to attend the therapy, clientsâ€™ personal attributes such as an age and sex, availability of resources and complexity of the issues or problems to be handled during the therapy. The duration of the group therapy may also vary from a few days or weeks to years, depending on the complexity of the problems and the response of patients to treatment. Group therapy and individual counseling are dissimilar in a number of ways. Thus, understanding the differences between group therapy and individual counseling is very important in selecting the most appropriate type of therapeutic approach to be used in treatment.
Although individual counseling is the most common type of therapeutic approach used by many therapists, some therapists may prefer group therapy to individual counseling because of a number of reasons. Some of the reasons why a therapist would choose group therapy over individual counseling are discussed below.
First and foremost, group therapy brings people with similar problems and challenges together. This enables them to share their experiences and to support and comfort one another. Sharing of experiences also provides them with a feeling of hope. This helps the members to unite emotionally. It also enables patients to learn from the experiences of others. Sharing of ideas and experiences also makes it possible for the members of a group therapy to visualize how others have dealt with or are tackling similar problems. They witness their own recovery and gain insights while listening to the information from other people. This enables members of a group therapy to learn how to cope with the challenges they face. According to Leichensring, Hiller, Weissberg, & Leibing (2006), the sharing of views, ideas and experiences also enables patients to reconcile their predetermined beliefs and thoughts with the realities of life. This leads to improved and quick emotional healing.
Secondly, group therapies also create a sense or feeling of social importance and worthiness among clients. This is because it gives members of a group therapy an opportunity to assist and guide other patients on how to tackle challenges of life. Group therapy enables patients to feel that they have something to offer to other people in the society. For instance, a participant would have an opportunity to use his or her own strengths to boost and bolster the problems of other members of the group. Moreover, regular attendance of group therapies also creates a sense of belonging, close social connection and unity among patients. Hardy and Cull (2010) also affirm that group therapy enables patients to reduce feelings of loneliness and to work collaboratively towards the development of the appropriate solutions to the problems they face. This also helps in quick recovery of the clients. Bernard and McKenzie (1994) also concur that group therapies allow members to freely and openly discuss the various challenges they face. Moreover, it provides them with the opportunity to come up with the appropriate solutions that are tailored towards effective meeting of their specific individual needs. For example, obese women in a group therapy may share their experiences with weight management techniques and formulate appropriate ways of weight loss that are best suited to them, based on their socio-economic and financial capabilities, age and occupations. Similarly, a group therapy for teenagers and adolescents would enable girls and boys to realize that their peers from different social backgrounds or geographical regions are also facing similar challenges such as drug and substance abuse or domestic violence. This would help them develop positive attitudes towards the challenges they face in their lives.
Thirdly, a therapist may prefer group therapy over individual counseling because it permits diversity of opinions. This is because group therapy promotes social interactions between clients from different social, economic, cultural and educational backgrounds. A group therapy may also be composed of clients of different sexes and ages. This helps in generating diverse points of views, ideas and experiences that greatly benefit the clients. A therapist may use animosity to encourage identification of specific factors that affect other clients in the group. For example, one client may act anonymously as an oppressive parent while another client would act as the oppressed child. This play can possibly help identify the factors that lead to oppression in parenting. According to Ruitenbeek (2012), this diversity in group therapy is very helpful especially among those clients who are suffering from traumatic experiences, anxiety disorders and certain illnesses. For example, a beautiful lady suffering from HIV/AIDS may learn how men perceive her moral conducts based on her HIV/AIDS status. This is because the disease is likely to impact her dating and relationships with men as well as her marriage life in the future. Sublette and Novick (2004) assert that social interactions also help in eliminating feelings of social isolation and fear among clients. Increased social interactions and the exchange of ideas and experiences between group members also create an environment, conducive for emulative learning among the members (Clarkin, 2012). Group therapies also allow clients to interact with each other in a more realistic social setting. This helps them realize and understand comprehensively how their behaviors and wellbeing may affect or be affected by other people in the society.
