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Social Psychology homework help

Social Psychology homework help

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12/14

PSY 228 Social Psychology

Tracking Your Academic Activities Verifying an accurate course completion time is essential for accreditation. To meet both accreditation requirements and award academic credit, educational institutions must document the total number of hours students spend completing designated academic activities related to their coursework.

The total hours are then translated into academic credit based on a prescribed method of measuring educational attainment known as the Carnegie Unit. 90 hours of student preparation time and 45 hours of student engagement time are required for a 3 credit hour course.

Using the attached form as an example, keep track of the time you spend on each lesson, pre-test, self-test, unit test, writing assignment, reading assignment, outside reading, final examination, etc. You will not be required to turn in the worksheet; however, at the end of the course you will receive a Student Course Survey and the final question will ask how long it took you to complete the course. Your assistance in completing this requirement and providing the university with this valuable data is greatly appreciated.

As you fill out the worksheet, please keep in mind that your Academic Engagement Activities should total approximately 45 hours. Some examples of this type of activity may include:

Lesson Review Exercises

Key Term Reviews

Analysis

Study Guide Review

Writing Assignments

Review Grading Rubric

Unit Examinations

Proctored Final Examination

Course Academic Online Discussions

Student/Instructor Interaction

Documents/Student Resources

As you fill out the Academic Preparation Activities, please keep in mind that these should total approximately 90 hours. Some samples of this type of activity may include:

Pre-Test

Reading Assignments

Key Term Reviews

Studying for Examinations

Writing Assignments

Review Grading Rubric

Study Lesson Review Exercises

Internet/Web Research

Reading Websites

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Qualitative Findings and Social Work Interventions

Qualitative Findings and Social Work Interventions

Discussion 1: Qualitative Findings and Social Work Interventions

Evidence-based social work practice calls for the use of research data to guide the development of social work interventions on the micro, mezzo and/or macro-levels. Kearney (2001) described ways qualitative research findings can inform practice. Qualitative findings can help social workers understand the clients’ experiences and “what it may feel like” (Kearney, 2001). Therefore, social workers can develop clinical interventions that take into account the experiences of their clients. Qualitative findings can also help social workers monitor their clients. For example, if after reading a qualitative study on how domestic violence survivors respond to stress, they can monitor for specific stress behaviors and symptoms (Kearney, 2001). In addition, they can educate their client what stress behaviors to look for and teach them specific interventions to reduce stress (Kearney, 2001)

Given the increasing diversity that characterizes the landscape in the United States, social workers need to take into account culture when formulating interventions. Social workers can utilize qualitative findings to plan interventions in a culturally meaningful manner for the client.

To prepare for this Discussion, read Knight et al.’s (2014) study from this week’s required resources. Carefully review the findings, the photographs, and how the researchers wrote up the findings. Finally, review the specific macro-, meso-, and micro-oriented recommendations.

Then read Marsigilia and Booth’s article about how to adapt interventions so that they are culturally relevant and sensitive to the population the intervention is designed for. Finally, review the chapter written by Lee et al. on conducting research in racial and ethnic minority communities.

Kearney, M. (2001). Levels and applications of qualitative research evidence. Research in Nursing and Health, 24, 145–153.

Post the following:

1. Using one of the direct quotes and/or photos from Knight et al.’s study, analyze it by drawing up a tentative meaning. Discuss how this would specifically inform one intervention recommendation you would make for social work practice with the homeless. This recommendation can be on the micro, meso, or macro level.

2. Next, explain how you would adapt the above practice recommendation that you identified so that it is culturally sensitive and relevant for African Americans, Hispanics, or Asian immigrants. (Select only 1 group). Apply one of the cultural adaptations that Marsigilia and Booth reviewed (i.e., content adaption to include surface and/or deep culture, cognitive adaptations, affective-motivational adaptations, etc.)(pp. 424-426). Be as specific as you can, using citations to support your ideas.

References (use 3 or more)

Knight, K. R., Lopez, A. M., Comfort, M., Shumway, M., Cohen, J., & Riley, E. D. (2014). Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: The intersection of policy, drug use, trauma, and urban space. International Journal of Drug Policy, 25(3), 556-561.

Document: Lee, M. Y, Wang, X., Cao, Y., Liu, C., & Zaharlick, A. (2016). Creating a culturally competent research agenda. In A. Carten, A. Siskind, & M. P. Greene (Eds.), Strategies for deconstructing racism in the health and human services (pp. 51-65). New York, NY: Oxford University Press. (PDF)

Marsiglia, F.F. & Booth, J.M. (2015). Cultural adaptations of interventions in real practice settings. Research on Social Work Practice, 25(4), 423-432.

Note: Retrieved from the Walden Library databases.

Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398-405.

Discussion 2: Addressing Change

What does a leader do when things do not go as planned? How can a leader help to restore or improve an organization’s operations when a situation stalls or interferes with its functions? Although taking a proactive approach to planning is desired, change may occur suddenly and unexpectedly causing immediate consequences. A skilled leader must be able to assess a situation in order to prioritize the steps necessary to stabilize the organization. This process must focus on a short-term strategy to address immediate concerns and include strategic decisions that will affect the long-term sustainability of the organization.

For this Discussion, you address the Southeast Planning Group (SPG) case study in the Social Work Case Studies: Concentration Year text.

· Post an analysis of the change that took place in the SPG.

· Furthermore, suggest one strategy that might improve the organizational climate and return the organization to optimal functioning.

· Provide support for your suggested strategy, explaining why it would be effective.

References (use 3 or more)

Lauffer, A. (2011). Understanding your social agency (3rd ed.). Washington, DC: Sage.

Northouse, P. G. (2018). Introduction to leadership: Concepts and practice (4th ed.). Washington, DC: Sage.

Finley, D. S., Rogers, G., Napier, M., & Wyatt, J. (2011). From needs-based segmentation to program realignment: Transformation of YWCA of Calgary. Administration in Social Work, 35(3), 299–323.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing [Vital Source e-reader].

“Social Work Supervision, Leadership, and Administration: The Southeast Planning Group” (pp. 85–86)

Working With Organizations: The Southeast Planning Group

The Southeast Planning Group (SPG) is an organization that was created in 2000 to facilitate the Office of Housing and Urban Development’s (HUD) Continuum of Care planning process. The key elements of the approach were strategic planning, data collection systems, and an inclusive process that involved clients and service providers. The fundamental components of the system are 1) outreach, intake, and assessment; 2) emergency shelter; 3) transitional housing; and 4) permanent housing and permanent supportive housing. The outreach, intake, and assessment component identifies an individual’s or family’s needs in order to connect them with the appropriate resources. Emergency shelter provides a safe alternative to living on the streets. Transitional housing provides supportive services such as recovery services and life skills training to help clients develop the skills necessary for permanent housing. The final component, permanent housing, works with clients to obtain long-term affordable housing.

SPG works with the local government; service providers; the faith, academic, and business communities; homeless and formerly homeless individuals; and concerned citizens in the designated service area. During the first 5 years of its existence, SPG was staffed by one part-time and four full-time staff members and oversight was provided by a 21-member board. SPG’s founding director was well respected and liked in the community. She was noted for her ability to bring stakeholders together across sectors and focus on the single mission of ending homelessness.

After serving 5 years as the executive director, she abruptly resigned amidst rumors that she was forced out by the board. Although she had been effective in bringing people together, there were concerns that the goals and objectives had not been met, and there was a lack of confidence in her ability to grow the organization. Approximately one month after her resignation, a new executive director was hired.

One of the new director’s first priorities was to reconfigure the structure of the organization in order to increase efficiency. As a result of the restructuring, two positions were eliminated. The people who were let go had been with the organization since it was created, and similar to the previous director, they had strong ties to the community. Once the community and SPG’s partners learned about the changes, there was suspicion about the new leadership and the direction they wanted to take the organization. Stakeholders were split in their views of the changes—some agreed that they were necessary in order to advance the goals of the organization, while others felt the new leadership was “taking over” with a hidden agenda to promote its own self-interest.

I worked with the group as an evaluation consultant to assess the SPG partnership during this period of transition. In order to assess how these changes were perceived by the stakeholders, I conducted key informant interviews with various stakeholders, both internal and external to the organization. The partners shared many insights about how the month without consistent leadership contributed to the uncertainty about SPG’s purpose and strategy, and it was generally agreed that the leadership transition was not handled well. The results from the evaluation were used to help SPG identify strategies to improve communication with stakeholders and utilize the director’s leadership role to build upon the organization’s past successes while preparing for future growth.

(Plummer 51-52)

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The Groth Typology Of Rape And The Massachusetts Treatment Center’s Classification Systems Of Rapists.

February 6, 2024/in Assignment Help, Homework Help /by Daniel Jennings

The Groth Typology Of Rape And The Massachusetts Treatment Center’s Classification Systems Of Rapists.

RESPONSES:

1. According to the U.S Department of Justice Archives, the new definition of rape is: “The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim” (Sullivan, Rogers, & Moran, 2017). The Groth typology was developed almost forty years ago. This typology of rape is based on presumed motivations and aims that underline almost all rapes committed by adult males. Groth believed rape to be a “pseudo-sexual act”. He also believed that rape is a symptom of some psychological dysfunction, whether is temporary and transient or chronic and repetitive. Groth divided rape into three major categories. First, anger rape, second, power rape, and sadistic rape. He believed rape is always and foremost an aggressive act.

The Massachusetts Treatment Center’s Classification Systems of rapists has many similarities to Groth’s typology. The MTC has originally identified four major categories of rapists. One, displaced aggression, two, compensatory, three, sexually aggressive, and four, impulsive rapists. Anger rapists are similar to displaced aggression rapists, sadistic rapists are similar to sexual aggressive rapists. The MTC typology is more extensive and more complex because is based on ongoing research.

2.The Groth Typology was developed around forty years ago. Groth stated that there is always other motivations, rather than simple sexual arousal, for rapists. He divides rape into three different categories, including anger rape, power rape, and sadistic rape. Anger rape is typically brutal, degrading, and extremely forceful. Anger rapists have some internal anger, usually towards a specific woman, and take it out on their victims. Power rape is when the rapists is establishing dominance and control over their victim. The aggressiveness depends on how submissive the victim is. Victims of power rape are often kidnapped and experience multiple assaults. Sadistic rape involves the rapist experiencing arousal and pleasure of the victim’s torture and abuse.

Massachusetts Treatment Center’s Classification Systems of rapists is far more complex and researched than Groth’s. It continues to be researched and updated, unlike The Groth Typology. MTC also identifies four types of rapist, rather than three. The types include displaced aggression, compensatory, sexual aggressive, and impulse rapists. Although the two typologies are different, their division of types of rape are similar. Anger rape is similar to displaced aggression, sadistic rape is similar to sexual aggressive rape, and power rape is similar to compensatory rape. The final MTC type of rape is the impulse rape, in which rapists usually have no other history of sexual assault and committed it spontaneously when the opportunity was there. This type has no similarities with any of Groth’s types.

