RESPONSE
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: Octavia
Describe in detail strategies you prefer to use to ensure confidentiality in a treatment group for individuals living with HIV/AIDS
There is no way that a worker can ensure that a group member won’t share confidential information outside of the group. However, the social worker can utilize different strategies to set the appropriate environment for clients. However social workers can “guard against breach of confidentiality by having all member of the group pledge that they will adhere to confidentiality policies” (Toseland,Rivas,2017). “The policy builds trust and avoids perceptions of favoritism or special alliances with certain members” (Toseland,Rivas,2017).
Clearly explain how informed consent applies to maintaining confidentiality in a group setting.
It is important to let the clients know that there are certain that if they share during any information regarding child abuse or that they are going to hurt someone else or themselves that you will then be sharing the information with the channels within and outside of the agency. “Providing this information allows clients to determine what kind of information and how much of it to disclose to the therapist and also allows them to understand the consequences of disclosing certain kinds of information in advance” (Lasky,Riva,2006)
Thoroughly describe how confidentiality in a group differs from confidentiality in individual counseling.
In individual therapy the worker is bound by policy and in a group setting the other member are not, which makes the risk for sharing higher. The other difference is that the group member is considered witness if there were any legal issues surrounding the client that are sharing. “From a legal standpoint, the presence of a third party means that personal disclosure is viewed as public, and it is assumed that the person did not intend to keep it confidential” (Laskky,Riva,2006).
Specifically describe discuss how you would address a breach of confidentiality in the group.
Considering that I have done work with this population before, I understand just how important confidentiality is. A recent study was conducted and found that “HIV-infected individuals found that group psychotherapy is efficacious” (Himalhoch,Medoff,Oyeniyi,2007). This information gather by the study is very important in treating individuals living with HIV. If an individual in a group feels as though they aren’t safe their chances of returning are not high. I have had this happen in the past and we had to not allow the member to return. I propose having a zero tolerance for this set a great boundary for the clients. I would ensure that in the letter that the client signs it is noted in bold that that if confidentiality is broken then member would not be allowed back to participate in the group.
References
Himalhoch, S., Medoff, D. R., & Oyeniyi, G. (2007). Efficacy of group psychotherapy to reduce depressive symptoms among HIV-infected individuals: A systematic review and meta-analysis. AIDS Patient Care and STDs, 21(10), 732–739.
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].
Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.
Colleague 2: Julie
An effective way to help people that are living with HIV/AIDS is to form a treatment group. The purpose of a treatment group is to meet the group member’s socio-emotional needs through mutual aid, support, education, therapy, growth, and socialization (Toseland & Rivas, 2017). A treatment group functions best when the group members participate, and share about their lives, and their experience, living with HIV/AIDS. The disclosure of the group members makes the benefits of the HIV/AIDS treatment group possible. Ideally, the things shared in a HIV/AIDS treatment group would be kept confidential. To promote the concept of confidentiality in a HIV/AIDS treatment group, I would introduce a written informed consent form, explain its purpose, and request each group member signs it. I would emphasize the importance of a sense of felt safety within the group that would facilitate the group members in sharing their experience. I would explain that by protecting the confidentiality of the HIV/AIDS treatment group, they are demonstrating that they respect the other group members, as well as the process. I would detail the potential for unanticipated harm that could occur with an individual, or the group, by a breach of confidentiality (Lasky & Riva, 2006). A thorough discussion on the concept of confidentiality within the HIV/AIDS treatment group will help each of the members to understand the value of it, in this setting.
In a group setting, informed consent is the effort made by the group leader to establish confidentiality. The group leader should strive to help the group members to understand that the purpose of signing the informed consent document is to protect the confidentiality of each person in the group. The informed consent form should be clear in its description of what that exactly entails. At the beginning of the group, the leader should provide a description about each point to ensure that each group member understands and is in agreement. If a new member joins the group at a later point in time, the leader should explain the informed consent form again for the new member, and provide a review, and a reminder for the regular members. By signing a written informed consent, the group members are stating that they agree to adhere to the confidentiality policies (Toseland & Rivas, 2017). This is a step that the leader and the group members can take to guard against breaches of confidentiality (Toseland & Rivas, 2017). The group members would need to be understand the ramifications of breaking the confidentiality within the group. They should be detailed precisely on the informed consent form.
Confidentiality in groups, such as an HIV/AIDS treatment group, is more problematic than in individual therapy (Lasky & Riva, 2006). This is due to the fact that there are multiple people in the group that are privy to the disclosures (Lasky & Riva, 2006). The treatment’s effectiveness is dependent upon the mutual interaction and disclosing of personal information among the group members (Lasky & Riva, 2006). The group leader is limited in controlling the progression of a group session, or what occurs between the group members, between sessions (Lasky & Riva, 2006). There are limitations to confidentiality in groups. It is easier to ensure confidentiality in individual therapy. Individual therapists may have a greater understanding of the concept of confidentiality than the average person. There are typically, fewer ethical dilemmas involved in individual therapy (Lasky & Riva, 2006). Both individual, and group, therapy have an ethical obligation to breach confidentiality when safety becomes a concern.
As a group leader, I have the responsibility to protect the group members so that they feel safe to self-disclose. When a group member is impacted by a violation of confidentiality, they can feel betrayed by their group, and angry with the group leader, for being passive in addressing the violations of confidentiality (Lasky & Riva, 2006). If a breach of confidentiality occurred in a group that I was leading, I would, sit down and talk with the individual to inquire about their understanding of confidentiality, as well as the informed consent form, that they signed. It is possible that the individual did not fully understand the concept of confidentiality. If this was the case, I would want to, at a later time, review the methods used to present the concepts to ensure that I was clear in my explanation. I would then point out that informed consent form that they signed when the group started. Depending on the particulars of the violation, the group member could be dismissed from the treatment group.
References
Lasky, G. B., & Riva, M. T. (2006). Confidentiality and privileged communication in group psychotherapy.International
Journal of Group Psychotherapy, 56(4), 455-476.
Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston MA: Pearson.
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