Fourthly, a therapist may choose group therapy over individual counseling in the situations where the relationship between the therapist and the client become insular and limiting. According to Mangione, Forti and Jacuzzi (2007), the relationship between a therapist and a client during face-to-face counseling sessions may become of an extremely narrow-minded nature as well as parochial. The views and thoughts expressed by the client and the therapist during such kind of counseling sessions may not be challenged by either party. This leads to an inadequate examination of the situation affecting the client. As a consequence, a therapist would prefer group therapy to individual counseling in order to permit incorporation of varied points of view from other clients. This is because a group therapy gives equal opportunities to all members of the group to challenge and criticize thoughts from other patients as well as suggestions from the therapist. For example, an experienced and rehabilitated drug addict may recognize the denial of addiction to drugs by a youth and convince him to accept the situation and face the realities of drug addiction. This also promotes the development of positive viewpoints among clients. However, the extent of criticism is often limited by specific guidelines developed during the creation of the group in order to set boundaries of criticisms during group discussions.
Fifthly, group therapies help not only in finding appropriate solutions to the problems faced by clients, but also in promoting the acquisition of good social skills such as interpersonal skills, effective communication skills, critical and creative thinking and problem-solving abilities of the clients. Group therapies provide ideal means of learning and practicing new interpersonal behaviors. Agazarian (1997) also agrees that group therapies provide a safe environment where patients can learn and experiment new patterns of behavior, improve their communication and interpersonal skills, obtain reliable and specific feedbacks from other people experiencing similar challenges and share ideas, concerns, experiences and interests with people who have similar challenges. This helps in promoting personal growth and development among patients.
A therapist would also choose group therapy over individual counseling in a situation that Â involves couples and families because the contribution of all parties affected by the problem is highly valuable. This also helps in creating a clear understanding of the problem among the couples or members of the family. According to Brabender and Fallon (2009), individual counseling would not be appropriate for therapies dealing with family issues. It is explained by partial nature of the technique use.
Last but not least, a therapist would choose group therapy because it permits the generation of more accurate feedbacks from the patients that are very fundamental during the treatment process. The feedbacks obtained at the end of the session would be used by the therapist to improve the treatment process as well as to plan the new courses of treatment. Group therapy also promotes accountability because members of the group tend to keep an eye on each other.
However, Conyne (1999) warns that group therapies are often faced with grievous challenges such as lack of confidentiality and privacy, unequal contribution and participation of members, disclosure of personal information to strangers, time consuming, personal clashes, conflicts and disagreements within the groups and withdrawal of members from the groups as the therapies progress. These challenges may adversely affect the success and effectiveness of treatment and emotional healing of patients. Similarly, individual counseling promotes greater confidentiality and privacy. Thus, a patient shares his or her emotions, experiences and thoughts freely, relying on the activity of the therapist.
Personal Leadership Qualities
As a leader of a group therapy, an individual requires certain desirable traits, characteristics and behaviors that would enable him or her to lead, guide and manage effectively. Moreover, it provides proper direction for all members of a group during treatment. The leader must also have a sound grasp and mastery of the concepts and techniques used in group therapy.For example, Cho and Hosteller (1981) assert that it is important for a group leader to develop consistency in the manner and procedures used during the therapy. It would enable him to provide a safe and stable environment that facilitates quick recovery of patients.The group leader is also responsible for making a series of important choices that would determine the success or failure of the group therapy.The group leader must also decide on how much power and authority he may exercise in the group as the therapy progresses.Appropriate application of leadership qualities enables the group leader to successfully intervene during the group therapy, hence facilitates smooth progress of the therapy process and quick recovery of clients. The following paragraphs provide brief discussions of some of my leadership qualities that would be useful in a group therapy.
First and foremost, it is necessary to have good communication skills that would assist during group therapies to effectively share ideas, skills and knowledge and life experiences with clients. Effective communication skills would be highly useful during group discussions as the therapy progresses. As a therapist I should also possess excellent listening skills that would facilitate positive outcomes during the group therapies. According to Chen and Rybak (2004), therapeutic interventions require group leaders to possess good listening skills that would enable proper perception and understanding of verbal messages, exchanged between the therapist and the clients.