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Case Study Assignment

February 6, 2024/in Assignment Help, Homework Help /by Daniel Jennings

Case Study Assignment

Page 1

PSY105 CASE STUDY

Type Your Name Here

Introduction to Psychology
April 3, 2019

Given what you have learned in Chapter 3 about brain development and social development, explain why Gloria’s son is making poor decisions. (Use page 3.4 for brain development and page 3.6 for social development).

What specific strategies can Gloria use to help her son make better decisions? (Hint: pages 3.7 and 3.17 have resources to help)

From what you have learned about human development and self-regulation, why do you think these strategies will be effective?

(Hint – based on what you offered as a suggestion in question 2, why would that strategy help Gloria’s son)

How does Reggie’s mindset affect the way that he prepares for the compliance test? (Hint: page 7.6 will help you learn about mindset)

Use brain plasticity (neuroplasticity) to explain how Reggie can start to develop a growth mindset. What can Reggie do to actually change his brain so that he can adopt a growth mindset approach? (Hint: page 7.6 will be a great resource for this question)

Suggest at least three study strategies that Reggie can use to study for the compliance test. Based on what you have learned about memory in Chapter 4, explain why these would be effective study techniques. (Hint: page 4.15 has suggestions to improve your memory)

What are the big five personality traits? When thinking about the big five personality traits, on which ones do Gloria and Lakeisha differ the most? (Hint: page 3.12 helps you learn about the big five traits)

Give some advice to Gloria. How can she use emotional regulation to work more effectively with Lakeisha? Give at least two things that Gloria can do and provide a rationale for why these will be effective. (Hint: Pages 6.4 and 6.11 have resources to help with this question)

References

Myers, D. (2017). Psychology (4th ed.). Asheville, NC: Soomo Learning. Available from hMp://www.webtexts.com

Case Study Assignment Template Note: Please use this template to complete the Case Study Assignment (due in Week 7). All you need to do is write a paragraph within each box contained in the template to receive credit for this assignment.

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Case Study Assignment Overview

Case Study Section 1 Review

Case Study Section 2 Review

Case Study Section 3 Review

_________________

Gloria has recently graduated college and started a new job. Her coworkers seem very nice, and Gloria has gotten to know Lakeisha and Reggie the best.

Reggie is a friendly older man who often talks about his plans for retirement in five years. He likes to make people laugh but often jokes about his struggles to learn new programs and technology.

Gloria and Lakeisha have been assigned to work on a project together. Lakeisha is very organized and has prepared a list of to-do items along with due dates. She even color-coded the list to indicate which partner will do each item. Gloria, who is more laid-back, feels a bit uncomfortable with this micromanaging from Lakeisha, who has only been at the job a few months longer than she has. Gloria wonders if Lakeisha thinks she is either lazy or stupid, and she does not look forward to working on this project. In the past, Gloria attempted to communicate her feelings with a co-worker; however, her coworker told Gloria that she needed to put her feelings aside and just do the work assigned to her. As Gloria ponders having a conversation with Lakeisha, she starts to feel overwhelmed and thinks she might have to ask to be removed from this project.

Still, she and Lakeisha have connected because they are both single mothers of teenagers. Gloria confides in Lakeisha about her 16-year-old son who has started making poor choices and is currently grounded for sneaking out of the house and getting drunk at a party the night before a big exam.

The company recently informed the team that there will be a compliance test on new safety policies, which employees will need to pass in order to keep their jobs. The company has provided materials to study as well as optional practice exams. Gloria and Lakeisha have signed up to take the first practice test. Reggie, however, jokes that he will probably wait until the night before the test to read the material. As the date of the test approaches, Reggie becomes increasingly nervous. He makes frequent comments about how hard it is for him to learn a different way of doing the jobs that he has been doing for years, joking that “you can’t teach an old man new tricks.”

1. Gloria’s son is making poor decisions. Given what you have learned about a) brain development and b) social development in Chapter 3:
Explain why Gloria’s son is making those poor decisions.
Discuss specific strategies Gloria can implement to help her son make better choices.
Use specific concepts related to development and self-regulation to explain why these strategies would be effective.
2. Reggie is demonstrating a fixed mindset. How is Reggie’s mindset affecting the way he prepares for the new compliance test?
Use brain plasticity (neuroplasticity) to explain how Reggie can start to develop a growth mindset.
Suggest study strategies for Reggie so that he will be prepared for the compliance test. Use specific concepts from Chapter 4 to explain why these strategies will be effective.
3. Consider Gloria and Lakeisha’s different approaches to the project. On which of the Big 5 personality traits do they most differ?
Give advice to Gloria on how she can use emotional regulation and cognitive reappraisal to work with Lakeisha.

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Psychology homework help

February 6, 2024/in Assignment Help, Homework Help /by Daniel Jennings

Psychology homework help

I need only 4 simple pages without any out resources USE JUST THE FILE ATTACHED AND THE LINK AT THE BOTTOM. **With the verb (I). I will attach Pamela Hays’ Addressing Model and the first part that I did about myself.

The name of this class is Culture and Gender in Counseling and Psychotherapy

The paper has to be divided into two parts. The first part I did in the first half of the semester, and the second part is due now.

It is a self-assessment. The first part was about my self-identity. The second part is:

The second section is due in Week 11 and should be 4-6 pages in APA style. This section is to include a self-assessment using Pamela Hays’ Addressing Model discussed in class, along with reflections on changes or new awareness that have emerged as a result of the course. In other words, reflect on Part 1. You are to turn in the graded copy of Part 1 along with Part 2.

……………………………………………………………………………………………………..

Here, the professor said:

C) Self-Assessment. This paper has two parts. The first section will be a follow-up to in-class activities presented in Weeks 1 and 2. For this assignment, you will reflect on your cultural identity. Honesty is expected and will not be penalized; however, a respectful tone is required. The first section should be 2-3 pages in APA style and be an honest assessment of your cultural identity and how you see yourself at the start of this class. We will do a few in-class exercises during the first two weeks to support this process. The second section is due in Week 11 and should be 4-6 pages in APA style. This section is to include a self-assessment using Pamela Hays’ Addressing Model discussed in class, along with reflections on changes or new awareness that have emerged as a result of the course. In other words, reflect on Part 1.

The following are questions to consider in the completion of this assignment:

a) Which one of these identities (from the ADDRESSING model) do you find to be most salient? Why? Which is least salient? Why?

b) What does it mean to you (and to American society as a whole) to be part of this group?

c) What are some of your recollections about interactions and experiences that have significantly impacted your cultural identity development as part of this group? Have your feelings changed or stayed the same about being part of this group?

d) Have you contributed to discrimination or oppression as part of this group? Have you been a victim of discrimination or oppression as part of this group?

e) What messages have you received (directly or indirectly) about people who share your identity and people who do not share your identity?

f) What are some skills you have learned in this class that you can use when working with individuals from diverse groups?

g) Have your views changed since taking this class? If so, how? What are some areas you still need to work on?

The link for Pamela Hay’s

https://ltc.highline.edu/cce/Addressing%20Complexities%20in%20Counseling%20(ADRESSING%20model)-%20Hays.pdf

Running head: SELF-ASSESSMENT 1

SELF-ASSESSMENT 2

Self-Assessment Part1

Everyone has different cultural identity. Each of them has their owns’ cultures, behavior, ethics, religions, languages, education, social..etc. People are different in the whole world. They cannot be similar, but they can respect each other. In this essay, I will reflect my cultural identity.

I am from Saudi Arabia, and we have our behavior that connect with our religion and habits. For example, all of my family members live together at the same house. The daughter or the son cannot live in separate home until they get married. That means, they can move to another house when they want to get married. That because of my religion, which prevents intimacy between any couple without marriage.

Furthermore, in my culture, women cannot drive a car. This related to our habits cultures. Men think that is dangers for woman to drive by herself. They believe that is a part from their responsibility. I do not agree with them, however, I respect their opinions. Thus, women having hard time moving inside the city especially we do not have good transportation.

As a Muslims woman, I grow up in a conservative family. For example, I and other females in my family wear hijab, which is a scarf on our head with long and wide dress. In addition, we do not shake hand with other gender. Sometimes this put me in embarrassing situation with people who are from different cultures. We like our religion and respect other religions and beliefs.

I grow up in a big lovely family, which I have seven siblings. They are five sweet sisters, and two great brothers. I really appreciate my parents’ fatigue. They support all of us and they did their best to make us good people. Therefore, we have strong communication between each other and all of us complete our education until Bachelor’s degree or higher.

My parents give me the power to have a family too. I marry in early age, which I was only 18 years old. In my culture, this is normal age to get married for girls, but it is very young and up normal for other cultures. Men in my culture can get married as soon as they have a job. I got my decision to be marry for my husband when I was in high school. Now, I am so happy and proud to be a mother for two beautiful children, and a wife for an awesome husband.

Schools and universities in Saudi Arabia are very different form the United States. For example, form first grade to university students study in separate schools for each grander. That means males and females study in divided building, and that do not happened in the United States, which student with different gender study together. This difference come by cultures behaviors.

My language is Arabic, and it is a basic language in the Middle East. Recently, I learned English language as a second language after I decided to study my master degree in the United States. I got intensified English classes for one year and half. That because the fact that my county gives me the opportunity to study here after I took a high grade in my under gradate.

Therefore, I am a graduate student in Chestnut Hill College. I am proud that I achieve part of my dreams, which was to study Psychology in under graduate, and Clinical and Counseling in my graduate; however, many people around me tried to change my mind in choosing this major. Unfortunately, they think is a major that take for madness. I did not hear for them because of my desire to help people getting better life.

In spite the fact that I am shy in making friendship, I am a social person and I like to have many friends. I am always interesting for having friends, but it is difficult for me to have a friend from different gender. In my culture, it is fine for females to work with males, but it should not be friendship.

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Psychology homework help

February 6, 2024/in Assignment Help, Homework Help /by Daniel Jennings

Psychology homework help

MILT 375

APA Format Paper Instructions

This assignment will prepare you for developing well-written and formatted papers for this course, and others in which you use APA formatting. The paper is to be 4 pages that demonstrate your ability and understanding of APA format and writing style.

The paper will consist of:

1. A Title/Cover Page: This page of the assignment will have your running head and page number, your title of the assignment, your name, and specific information necessary for any APA research paper. Make sure this page and every page is formatted with correct spacing, content positioning, type font, size of font, etc.

