Psychotherapy, also known as talk therapy, is a treatment modality in which the therapist and the client work together to improve the client’s psychopathologic conditions and functional impairment (Cook, Schwartz & Kaslow, 2017). Group or family therapy is characterized by the therapist treating more than one client at the same time, enabling the participants to work together while learning from the feedback they receive from each other, including the therapist. Individual therapy, on the other hand, involves interaction between the therapist and the client. This enables the client to engage in a self-reflective process on his or her emotions and behaviors, and a treatment plan tailored to meet the specific need of the client is designed. This narrative examines how legal and ethical considerations for group and family therapy differ from those for individual therapy.
Legal and Ethical Consideration
Group/family and individual therapy are relatively equivalent in their effectiveness in addressing many psychiatric issues. However, the legal and ethical considerations for the two types of therapy differ. Confidentiality and the ethical principle of beneficence are some areas in which these forms of therapy differ. With individual therapy, patient information is strictly protected as it is shared only with personnel involved in the client’s care. Secondly, treatment modality is designed specifically for the client. In group therapy sessions, members are encouraged to discuss the issues that brought them into therapy openly; as a result, sensitive patient information may be revealed to the group. Even though group members are bound not to discuss events/issues that occur in the group outside of the group environment, there is no guarantee that they will keep to their words as there are no ethical standards to hold group members accountable. Confidentiality in group psychotherapy is more complicated than in individual therapy because self-disclosure is at the core of group therapy, and numerous people hear the disclosures (Lasky & Riva, 2016). Beneficence is another area of concern when it comes to group therapy. Zapata and Moriates (2015) describe beneficence as the obligation of the clinician to act in the best interest of the patient. Group therapy may not be appropriate for certain types of individuals, such as timid individuals or those who are mentally challenged; they might not be able to participate actively or benefit from group therapy.
Impact on Therapeutic Approach
Patient confidentiality and patient-centered intervention are essential elements in attaining successful patient outcomes. Ensuring adequate privacy protections is critical to maintaining an individual’s trust in their clinicians and promotes their willingness to obtain needed mental health services (U.S. Department of Health & Human Services, 2014). When group treatment is being considered for clients, the client’s informed consent must be obtained. Education regarding confidentiality should be implemented before the client enters the group as McClanahan (2014) indicate that some group participants might not fully understand how confidentiality in group settings differs from confidentiality in individual therapy. Potential group members should be informed that the clinician may have a legal obligation to break confidentiality in certain circumstances, and those circumstances must be explained thoroughly (McClanahan, 2014). The need to maintain client’s confidentiality should be continuously reinforced among the group participant. In promoting the principle of beneficence, the clinician must conduct a one-on-one discussion with each client before he or she joins a group to evaluate the client’s comprehension of confidentiality issues in a group setting and determine the type of therapy that is suitable for the client.
Cook, S. C., Schwartz, A. C., & Kaslow, N. J. (2017). Evidence-based psychotherapy: advantages and challenges. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics, 14(3), 537–545. doi:10.1007/s13311-017-0549-4
Lasky, G. B., & Riva, M. T. (2016). Confidentiality and privileged communication in group psychotherapy. International Journal of Group Psychotherapy, 56(4), 455-476. doi:10.1521/ijgp.2016.56.4.115
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 rules and sharing information related to mental health. Retrieved from http://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/special/mhguida cepdf.pdf
Zapata, J. A., & Moriates, C. (2015). An ethical basis for considering value. American Medical Association Journal of Ethics, 17(11), 1022-1027.