Secondly, I have good conflict resolution skills that would help in resolving and determining appropriate solutions to various personal clashes and disagreements that may arise during the group therapy. I am also highly spontaneous and flexible. Spontaneity involves being creative and innovative. In my view, spontaneity would help me know how to admit mistakes that I may make during the group therapy instead of trying to defend my perfectness. This would help other group members understand and accept that no one is perfect thus they can make and admit mistakes without destroying their self-esteems and interpersonal relationships with other people.
Thirdly, I also have high self-esteem, much confidence and courage that would make it possible for me to deal with clients effectively. In my view, a good leader in group therapy should not rely on predetermine formulas in order to formulate solutions or find answers to complex challenges and problems faced by the clients but be able to develop solutions and answers, relying on the knowledge and clear understanding of the issues he or she has. This would facilitate the creation of a sense of security and stability among clients as the therapy progresses. This can only be achieved if the group leader is confident enough about his actions.
Fourthly, I have a firm personal identity. Firm personal identity refers to the ability of an individual to identify and reflect on his personal experiences and attributes and to take a firm stand on issues that may negatively impact his personal beliefs and values. A firm personal identity also concerns the ability of an individual to control his emotions such as anger effectively. Firm personal identity would enable me gain adequate understanding and proper management of my capabilities and emotional challenges. For example, I would be able to identify situations that may lead to emotional arousal such as fierce discussions or heated debates that tackle issues that are against my values and beliefs such as religious values. Similarly, a firm personal identify would enable avoid situations that would impede me from dealing with clients effectively, for instance, effective management and control of anger would enabled me to deal effectively with clients without harming them emotionally. Firm personal identity would also enables me set clear boundaries for interactions with clients. Pepper (2002) also emphases that a group therapist must be emotionally stable and healthy in order to be able to manage personal emotional problems effectively. Yarbrough (2008) also affirms that firm personal identity is helpful in setting boundaries between personal issues and the matters concerning clients that may be discussed during group therapies and counseling sessions.
Fifthly, I also have adequate constancy. This refers to the ability to remain steady and unvarying. Constancy helps a leader to reduce the number of changes introduced into the group as the therapy progresses. According to Karpetis (2012), small, intermittent changes are very important during group therapy because they ensure stability in the therapy environment, hence facilitate recovery for clients. I have achieved constancy through a wide range of specific behaviors, conducts and actions such as sitting at a single position during group meetings. Stone (2009) also asserts that it is important for group therapists to maintain a clear and consistent manner of doing things. Constancy can also be achieved through setting rules, guidelines and boundaries for the group. For my part, I would also demonstrate constancy through conducts such as maintaining a particular dressing code for group members.
Sixthly, I am highly trustworthiness and dependable. Trustworthiness refers to the ability to be relied upon by other people. In my view, a group therapist should be one to trust. He should be an individual who people can base their faith upon. Trustworthiness is an important leadership quality in group therapy as it helps in restoring the faith of clients on the therapist. Stone (2009) also affirms that trust is a key component in group therapies. I also have a good sense of humor. Humor refers to the ability to create fun or crack jokes with other people. In my view, humor is an important quality for leaders during group therapies because it helps in putting light weight on weighty or serious issues. However, Ruitenbeek (2012) warns that humor should be used carefully during group therapies. For example, leaders in group therapies should not use humor to joke about personal issues in an offensive manner because this would ignite emotions among clients thus lead to rifts in the groups. Humor can only be used as tools of psychological therapy to put smiles of the faces of the clients, hence provide temporary relive or healing.
In addition, I am an empathetic individual. It can help make a good leader during group therapies. Empathy refers to the ability to recognize the emotional problems or to identify with the situation which an individual is experiencing. It is caring about another person. Empathy would enable me gain a comprehensive understanding of the challenges and problems faced by clients. For example, empathetic listening would enable me pay close attention to issues brought forward by the clients during the therapy and to identify and take note of the underlying causes of the problem. Empathy also permits generation of sincere comments and advice that would not belittle or disparage the self-esteem of the clients. It also helps in the generation of appropriate alternative solutions that can be easily accepted by clients. I am also capable of recognizing the level of vulnerability of members of the group therapy as well as providing appropriate social and emotional support to clients.
Other leaders skills that I possess, those which would be beneficial during a group therapy, include the abilities to accept criticisms from other people, to show patience with group members and to perceive issues raised by group members during therapies as accurately as possible.