2. Abstract Page: Write this abstract as the one you would write for your Needs Assessment paper. It is very important that you read the APA manual to understand what an abstract is supposed to be. Make sure it is in the correct tense and correct format. You will not be able to give your reader your final findings as indicated in number 3 in the instructions for the Needs Assessment paper, yet you can write the rest of the abstract with a fair amount of accuracy. Remember, this paper is an “exercise” to get a head start, demonstrate your ability to develop a good APA formatted paper, and receive feedback on this before you submit the other 2 writing assignments for the course.

3. Paper Body Page: This page will consist of 2 basic components. The first will be a brief introduction paragraph. Introduce the Needs Assessment Paper. Even though you have not done a lot of reading or research yet, this should be fairly easy to do. The second component is a correctly formatted demonstration of all 5 APA level headings. You will need to use each heading with a single sentence telling your instructor which level it is. See the example of the first heading below.

Level 1 heading

A level 1 heading is bold face font, centered and uses upper and lower case font.

4. Reference Page: Use your page 4 to demonstrate your ability to cite references correctly. You will need to format the page while citing a website/internet article, a research article, book, the Bible, and an eBook. Use care to make sure all spacing, capitals, abbreviations, etc. are done according to APA.

Submit this assignment by 11:59 p.m. (ET) on Monday of Module/Week 3.

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Psychology Theoretical Analysis homework help

February 6, 2024/in Assignment Help, Homework Help /by Daniel Jennings

Psychology Theoretical Analysis homework help

Ethical and Professional Issues in Group Practice

Those who seek to be professional group leaders must be willing to examine both their ethical standards and their level of competence. Among the ethical issues treated in this chapter are the rights of group members, including informed consent and confidentiality; the psychological risks of groups; personal relationships with clients; socializing among members; the impact of the group leader’s values; addressing spiritual and religious values of group members; working effectively and ethically with diverse clients; and the uses and misuses of group techniques. In my opinion, a central ethical issue in group work pertains to the group leader’s competence. Special attention is given to ways of determining competence, professional training standards, and adjuncts to academic preparation of group counselors. Also highlighted are ethical issues involved in training group workers. The final section outlines issues of legal liability and malpractice.

As a responsible group practitioner, you are challenged to clarify your thinking about the ethical and professional issues discussed in this chapter. Although you are obligated to be familiar with, and bound by, the ethics codes of your professional organization, many of these codes offer only general guidelines. You will need to learn how to make ethical decisions in practical situations. The ethics codes provide a general framework from which to operate, but you must apply these principles to concrete cases. The Association for Specialists in Group Work’s (2008) “Best Practice Guidelines” is reproduced in the Student Manual that accompanies this textbook. You may want to refer to these guidelines often, especially as you study Chapters 1 through 5.

The Rights of Group Participants

My experience has taught me that those who enter groups are frequently unaware both of their basic rights as participants and of their responsibilities. As a group leader, you are responsible for helping prospective members understand what their rights and responsibilities are. This section offers a detailed discussion of these issues.

A Basic Right: Informed Consent

If basic information about the group is discussed at the initial session, the participants are likely to be far more cooperative and active. A leader who does this as a matter of policy demonstrates honesty and respect for group members and fosters the trust necessary for members to be open and active. Such a leader has obtained the informed consent of the participants.

Informed consent is a process that begins with presenting basic information about group treatment to potential group members to enable them to make better decisions about whether or not to enter and how to participate in a group (Fallon, 2006). Members have a right to receive basic information before joining a group, and they have a right to expect certain other information during the course of the group. Discussing informed consent is not a one-time event, and clients should understand at the outset that informed consent is an ongoing process.

It is a good policy to provide a professional disclosure statement to group members that includes written information on a variety of topics pertaining to the nature of the group, including therapists’ qualifications, techniques often used in the group, the rights and obligations of group members, and the risks and benefits of participating in the group. Other information that potential members should have includes alternatives to group treatment; policies regarding appointments, fees, and insurance; and the nature and limitations of confidentiality in a group. Group leaders should not overwhelm members with too much information at one time because an overly lengthy informed consent process may replace a collaborative working relationship with a legalistic framework, which is not in the best interests of group members (Fallon, 2006).

Pregroup Disclosures Here is a list of what group participants have a right to expect before they make the decision to join a group:

• A clear statement regarding the purpose of the group

• A description of the group format, procedures, and ground rules

• An initial interview to determine whether this particular group with this particular leader is at this time appropriate to their needs

• An opportunity to seek information about the group, to pose questions, and to explore concerns

• A discussion of ways the group process may or may not be congruent with the cultural beliefs and values of group members

• A statement describing the education, training, and qualifications of the group leader

• Information concerning fees and expenses including fees for a follow-up session, should there be one; also, information about length of the group, frequency and duration of meetings, group goals, and techniques being employed

• Information about the psychological risks involved in participating in a group

• Knowledge of the circumstances in which confidentiality must be broken because of legal, ethical, or professional reasons

• Clarification of what services can and cannot be provided within the group

• Help from the group leader in developing personal goals

• A clear understanding of the division of responsibility between leader and participants

• A discussion of the rights and responsibilities of group members

Clients’ Rights During the Group Here is a list of what members have a right to expect during the course of the group:

• Guidance concerning what is expected of them

• Notice of any research involving the group and of any audio- or videotaping of group sessions

• Assistance from the group leader in translating group learning into action in everyday life

• Opportunities to discuss what one has learned in the group and to bring some closure to the group experience so participants are not left with unnecessary unfinished business

• A consultation with the group leader should a crisis arise as a direct result of participation in the group, or a referral to other sources of help if further help is not available from the group leader

• The exercise of reasonable safeguards on the leader’s part to minimize the potential risks of the group; respect for member privacy with regard to what the person will reveal as well as to the degree of disclosure

• Observance of confidentiality on the part of the leader and other group members

• Freedom from having values imposed by the leader or other members

• The right to be treated as an individual and accorded dignity and respect

It is critical that group leaders stress that participation in groups carries certain responsibilities as well as rights. These responsibilities include attending regularly, being prompt, taking risks, being willing to talk about oneself, giving others feedback, maintaining confidentiality, and defining one’s personal goals for group participation. Some of these group norms may pose problems for certain members because of their cultural background. It is essential that the expectations for group members be clear from the outset and that members be in agreement with such expectations. Of course, part of the group process involves the participation of members in developing norms that will influence their behavior in a group situation.

Issues in Involuntary Groups

When participation is mandatory, informed consent is as important as it is when working with voluntary groups. Much effort needs to be directed toward fully informing involuntary members of the nature and goals of the group, the procedures to be used, their rights and responsibilities, the limits of confidentiality, and what effect their level of participation in the group will have on critical decisions about them outside of the group. When groups are involuntary, every attempt should be made to enlist the cooperation of the members and encourage them to continue attending voluntarily. One way of doing this is to spend some time with involuntary clients helping them reframe the notion “I have to come to this group.” They do have some choice whether they will attend group or deal with the consequences of not being in the group. If “involuntary” members choose not to participate in the group, they will need to be prepared to deal with consequences such as being expelled from school, doing jail time, or being in juvenile detention.

Another alternative would be for the group leader to accept involuntary group members only for an initial limited period. There is something to be said for giving reluctant members a chance to see for themselves what a group is about and then eventually (say, after three sessions) letting them decide whether they will return. Group leaders can inform members that it is their choice of how they will use the time in the group. The members can be encouraged to explore their fears and reluctance to fully participate in the group, as well as the consequences of not participating in the group. Ethical practice would seem to require that group leaders fully explore these issues with clients who are sent to them.

The Freedom to Leave a Group

Leaders should be clear about their policies pertaining to attendance, commitment to remaining in a group for a predetermined number of sessions, and leaving a particular session if they do not like what is going on in the group. If members simply drop out of the group, it is extremely difficult to develop a working level of trust or to establish group cohesion. The topic of leaving the group should be discussed during the initial session, and the leader’s attitudes and policies need to be clear from the outset.

In my view, group members have a responsibility to the leaders and other members to explain why they want to leave. There are a number of reasons for such a policy. For one thing, it can be deleterious to members to leave without having been able to discuss what they considered threatening or negative in the experience. If they leave without discussing their intended departure, they are likely to be left with unfinished business, and so are the remaining members. A member’s dropping out may damage the cohesion and trust in a group; the remaining members may think that they in some way “caused” the departure. It is a good practice to tell members that if they are even thinking of withdrawing they should bring the matter up for exploration in a session. It is critical that members be encouraged to discuss their departure, at least with the group leader.

If a group is counterproductive for an individual, that person has a right to leave the group. Ideally, both the group leader and the members will work cooperatively to determine the degree to which a group experience is productive or counterproductive. If, at a mutually agreed-upon time, members still choose not to participate in a group, I believe they should be allowed to drop out without being subjected to pressure by the leader and other members to remain.

Freedom From Coercion and Undue Pressure

Members can reasonably expect to be respected by the group and not to be subjected to coercion and undue group pressure. However, some degree of group pressure is inevitable, and it is even therapeutic in many instances. People in a group are challenged to examine their self-defeating beliefs and behaviors and are encouraged to recognize what they are doing and determine whether they want to remain the way they are. Further, in a counseling group, there is pressure in sessions to speak up, to make personal disclosures, to take certain risks, to share one’s reactions to the here-and-now events within the group, and to be honest with the group. All of these expectations should be explained to potential group members during the screening and orientation session. Some individuals may not want to join a group if they will be expected to participate in personal ways. It is essential for group leaders to differentiate between destructive pressure and therapeutic pressure. People often need a certain degree of pressure to challenge them to take the risks involved in becoming fully invested in the group.

The Right to Confidentiality

Confidentiality is a central ethical issue in group counseling, and it is an essential condition for effective group work. The legal concept of privileged communication is not recognized in a group setting unless there is a statutory exception. However, protecting the confidentiality of group members is an ethical mandate, and it is the responsibility of the counselor to address this at the outset of a group (Wheeler & Bertram, 2012). The American Counseling Association’s (ACA, 2014) Code of Ethics makes this statement concerning confidentiality in groups: “In group work, counselors clearly explain the importance and parameters of confidentiality for the specific group” (Standard B.4.a.). The ASGW (2008) addresses the added complexity entailed in coming to a mutual understanding of confidentiality in diverse groups: “Group Workers maintain awareness and sensitivity regarding the cultural meaning of confidentiality and privacy. Group Workers respect differing views toward disclosure of information” (A.6.). As a leader, you are required to keep the confidences of group members, but you have the added responsibility of impressing on the members the necessity of maintaining the confidential nature of whatever is revealed in the group. This matter bears reinforcement along the way, from the initial screening interview to the final group session.

Although group leaders are themselves ethically and legally bound to maintain confidentiality, a group member who violates another member’s confidences faces no legal consequences (Lasky & Riva, 2006). If the rationale for confidentiality is clearly presented to each individual during the preliminary interview and again to the group as a whole at the initial session, there is less chance that members will treat this matter lightly. Confidentiality is often on the minds of people when they join a group, so it is timely to fully explore this issue. A good practice is to remind participants from time to time of the danger of inadvertently revealing confidences. My experience continues to teach me that members rarely gossip maliciously about others in their group. However, people do tend to talk more than they should outside the group and can unwittingly offer information about fellow members that should not be revealed. If the maintenance of confidentiality is a matter of concern, the subject should be discussed fully in a group session.

In groups in institutions, agencies, and schools, where members know and have frequent contact with one another outside of the group, confidentiality becomes especially important and is more difficult to maintain. Clearly, there is no way to ensure that group members will respect the confidences of others. As a group leader, you cannot guarantee confidentiality in a group setting because you cannot control absolutely what the members do or do not keep private. Members have a right to know that absolute confidentiality in groups is difficult and at times even unrealistic (Lasky & Riva, 2006). However, you can discuss the matter, express your convictions about the importance of maintaining confidentiality, and have members sign contracts agreeing to it. Your own modeling and the importance that you place on maintaining confidentiality will be crucial in setting norms for members to follow. Ultimately, it is up to the members to respect the need for confidentiality and to maintain it.

Members have the right to know of any audio- or videotape recordings that might be made of group sessions, and the purpose for which they will be used. Written permission should be secured before recording any session. If the tapes will be used for research purposes or will be critiqued by a supervisor or other students in a group supervision session, the members have the right to deny permission.

Exceptions to Confidentiality Group leaders have the ethical responsibility of informing members of the limits of confidentiality within the group setting. For instance, leaders can explain to members when they are legally required to break confidentiality. Leaders can add that they can assure confidentiality on their own part but not on the part of other members. It is important to encourage members to bring up matters pertaining to confidentiality whenever they are concerned about them. The ACA Code of Ethics (ACA, 2014) identifies exceptions to confidentiality that members should understand:

The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues. (Standard B.2.a.)

It is a good policy for group workers to give a written statement to each member setting forth the limitations of confidentiality and spelling out specific situations that would require breaching confidences. Such straightforwardness with members from the outset does a great deal to create trust because members then know where they stand.

Of course, it is imperative that those who lead groups become familiar with the state laws that have an impact on their practice. Group leaders do well to let members know that legal privilege does not apply to group treatment, unless provided by state statute (ASGW, 2008). The American Group Psychotherapy Association (AGPA, 2002) states: “The group therapist is knowledgeable about the limits of privileged communication as they apply to group therapy and informs group members of those limits” (2.2). Counselors are legally required to report clients’ threats to harm themselves or others. This requirement also covers cases of child abuse or neglect, incest, child molestation, elder abuse, and dependent-adult abuse. Taking an extreme case, if one of your group members convincingly threatens to seriously injure another person, you may have to consult your supervisor or other colleagues, warn the intended victim, and even notify the appropriate authorities. The threat need not involve others; clients may exhibit bizarre behavior that requires you to take steps to have them evaluated and possibly hospitalized.

If you lead a group at a correctional institution or a psychiatric hospital, you may be required to act as more than a counselor; for instance, you will probably have to record in a member’s file certain behaviors that he or she exhibits in the group. At the same time, your responsibility to your clients requires you to inform them that you are recording and passing on certain information. Generally speaking, you will find that you have a better chance of gaining the cooperation of group members if you are candid about a situation rather than hiding your disclosures and thereby putting yourself in the position of violating their confidences.

Confidentiality With Minors In a group for children in a school setting, care needs to be exerted to ensure that what goes on within the group is not a subject for discussion in class or on the playground. If children begin to talk about other members outside of the group, this will certainly block progress and damage the cohesion of the group. As is the case for adults and adolescents, children require the safety of knowing they will be treated respectfully. On this matter, the American School Counselor Association’s (ASCA, 2010) Ethical Standards for School Counselors provides an important guideline:

Professional school counselors establish clear expectations in the group setting, and clearly state that confidentiality in group counseling cannot be guaranteed. Given the developmental and chronological ages of minors in schools, recognize the tenuous nature of confidentiality for minors renders some topics inappropriate for group work in a school setting. (A.6.c.)

Group leaders must also be careful in how they talk about the children to teachers and administrators. Those who do groups with children need to explain what will be kept confidential and what may need to be shared with school personnel. This also applies to talking with parents. Do parents have a right to information that is disclosed by their children in a group? The answer to that question depends on whether you are looking at it from a legal, ethical, or professional viewpoint. It is a good practice to require written permission from parents before allowing a minor to enter a group. It is useful to have this permission include a brief statement concerning the purpose of the group, along with comments regarding the importance of confidentiality as a prerequisite to accomplishing such purposes, and your intention not to violate any confidences. It may sometimes be useful to provide parents with information about their child if this can be done without violating confidences. One useful practice to protect the privacy of what goes on in the group is to provide feedback to parents in a session with the child and one or both parents. In this way the child will have less cause to doubt the group leader’s integrity in keeping his or her disclosures private.

Group leaders have a responsibility in groups that involve children and adolescents to take measures to increase the chances that confidentiality will be kept. It is important to work cooperatively with parents and guardians as well as to enlist the trust of the young people. It is also useful to teach minors, in terms that they are capable of understanding, about the nature, purposes, and limitations of confidentiality. In summary, group leaders would do well to continue to remind members to bring up their concerns about confidentiality for discussion whenever the issue is on their minds.

Social Media in Group Work: Confidentiality and Privacy Considerations Confidentiality and privacy issues take on special considerations when group members and their therapists communicate with each other online and when group members communicate with other members via the Internet. There is an increased risk of breach of confidentiality when members of a counseling group engage in social media (Wheeler & Bertram, 2012). Group counselors must address the parameters of online behavior through informed consent and should establish ground rules regarding members’ commitment to avoid posting pictures, comments, or any type of confidential information about other members online. Developing these rules needs to be part of the discussion about norms governing the group.

Breaches of confidentiality or privacy may occur when members share their own information online, especially if they struggle with poor boundaries. Others may lack the technological skills and knowledge to protect information that is intended to remain private. Educate members to share their experience with others outside the group by talking about their own experience, reactions, and insights rather than telling stories about other members or mentioning others in the group by name.

The Issue of Psychological Risks in Groups

Groups can be powerful catalysts for personal change, and they can also pose definite risks for group members. Ethical practice demands that group practitioners inform prospective participants of the potential risks involved in the group experience. The nature of these risks—which include life changes that cause disruption, hostile and destructive confrontations, scapegoating, and harmful socializing among members—and what the leader can do about them are the subject of this section. It is unrealistic to expect that a group will not involve risk, for all meaningful learning in life involves taking some kind of risk. It is the ethical responsibility of the group leader to ensure that prospective group members are aware of the potential negative outcomes that are associated with various risks and to take every precaution against them.

The ACA Code of Ethics (ACA, 2014) specifies that “[i]n a group setting, counselors take reasonable precautions to protect clients from physical, emotional, or psychological trauma” (Standard A.9.b.). This includes discussing the impact of potential life changes and helping group members explore their readiness to deal with such changes. A minimal expectation is that group leaders discuss with members the advantages and disadvantages of a given group, that they prepare the members to deal with any problems that might grow out of the group experience, and that they be alert to the fears and reservations that members might have.

It is also incumbent on group leaders to have a broad and deep understanding of the forces that operate in groups and how to mobilize those forces for ethical ends. Unless leaders exert caution, members not only may miss the benefits of a group but also could be harmed by it psychologically. Group leaders must take precautionary measures to reduce unnecessary psychological risks by knowing members’ limits, respecting their requests, developing an invitational style as opposed to an aggressive or dictatorial style, avoiding abrasive confrontations, describing behavior rather than making judgments, and presenting hunches in a tentative way.

Here are a few of the problems group leaders can warn members about and work toward minimizing:

1. Members should be made aware of the possibility that participating in a group (or any other therapeutic endeavor) may disrupt their lives. As members become increasingly self-aware, they may make changes in their lives that, although constructive in the long run, can create turmoil along the way. For example, changes that a woman makes as a result of what she gains in a group may evoke resistance, even hostility, in her partner, with a resulting strain on their relationship. Furthermore, others with whom she is close may not appreciate her changes and may prefer the person she was before getting involved in counseling.

2. Occasionally an individual member may be singled out as the scapegoat of the group. Other group members may “gang up” on this person, blaming him or her for problems of the group. Clearly, the group leader must take firm steps to deal with such occurrences.

3. Confrontation, a valuable and powerful tool in any group, can be misused, especially when it is employed to destructively attack another. Intrusive interventions, overly confrontive leader tactics, and pushing members beyond their limits often produce negative outcomes. Here, again, leaders (and members as well) must be on guard against behavior that can pose a serious psychological risk for group participants. To lessen the risks of destructive confrontation, leaders can model the type of confrontation that focuses on specific behaviors and can avoid making judgments about members. They can teach members how to talk about themselves and the reactions they are having to a certain behavior pattern of a given member.

4. If safety is lacking in a group, members who have been subjected to social injustices may be revictimized when they explore their experiences in the group.

One way to minimize psychological risks in groups is to use a contract in which the leader specifies his or her responsibilities and the members specify their commitment by stating what they are willing to explore and do in the group. Such a contract reduces the chances that members will be exploited or will leave the group feeling that they have had a negative experience.

Another safeguard against unnecessary risk is the ability of leaders to recognize the boundaries of their competence and to restrict themselves to working only with those groups for which their training and experience have properly prepared them. Ultimately, the group leader is responsible for minimizing the inevitable psychological risks associated with group activity. To best assume this responsibility, the leader will undergo the supervised practice and course work described later in this chapter.

The Ethics of Group Leaders’ Actions

Being a group practitioner demands sensitivity to the needs of the members of your group and to the impact your values and techniques can have on them. It also demands an awareness of community standards of practice, the policies of the agency where you work, and the state laws that govern group counseling. In the mental health professions in general, there is a trend toward accountability and responsible practice. Graduate programs in counseling and social work are increasingly requiring course work in ethics and the law.

Almost all of the professional organizations have gone on record as affirming that their members should be aware of prevailing community standards and of the impact that conformity to or deviation from these standards will have on their practice. These organizations state explicitly that professionals will avoid exploitation of the therapeutic relationship, will not damage the trust that is necessary for a relationship to be therapeutic, and will avoid dual relationships if they interfere with the primary therapeutic aims. Typically, the ethics codes caution against attempting to blend social or personal relationships with professional ones and stress the importance of maintaining appropriate boundaries.

Group counselors need to be mindful about misusing their role and power to meet their personal needs at the expense of clients. To do so is to commit an ethical violation. The role of leaders is to help members meet their goals, not to become friends with their clients. Of course, leaders who develop sexual relationships with current group members are acting unethically. They not only jeopardize their license and their professional career, but they also degrade the profession at large. For a more complete discussion of these topics, see Herlihy and Corey (2015a, 2015b).

Socializing Among Group Members

An issue to consider is whether socializing among group members hinders or facilitates the group process. This concern can become an ethical issue if members are forming cliques and gossiping about others in the group or if they are banding together and talking about matters that are best explored in the group sessions. If hidden agendas develop through various subgroups within the group, it is likely that the progress of the group will come to an abrupt halt. Unless the hidden agenda is brought to the surface and dealt with, it seems very likely that many members will not be able to use the group therapeutically or meet their personal goals.

Yalom (2005) states that a therapy group teaches people how to form intimate relationships but is not designed to provide these relationships. He also points out that members meeting outside of the group have a responsibility to bring information about their meeting into the group. Any type of outof- group socialization that interferes with the functioning of the group is counterproductive and should be discouraged. This is especially true when some participants discuss issues relevant to the group but avoid bringing up the same issues in the group itself. As Yalom (2005) explains, “It is not the subgrouping per se that is destructive to the group, but the conspiracy of silence that generally surrounds it” (p. 352).

In some cases, out-of-group contact and socialization can be beneficial. From the perspective of feminist group therapy, out-of-group socialization is not viewed as harmful. This is especially true if members are selected carefully and are able to manage out-of-group contact so that it works to their own best interests and to the good of the group as a whole. During out-of-group contact, members often have the opportunity to expand on their goals outside of the group.

One of the best ways for the group leader to prevent inappropriate and counterproductive socialization among group members is to bring this issue up for discussion. It is especially timely to explore the negative impact of forming cliques when the group seems to be stuck and is getting nowhere or when it appears that members are not talking about their reactions to one another. The members can be taught that what they do not say in the group itself might very well prevent their group from attaining any level of cohesion or achieving its goals.

The Impact of the Leader’s Values on the Group

In all controversial issues related to the group process, the leader’s values play a central role. Your awareness of how your values influence your leadership style is in itself a central ethical issue. Value-laden issues are often brought to a group—religion, spirituality, abortion, divorce, gender roles in relationships, and family struggles, to name just a few. The purpose of the group is to help members clarify their beliefs and examine options that are most congruent with their own value system. Group counseling is not a forum in which leaders impose their worldview on the members; it is a way to assist members in exploring their own cultural values and beliefs. To practice effectively and to empower members of a group, group leaders must be able to keep their personal values separate from their work with group members. Kocet and Herlihy (2014) describe this process as ethical bracketing, the “intentional setting aside of the counselor’s personal values in order to provide ethical and appropriate counseling to all clients, especially those whose worldviews, values, belief systems, and decisions differ significantly from those of the counselor” (p. 182).

If you become aware of a value conflict that interferes with your ability to respect a particular value of a member, you may need to seek consultation or supervision. It is critical that group counselors increase their awareness of how their personal reactions to members may inhibit the group process. They must monitor their countertransference and recognize the danger of stereotyping individuals on the basis of race, ethnicity, gender, age, religious or spiritual background, or sexual identity.

Members are best served if they learn to evaluate their own behavior to determine how it is working for them. If they come to the realization that what they are doing is not serving them well, it is appropriate for them to consider alternative ways of behaving that will enable them to reach their goals. A group is an ideal place for members to assess the degree to which their behavior is consistent with their own values. They can get feedback from others, yet it will be their responsibility to make their own decisions.

Religious and Spiritual Values in Group Counseling

Some counselors support the inclusion of religious and spiritual interventions in group work (Christmas & Van Horn, 2012; Cornish & Wade, 2010). Even when such interventions are viewed as appropriate by group counselors, Cornish, Wade, and Post (2012) found that religious and spiritual interventions were infrequently used in group counseling. Almost all survey participants found it appropriate to discuss both spiritual and religious topics when group members brought up these concerns, but they did not introduce these topics or ask group members about their spiritual or religious background and beliefs. In addition, counselors were twice as likely to comment on the therapeutic value of spiritual discussions over religious discussions.

Explicitly religious or spiritual interventions may be inappropriate in some groups due to the heterogeneous nature of clients’ beliefs and practices. It is important to pay attention to how this topic is introduced in a group. Interventions tied to a particular faith could present problems in a group composed of members from diverse backgrounds. Some highly religious or spiritual therapists may find that some group members are uncomfortable with these interventions, especially if their own beliefs do not match the interventions integrated into the group process (Cornish, Wade, & Knight, 2013).

To better understand how religion and spirituality are addressed in groups, Post, Cornish, Wade, and Tucker (2013) conducted a study in the university counseling setting. Counselors in this setting generally held the following views:

• Religious and spiritual concerns are appropriate topics of discussion for the groups they facilitate.

• Spiritual interventions are more appropriate than religious interventions, and spiritual interventions are used more frequently.

• When a client brings up a religious or spiritual concern, basic interventions rather than specific spiritual or religious interventions are most often used.

Addressing spiritual and religious values in group counseling encompasses particularly sensitive, controversial, and complex concerns. It is critical to be aware of and to understand your own spiritual or religious attitudes, beliefs, values, and experiences if you hope to facilitate an exploration of these issues with members of your group. Religious and spiritual values are a basic aspect of the lives of some group members, and clients may feel that their needs are not being met if their religious or spiritual concerns are ignored. In this area, the group members should set the agenda.

Ethical Issues in Multicultural Group Counseling

Becoming Aware of Your Cultural Values

If group leaders ignore some basic differences in people, they can hardly be doing what is in the best interests of these clients, which is an ethical matter. Regardless of your ethnic, cultural, and racial background, if you hope to build bridges of understanding between yourself and group members who are different from you, it is essential that you guard against stereotyped generalizations about social and cultural groups.

Johnson, Santos Torres, Coleman, and Smith (1995) write about issues that group counselors are likely to encounter as they attempt to facilitate culturally diverse counseling groups. They point out that group members typically bring with them their values, beliefs, and prejudices, which quickly become evident in a group situation. For Johnson and her colleagues, one goal of multicultural group counseling is to provide new levels of communication among members. This can be instrumental in assisting members in challenging their stereotypes by providing accurate information about individuals. Another goal of a diverse group is to promote understanding, acceptance, and trust among members of various cultural groups. For group leaders to facilitate this understanding and acceptance in a diverse group, it is essential that they be aware of their biases and that they have challenged their stereotypes.

Social justice issues often surface when working with people from culturally diverse backgrounds (MacNair-Semands, 2007). Individuals can be invited to talk about their pain from the social injustices they have encountered. In these instances, group leaders have an opportunity and a responsibility to transform the group experience and work toward healing rather than perpetuating harmful interactions marked by sexism, racism, and heterosexism. Leaders can do this by assisting members in evaluating their attitudes about a range of diversity issues. The ASGW (2008) “Best Practice Guidelines” offers this guidance on recognizing the role of diversity in the practice of group work:

Group workers practice with broad sensitivity to client differences including but not limited to ethnic, gender, religious, sexual, psychological maturity, economic class, family history, physical characteristics or limitations, and geographic location. Group workers continuously seek information regarding the cultural issues of the diverse population with whom they are working both by interaction with participants and from using outside resources. (B.8.)

An essential aspect of training for group leaders is promoting sensitivity and competence in addressing diversity in all forms of group work. Ethical practice requires that multicultural issues be incorporated in the training of group counselors (Debiak, 2007). There is increased recognition that all group work is multicultural; thus effective training of group counselors must address multicultural dimensions. Addressing diversity is an ethical mandate, but this practice is also a route to more effective group work.

Transcending Cultural Encapsulation

Cultural encapsulation is a potential trap that all group counselors are vulnerable to falling into. If you accept the idea that certain cultural values are supreme, you limit yourself by refusing to consider alternatives. If you possess cultural tunnel vision, you are likely to misinterpret patterns of behavior displayed by group members who are culturally different from you. Unless you understand the values of other cultures, you are likely to misunderstand these clients. If you are able to appreciate cultural differences and do not associate such differences with superiority or inferiority, you can increase your psychological resourcefulness.

Cultural encapsulation, or provincialism, can afflict both group members and the group leader. As group counselors, we have to confront our own distortions as well as those of the members. Culture-specific knowledge about a client’s background should not lead counselors to stereotype the client. Culturally competent group leaders recognize both differences among groups and differences within groups. It is essential that you avoid perceiving individuals as simply belonging to a group. Indeed, the differences between individuals within a group are often greater than the differences among the various groups (Pedersen, 2000). Not all Native Americans have the same experiences, nor do all African Americans, Asians, women, older people, or people with disabilities. It is important to explore individual differences among members of the same cultural group and not to make general assumptions based on an individual’s group. Regardless of your cultural background, you must be prepared to deal with the complex differences among individuals in areas such as race, culture, ethnicity, sexual orientation, disability status, religion, socioeconomic status, gender, and age (Lee & Park, 2013).

Certain practitioners may encounter resistance from some people of color because they are using traditional White, middle-class values to interpret these clients’ experiences. Such culturally encapsulated practitioners are not able to view the world through the eyes of all of their clients. Wrenn (1985) defines the culturally encapsulated counselor as one who has substituted stereotypes for the real world, who disregards cultural variations among clients, and who dogmatizes technique-oriented definitions of counseling and therapy. Such individuals, who operate within a monocultural framework, maintain a cocoon by evading reality and depending entirely on their own internalized value assumptions about what is good for society and the individual. These encapsulated people tend to be trapped in one way of thinking, believing their way is the universal way. They cling to an inflexible structure that resists adaptation to alternative ways of thinking.

Western models need to be adapted to serve the members of certain ethnic groups, especially those clients who live by a different value system. Many clients from non-Western cultures, members of ethnic minorities, and women from nearly all cultural groups tend to value interdependence more than independence, social consciousness more than individual freedom, and the welfare of the group more than their own welfare. Western psychological thought emphasizes self-sufficiency, individualism, directness of communication, assertiveness, independence from family, and self-growth. However, many Asian Americans come from collectivistic cultures that value interconnectedness with family and community (Chung, 2004; Chung & Bemak, 2014). In Asian cultures, moreover, family roles tend to be highly structured, and “filial piety” exerts a powerful influence; that is, obligations to parents are respected throughout one’s life, especially among the male children. The roles of family members are highly interdependent, and family structure is arranged so that conflicts are minimized while harmony is maximized. Traditional Asian values emphasize reserve and formality in most social situations, restraint and inhibition of intense feelings, obedience to authority, and high academic and occupational achievement. The family structure is traditionally patriarchal in that communication and authority flow vertically from top to bottom. The inculcation of guilt and shame are the main techniques used to control the behavior of individuals within a family (D. Sue & Sue, 1993).

These traditional values are shared by other cultural groups. For instance, Latinos/as emphasize familismo, which stresses interdependence over independence, affiliation over confrontation, and cooperation over competition. Parents are afforded a great deal of respect, and this respect governs all interpersonal relationships. The role of fate is often a pervasive force governing behavior. Latinos/as typically place a high value on spiritual matters and religion (Comas-Diaz, 1990). Torres-Rivera, Torres Fernandez, and Hendricks (2014) suggest that the common topics of discussion among Latino/a group members often include relationships, friendship, intimacy and love, sexuality, time, money, parenting, commitment and responsibility, decision making, power, rules, and morality.

The central point is that if the group experience is largely the product of values that are alien to certain group members, it is easy to see that such members will not embrace the group. Group counselors who practice exclusively with a Western perspective are likely to meet with a considerable amount of resistance from clients with a non-Western worldview. Culturally sensitive group practice can occur only when leaders are willing to reveal the underlying values of the group process and determine whether these values are congruent with the cultural values of the members. Group members can also be encouraged to express their values and needs. The major challenge for group leaders is to determine what techniques are culturally appropriate for which individuals.

Being aware of how cultural values influence their own thinking and behavior will help group leaders work ethically and effectively with members who are culturally different from themselves. It is clear that ethical practice demands that group counselors possess the self-awareness, knowledge, and skills that are basic components of diversity-competent practitioners.

Uses and Misuses of Group Techniques

In leading groups, it is essential that you have a clear rationale for each technique you use. This is an area in which theory is a useful guide for practice. As you will see, the 11 theories at the core of this book give rise to many therapeutic strategies and techniques. Such techniques are a means to increase awareness, to accomplish change, or to promote exploration and interaction. They can certainly be used ethically and therapeutically, yet they also can be misused.

Some of the ways in which leaders can practice unprofessionally are using techniques with which they are unfamiliar, using techniques in a mechanical way, using techniques to serve their own hidden agenda or to enhance their power, or using specific techniques to pressure members. Many techniques that are used in a group do facilitate an intense expression of emotion. For example, guided fantasies into times of loneliness as a child can lead to deep psychological memories. Such techniques should be congruent with the overall purpose of the group. If leaders use such techniques, they must be ready to deal with any emotional release.

Leaders should avoid pushing members to “get into their emotions.” Some group leaders measure the efficacy of their group by the level of catharsis, and group leaders who need to see members experience intense emotions can exploit the group members. This expression of emotion can sometimes reveal the leader’s needs rather than the needs of the members.

Techniques have a better chance of being used appropriately when there is a rationale underlying their use. Techniques are aimed at fostering the client’s self-exploration and self-understanding. At their best, they are invented in each unique client situation, and they are a collaborative effort between the leader and members. Techniques assist the group member in experimenting with some form of new behavior. It is critical that techniques be introduced in a timely and sensitive manner, with respect for the client, and that they be abandoned if they are not working.

Effective group counselors incorporate a wide range of techniques in their therapeutic style. Much depends on the purpose of the group, the setting, the personality and style of the group facilitator, the qualities of particular group members, and the problems selected for intervention. Effective leaders continuously assess their group and decide what relationship style to adopt; what techniques, procedures, or intervention methods to use; when to use them; and with which clients.

In working with culturally diverse client populations, leaders may need to modify some of their interventions to suit the client’s cultural and ethnic background. For example, if a client has been taught not to express his feelings in public, it may be inappropriate to quickly introduce techniques aimed at bringing out his feelings. It would be useful first to find out if this member is interested in exploring what he has learned from his culture about expressing his feelings. In another situation, perhaps a woman has been socialized to obey her parents without question. It could be inappropriate to introduce a role-playing technique that would have her confronting her parents directly. Leaders can respect the cultural values of members and at the same time encourage them to think about how these values and their upbringing have a continuing effect on their behavior. In some cases members will decide to modify certain behaviors because the personal price of retaining a value is too high. In other cases they will decide that they are not interested in changing certain cultural values or behaviors. The techniques used by leaders can help such members examine the pros and cons of making these changes. For a more detailed discussion of ethical considerations in using group techniques, see Corey, Corey, Callanan, and Russell (2015).

Group Leader Competence

Determining One’s Own Level of Competence

How can leaders determine whether they have the competence to use a certain technique? Some leaders who have received training in the use of a technique may hesitate to use it (out of fear of making a mistake), whereas other overly confident leaders without training may not have any reservations about trying out new methods. Leaders should have a clear theoretical and therapeutic rationale for any technique they use. Further, it is useful if leaders have experienced these techniques as members of a group. The issue of whether one is competent to lead a specific group or type of group is an ongoing question that faces all professional group leaders. You will need to remain open to struggling with questions such as these:

• Am I qualified through education and training to lead this specific group?

• What criteria can I use to determine my degree of competence?

• How can I recognize the boundaries of my competence?

• If I am not as competent as I’d like to be as a group worker, what specifically can I do?

• How can I continue to upgrade my leadership knowledge and skills?

• What techniques can I effectively employ?

• With what kinds of clients do I work best?

• With whom do I work least well, and why?

• When and how should I refer clients?

• When do I need to consult with other professionals?

There are no simple answers to these questions. Different groups require different leader qualities. For example, you may be fully competent to lead a group of relatively well-adjusted adults or of adults in crisis situations yet not be competent to lead a group of seriously disturbed people. You may be well trained for, and work well with, adolescent groups, yet you may not have the skills or training to do group work with younger children. You may be successful leading groups dealing with domestic violence yet find yourself ill-prepared to work successfully with children’s groups. In short, you need supervised experience to understand the challenges you are likely to face in working with different types of groups.

Most practitioners have had their formal training in one of the branches of the mental health field, which include counseling psychology, clinical psychology, clinical social work, community counseling, educational psychology, school counseling, couples and family counseling, nursing, pastoral psychology, rehabilitation counseling, mental health counseling, and psychiatry. Generally, however, those who seek to become group practitioners find that formal education, even at the master’s or doctoral level, does not give them the practical grounding they require to effectively lead groups. Practitioners often find it necessary to take a variety of specialized group therapy training workshops to gain experience.

The American Group Psychotherapy Association (AGPA) and the Association for Specialists in Group Work (ASGW) both address competence in group work. For example, “The group psychotherapist must be aware of his/ her own individual competencies, and when the needs of the patient/client are beyond the competencies of the psychotherapist, consultation must be sought from other qualified professionals or other appropriate sources” (AGPA, 2002, 3.1). Professional competence is not arrived at once and for all; it is an ongoing developmental process for the duration of your career.

The “Best Practice Guidelines” (ASGW, 2008, section A), which are reproduced in the Student Manual for Theory and Practice of Group Counseling, provide some general suggestions for enhancing your level of competence as a group worker:

• Remain current and increase your knowledge and skill competencies through activities such as continuing education, professional supervision, and participation in personal and professional development activities.

• Utilize consultation and/or supervision to ensure effective practice regarding ethical concerns that interfere with effective functioning as a group leader.

• Be open to getting professional assistance for personal problems or conflicts of your own that may impair your professional judgment or work performance.

Part of being a competent group counselor involves being able to explain to group members the theory behind your practice, telling members in clear language the goals of the group and how you conceptualize the group process, and relating what you do in a group to this model. As you acquire competence, you will be able to continually refine your techniques in light of your model. Competent group counselors possess the knowledge and skills that are described in the following section.

Professional Training Standards for Group Counselors

Effective group leadership programs are not developed by legislative mandates and professional codes alone. For proficient leaders to emerge, a training program must make group work a priority. Unfortunately, most master’s programs in counseling require only one group course, and it is typical for this single course to cover both the didactic and experiential aspects of group process. This course often deals with both theories of group counseling and group process as well as providing students with opportunities to experience a group as a member. It is a major challenge to train group counselors adequately in a single course!

The ASGW (2000) “Professional Standards for the Training of Group Workers” specify two levels of competencies and related training. First is a set of core knowledge and skill competencies that provides the foundation on which specialized training is built. At a minimum, one group course should be included in a training program, and it should be structured to help students acquire the basic knowledge and skills needed to facilitate a group.

The ASGW (2000) training standards state that group leadership skills (see Chapter 2) are best mastered through supervised practice that involves observation and participation in a group experience. Although a minimum of 10 hours of supervised practice is required, 20 hours is recommended as part of the core training. Furthermore, these training standards require that all counselor trainees complete core training in group work during their entry-level education.

Once counselor trainees have mastered the core knowledge and skill domains, they have the platform to develop a group work specialization in one or more of four areas (see Chapter 1): (1) task groups, (2) psychoeducational groups, (3) group counseling, or (4) group psychotherapy. The standards outline specific knowledge and skill competencies for these specialties and specify the recommended number of hours of supervised training for each.

The current trend in training group workers focuses on learning group process by becoming involved in supervised experiences. Certainly, the mere completion of one graduate course in group theory and practice does not equip a counselor to effectively lead groups. Both direct participation in planned and supervised small groups and clinical experience in leading various groups under careful supervision are needed to provide leaders with the skills to meet the challenges of group work.

Ieva, Ohrt, Swank, and Young (2009) investigated the impact on master’s students who participated in experiential personal growth groups. The students’ perceptions of their experience supported the following assumptions:

• Group process is a beneficial aspect of training.

• Experience in a personal growth group increases knowledge about groups and leadership skills.

• Experience in a personal growth group enhances students’ ability to give and receive feedback.

All study participants reported some personal or professional progress as a result of their experience in a group. Areas of benefit included interpersonal learning, knowledge about group process, self-awareness, empathy for future clients, and opportunities to learn by observing group process in action. The participants’ confidence in facilitating a group increased after having experience as a group member, and they believed their participation assisted them in developing their own personal leadership style. Not only did the counselors-in-training report benefiting both personally and professionally from participating in personal growth groups, but they thought this should be a requirement for all students in a master’s level counseling program. Ieva and colleagues (2009) conclude that this study provides counselor educators with valuable information that can help them design and facilitate training experiences that are positive, beneficial, and ethically responsible.

Three Important Adjuncts to the Training of Group Counselors

If you expect to lead groups, you will want to be prepared for this work, both personally and academically. If your program has not provided this preparation, it will be necessary for you to seek in-service workshops in group processes. It is not likely that you will learn how to lead groups merely through reading about them and listening to lectures.

I recommend at least three experiences as adjuncts to a training program for students learning about group work: (1) participation in personal counseling, (2) participation in group counseling or a personal growth group, and (3) participation in a training and supervision group. Following is a discussion of these three adjuncts to the professional preparation of group counselors.

Personal Counseling for Group Leaders I believe that extensive selfexploration is necessary for trainees to identify countertransference feelings, to recognize blind spots and biases, and to use their personal attributes effectively in their group work. Group trainees can benefit greatly from the experience of being a client at some time. To me it makes sense that group leaders need to demonstrate the courage and willingness to do for themselves what they expect members in their groups to do—expand their awareness of self and the effect of that self on others.

What does research reveal on this subject? More than 90% of mental health professionals report positive outcomes from their own counseling experiences (Geller, Norcross, & Orlinsky, 2005). In his synthesis of 25 years of research on the personal therapy of mental health professionals, Norcross (2005b) states: “The cumulative results indicate that personal therapy is an emotionally vital, interpersonally dense, and professionally formative experience that should be central to the development of health care psychologists” (p. 840). Norcross points out that most mental health care practitioners strongly value experiential over didactic learning.

Increasing self-awareness is a major reason to seek out personal counseling. In leading a group, you will encounter many instances of transferences, both among members and toward you. Transference refers to the unconscious process whereby members project onto you, the group leader, past feelings or attitudes that they had toward significant people in their lives. Of course, you can easily become entangled in your own feelings of countertransference, which often involves both conscious and unconscious emotional responses to group members. You may have unresolved personal problems, which you can project onto the members of your group. Through personal counseling, you can become increasingly aware of personal triggers and can also work through some of your unfinished business that could easily interfere with your effectiveness in facilitating groups. If you are not actively involved in the pursuit of healing your own psychological wounds, you will probably have considerable difficulty entering the world of a client. Through being a client yourself, you can gain an experiential frame of reference to view yourself as you are. This experience will increase your compassion for your clients and help you learn ways of intervening that you can use in the groups you facilitate. For further reading on this topic, I recommend The Psychotherapist’s Own Psychotherapy (Geller, Norcross, & Orlinsky, 2005).

Self-Exploration Groups for Group Leaders Being a member of a variety of groups can prove to be an indispensable part of your training as a group leader. By experiencing your own cautiousness, resistances, fears, and uncomfortable moments in a group, by being confronted, and by struggling with your problems in a group context, you can experience what is needed to build a trusting and cohesive group.

In addition to helping you recognize and explore personal conflicts and increase self-understanding, a personal growth group can be a powerful teaching tool. One of the best ways to learn how to assist group members in their struggles is to participate yourself as a member of a group. A survey of 82 master’s-level counseling programs suggests that experiential group training is alive, evolving, and an accepted method for training group leaders (Shumaker, Ortiz, & Brenninkmeyer, 2011).

Yalom (2005) states that a substantial number of training programs require both personal therapy and a group experience for trainees. Some of the benefits of participating in a therapeutic group that he suggests are experiencing the power of a group, learning what self-disclosure is about, coming to appreciate the difficulties involved in self-sharing, learning on an emotional level what one knows intellectually, and becoming aware of one’s dependency on the leader’s power and knowledge.

If a self-exploration group or an experiential group is a program requirement, students must be made aware of this requirement at an orientation meeting during the admissions process or prior to their enrollment in a program. Shumaker, Ortiz, and Brenninkmeyer’s (2011) survey of experiential group training in counseling master’s programs resulted in them recommending systematic instructor self-reflection, informed consent of students, and selfdisclosure training as “the most promising and critical safeguard elements dedicated to promoting a positive experiential group experience” (p. 127).

Participation in Experiential Training Workshops I have found training workshops most useful in helping group counselors develop the skills necessary for effective intervention. The trainees can also learn a great deal about their response to feedback, their competitiveness, their need for approval, their concerns over being competent, and their power struggles. In working with both university students learning about group approaches and with professionals who want to upgrade their group skills, I have found an intensive weekend or weeklong workshop to be an effective format. In these workshops the participants all have ample opportunity to lead their small group for a designated period with the benefit of direct supervision. After a segment in which a participant leads the group, my colleagues and I who are supervising their group offer feedback to those who led the group, provide a commentary on the process, and facilitate discussion of what happened in the group by the entire group.

My Journey Toward Becoming a Group Work Specialist

I want to share some highlights of what I found helpful in becoming a teacher and practitioner of group counseling. In my doctoral studies in the mid-1960s, I had no formal course work in group counseling. It was my experiences as a participant in many different kinds of groups after getting my doctorate that perked my interest in becoming a group practitioner, in teaching group courses, in training and supervising group workers, and in writing textbooks on group counseling.

During my 30s and 40s I availed myself to a wide range of different groups, a few of which included overnight marathon groups, traditional weekly therapy groups, and various residential workshops done in a group format. I participated in many personal growth workshops and encounter groups, which lasted in length from a weekend to 10 days. My early experiences as a group member provided insights and were instrumental in leading me to make significant changes in my personal life. This encouraged me to continue seeking out various groups aimed at personal and professional development. Although my main motivation for participating in these group workshops was not to learn techniques or to acquire skills in conducting groups, I received indirect benefits that I was able to apply to my professional work. This led to finding ways to incorporate group work into my teaching and professional practice. I learned significant lessons about organizing and facilitating groups from my experience as a group member even though I had concerns about the way some of the groups I attended were set up or conducted. These experiences were important in my learning how to design different kinds of therapeutic groups, and they helped me to think about ethics in group practice. Many of the specific dimensions of group facilitation that I address in this book came about as a result of the experiential learning and training I acquired beyond my doctoral program.

My own journey into group work has convinced me of how crucial it is for those who want to facilitate groups to open themselves to the experience of being in groups as a member. Certainly course work in group counseling is crucial, as is supervision when we are beginning to lead groups; in addition, what we can learn about ourselves personally by being a member of a group can pay dividends in our professional work. For a more detailed description of my journey into group work, both from a personal and professional perspective, see Creating Your Professional Path: Lessons From My Journey (Corey, 2010).

Ethical Issues in Training Group Counselors

Training programs differ on whether participating in a group is optional or required. My own bias is clear on the importance of doing personal work in a group as a prerequisite to becoming a group counselor. To be sure, requiring participation in a therapeutic group as part of a training program can present some practical and ethical problems of its own. A controversial ethical issue in the preparation of group workers involves combining experiential and didactic training methods.

I consider an experiential component to be essential when teaching group counseling courses. Admittedly, there are inherent problems in teaching students how groups function by involving them on an experiential level. Such an arrangement entails their willingness to engage in self-disclosure, to become active participants in an interpersonal laboratory, and to engage themselves on an emotional level as well as a cognitive one. Time and again, however, my colleagues and I hear both students and professionals who participate in our group training workshops comment on the value of supervised experience in which they have both leadership and membership roles. Through this format, group process concepts come alive. Trainees experience firsthand what it takes to create trust and what resistance feels like. They often say that they have gained a new appreciation of the group experience from a member’s perspective.

In talking with many other counselor educators throughout the country who teach group courses, I find that it is common practice to combine the experiential and didactic domains. Sometimes students colead a small group with a peer and are supervised by the instructor. Of course, this arrangement is not without problems, especially if the instructor also functions in the roles of facilitator and supervisor. Many of my colleagues believe the potential risks of experiential methods are offset by the benefits to students who become personally involved in experiential group work. These educators believe the experiential component helps students acquire the skills necessary to function as effective group leaders. Clearly, instructors need to be aware of the potential drawbacks inherent in multiple roles and relationships in teaching group courses, and they need to develop safeguards to minimize risk.

Students may fear that their grade will be influenced by their participation (or lack of it) in the experiential part of the class. In grading and evaluating students in group courses, the professionalism of the instructor is crucial. Ethical practice requires instructors to spell out their grading criteria clearly. The criteria may include the results of written reports, oral presentations, essay tests, and objective examinations. Most group counselor educators agree that students’ performance in the experiential group should not be graded, but they can be expected to attend regularly and to participate. Clear guidelines need to be established so that students know what their rights and responsibilities are at the beginning of the group course.

There is potential for abuse when using experiential approaches in training group leaders, but this does not warrant the conclusion that all such experiences are inappropriate or unethical. I view it as a mistake to conclude that group work educators should be restricted to the singular role of providing didactic information. The challenge of educators is to provide the best training available. I am convinced that teaching group process by involving students in personal ways is the best way for them to learn how to eventually set up and facilitate groups. I am in agreement with Stockton, Morran, and Chang (2014) who indicate that there is a fine line between offering experiential activities and safeguarding against gaining information that could be used in evaluating students. Faculty who use experiential approaches are often involved in balancing multiple roles, which requires consistent monitoring of boundaries. Stockton and colleagues emphasize that group work educators need to exert caution so that they offer training that is both ethical and efficacious.

Liability and Malpractice

Although the topics of professional liability and malpractice are not strictly a part of ethical practice, these are legal dimensions with implications for group practitioners. Group leaders are expected to practice within the code of ethics of their particular profession and also to abide by legal standards. Practitioners are subject to civil penalties if they fail to do right or if they actively do wrong to another. If group members can prove that personal injury or psychological harm was caused by a leader’s failure to render proper service, either through negligence or ignorance, the leader is open to a malpractice suit. Negligence consists of departing from the standard and commonly accepted practices of others in the profession. Practitioners involved in a malpractice action may need to justify the techniques they use. If their therapeutic interventions are consistent with those of other members of their profession in their community, they are on much firmer ground than if they employ uncommon techniques.

Group leaders need to keep up to date with the laws of their state as they affect their professional practice. Ignorance is not a sufficient excuse. Those leaders who work with groups of children and adolescents, especially, must know the law as it pertains to matters of confidentiality, parental consent, the right to treatment or to refuse treatment, informed consent, and other legal rights of clients. Such awareness not only protects the group members but also protects group leaders from malpractice suits arising from negligence or ignorance.

The best way to protect yourself from a malpractice suit is to take preventive measures, which means not practicing outside the boundaries of your competence. Following the spirit of the ethics codes of your professional organization is also important. The key to avoiding a malpractice suit is maintaining reasonable, ordinary, and prudent practices. Here are some prudent guidelines for ethical and professional standards of practice:

• Be willing to devote the time it takes to adequately screen, select, and prepare the members of your group.

• Develop written informed consent procedures at the outset of a group. Give the potential members of your groups enough information to make informed choices about group participation. Do not mystify the group process.

• Provide an atmosphere of respect for diversity within the group.

• Become aware of local and state laws that limit your practice, as well as the policies of the agency for which you work. Inform members about these policies and about legal limitations (such as exemptions to confidentiality, mandatory reporting, and the like).

• Emphasize the importance of maintaining confidentiality before the group begins and at various times during the life of a group.

• If social media is part of group work, establish with members the importance of maintaining boundaries, confidentiality, and privacy of others in the group.

• Restrict your practice to client populations for which you are prepared by virtue of your education, training, and experience.

• Be alert for symptoms of psychological debilitation in group members, which may indicate that their participation should be discontinued. Be able to put such clients in contact with appropriate referral resources.

• Do not promise the members of your group anything that you cannot deliver. Help them realize that their degree of effort and commitment will be key factors in determining the outcomes of the group experience.

• In working with minors, secure the written permission of their parents, even if this is not required by state law.

• Consult with colleagues or supervisors whenever there is an ethical or legal concern. Document the nature of these consultations.

• Make it a practice to assess the general progress of a group, and teach members how to evaluate their progress toward their personal goals; keep adequate clinical records on this progress.

• Learn how to assess and intervene in cases in which clients pose a threat to themselves or others.

• Avoid blending professional relationships with social ones. Avoid engaging in sexual relationships with either current or former group members.

• Remain alert to ways in which your personal reactions might inhibit the group process, and monitor your countertransference. Avoid using the group you are leading as a place where you work on personal problems.

• Continue to read the research, and use group interventions and techniques that are supported by research as well as by community practice.

• Have a theoretical orientation that serves as a guide to your practice. Be able to describe the purpose of the techniques you use in your groups.

As you read about the stages of group development in Chapters 4 and 5, reflect on the issues raised in this chapter as they apply to the tasks and challenges you will face as a group leader during various group phases. Realize that there are few simple answers to the ethical aspects of group work. Learn how to think through the ethical considerations that you will face as a group practitioner. Being willing to raise questions and think about an ethical course to follow is the beginning of becoming an ethical group counselor. The Student Manual for Theory and Practice of Group Counseling (9th edition) contains a number of resources that will help you develop your awareness of ethical group practice. I urge you to consult these resources frequently as you begin to formulate your own ideas about ethical practice in group work. For a more comprehensive discussion of ethical issues in group work, see Corey, Corey, Corey, and Callanan (2015, chap. 12).

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Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder

February 6, 2024/in Assignment Help, Assignment Help Nursing, BLOG, Homework Help, Nursing Exam Help, Nursing Paper Help, Solved Nursing Essays /by Aimee Grace

Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder

Behcet’s Disease, also known as Behcet’s Syndrome, is a rare autoimmune disorder characterized by recurrent oral and genital ulcers, skin lesions, and inflammation of the eyes. First identified by the Turkish dermatologist Hulusi Behcet in 1937, this condition primarily affects individuals in the Mediterranean, Middle Eastern, and Asian regions. Despite decades of research, the exact cause of Behcet’s Disease remains elusive, with genetic predisposition and environmental triggers believed to play key roles. The disease’s pathophysiology involves systemic inflammation and vasculitis, leading to various manifestations across multiple organs and tissues. Diagnosis is based on clinical criteria, and treatment aims to manage symptoms, reduce inflammation, and prevent complications. Patient education is crucial for empowering individuals with Behcet’s Disease to understand their condition and effectively manage their health. This paper aims to explore the causes, signs and symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education strategies related to Behcet’s Disease. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Nursing Paper Examples on Behcet's Disease: Understanding a Complex Disorder

Causes of Behcet’s Disease

Behcet’s Disease is a multifactorial condition with complex underlying causes. While the precise etiology remains uncertain, several factors are believed to contribute to the development and progression of the disease.

Genetic Predisposition: Genetic susceptibility plays a significant role in Behcet’s Disease, with certain genetic markers associated with increased susceptibility to the condition. Notably, the HLA-B51 gene has been identified as a potential genetic risk factor, particularly in populations with a higher prevalence of the disease. However, it is essential to recognize that genetic predisposition alone is not sufficient to cause Behcet’s Disease, indicating the involvement of additional factors in disease pathogenesis.

Environmental Triggers: Environmental factors are thought to trigger and exacerbate Behcet’s Disease in genetically susceptible individuals. Infections, particularly viral and bacterial pathogens, have been proposed as potential triggers due to their ability to stimulate the immune system and initiate inflammatory responses. Additionally, environmental factors such as exposure to certain chemicals, dietary components, and climatic conditions may influence disease susceptibility and severity.

Immune System Dysregulation: Behcet’s Disease is characterized by dysregulation of the immune system, leading to abnormal immune responses and inflammation. Dysfunction in immune pathways, including aberrant activation of T cells and cytokine imbalances, contributes to the chronic inflammatory process observed in the disease. Dysregulation of innate and adaptive immune responses further perpetuates the inflammatory cascade, resulting in tissue damage and organ involvement.

Abnormal Responses to Microorganisms: Some evidence suggests that Behcet’s Disease may result from abnormal immune responses to specific microorganisms. Molecular mimicry, where microbial antigens resemble self-antigens, may trigger autoimmune reactions, leading to tissue damage and inflammation. Furthermore, alterations in the microbiome composition and dysbiosis in the gut microbiota have been implicated in Behcet’s Disease pathogenesis, highlighting the potential role of microbial factors in disease development.

Overall, Behcet’s Disease is a complex disorder influenced by a combination of genetic predisposition, environmental triggers, immune system dysregulation, and abnormal responses to microorganisms. Further research is needed to elucidate the precise mechanisms underlying disease pathogenesis and identify targeted therapeutic approaches. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Nursing Paper Examples on Behcet's Disease: Understanding a Complex Disorder

Signs and Symptoms

Behcet’s Disease is characterized by a wide range of signs and symptoms affecting various organs and tissues throughout the body. The severity and frequency of symptoms can vary among affected individuals and may fluctuate over time.

Recurrent Oral and Genital Ulcers: One of the hallmark features of Behcet’s Disease is the presence of recurrent oral ulcers, which are often painful and can affect the lips, tongue, and oral mucosa. Genital ulcers, occurring on the vulva or scrotum, are also common and may recur frequently, leading to discomfort and impaired quality of life.

Skin Lesions: Behcet’s Disease can cause a variety of skin lesions, including erythema nodosum-like lesions, papulopustular lesions resembling acne, and pathergy, which is an exaggerated skin reaction to minor trauma. These skin manifestations can vary in appearance and distribution but are typically inflammatory and may leave scars upon healing.

Eye Inflammation (Uveitis): Inflammation of the eyes, specifically uveitis, is a significant complication of Behcet’s Disease and can lead to vision impairment or blindness if left untreated. Uveitis may present with symptoms such as eye pain, redness, blurred vision, sensitivity to light (photophobia), and floaters.

Arthritis: Joint involvement is common in Behcet’s Disease and can manifest as arthritis, causing joint pain, swelling, and stiffness. The arthritis associated with Behcet’s Disease often affects large joints such as the knees, ankles, and wrists, but can also involve smaller joints.

Gastrointestinal Involvement: Behcet’s Disease can affect the gastrointestinal tract, leading to symptoms such as abdominal pain, diarrhea, and gastrointestinal bleeding. Inflammation of the intestines, known as intestinal Behcet’s Disease, can mimic inflammatory bowel diseases like Crohn’s disease or ulcerative colitis.

Neurological Symptoms: In rare cases, Behcet’s Disease can involve the nervous system, leading to neurological symptoms such as headaches, cognitive dysfunction, seizures, and movement disorders. Neurological involvement typically occurs as a result of inflammation of the brain or spinal cord.

Vascular Complications: Behcet’s Disease can affect blood vessels, leading to various vascular complications such as deep vein thrombosis (DVT), arterial thrombosis, and arterial aneurysms. These vascular manifestations can pose significant risks and may require urgent medical intervention to prevent complications such as stroke or pulmonary embolism.

Overall, Behcet’s Disease is characterized by a diverse array of signs and symptoms affecting multiple organ systems, highlighting the systemic nature of the condition. Early recognition and appropriate management of these manifestations are essential for improving patient outcomes and preventing long-term complications. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Nursing Paper Examples on Behcet's Disease: Understanding a Complex Disorder

Etiology

Behcet’s Disease is a complex disorder with an intricate etiology involving a combination of genetic, environmental, and immunological factors. While the precise cause of Behcet’s Disease remains unclear, several hypotheses have been proposed to elucidate its underlying etiology.

Genetic Predisposition: Genetic factors play a significant role in Behcet’s Disease, with evidence suggesting a genetic predisposition to the condition. Certain genetic markers, particularly variations in the HLA-B51 gene, have been associated with increased susceptibility to Behcet’s Disease, particularly in populations with a higher prevalence of the disorder. However, the inheritance pattern of Behcet’s Disease is complex and likely involves multiple genetic factors interacting with environmental triggers.

Environmental Triggers: Environmental factors are thought to contribute to the development and progression of Behcet’s Disease by triggering immune dysregulation and inflammatory responses in genetically susceptible individuals. Infections, particularly viral and bacterial pathogens, have been proposed as potential environmental triggers due to their ability to stimulate the immune system and initiate inflammatory cascades. Additionally, environmental factors such as dietary components, smoking, and climatic conditions may influence disease susceptibility and severity.

Immune Dysregulation: Behcet’s Disease is characterized by dysregulation of the immune system, leading to abnormal immune responses and chronic inflammation. Dysfunction in immune pathways, including aberrant activation of T cells, dysregulated cytokine production, and impaired regulation of inflammatory responses, contributes to the pathogenesis of the disease. These immunological abnormalities result in systemic inflammation and tissue damage, leading to the characteristic manifestations of Behcet’s Disease across multiple organ systems.

Microbial Factors: Some evidence suggests that Behcet’s Disease may result from abnormal immune responses to specific microbial antigens. Molecular mimicry, where microbial antigens resemble self-antigens, may trigger autoimmune reactions, leading to chronic inflammation and tissue damage. Furthermore, alterations in the composition of the microbiome and dysbiosis in the gut microbiota have been implicated in Behcet’s Disease pathogenesis, suggesting a potential role for microbial factors in disease development.

Behcet’s Disease is a complex disorder with a multifactorial etiology involving genetic predisposition, environmental triggers, immune dysregulation, and abnormal responses to microbial factors. Further research is needed to unravel the intricate interplay between these factors and identify targeted therapeutic approaches for Behcet’s Disease. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Pathophysiology

Behcet’s Disease is characterized by systemic inflammation and vasculitis, leading to various manifestations across multiple organs and tissues. The pathophysiology of Behcet’s Disease involves a complex interplay of immune dysregulation, endothelial dysfunction, and inflammatory mediators.

Immune Dysregulation: Dysregulation of the immune system plays a central role in the pathogenesis of Behcet’s Disease. Abnormal activation of T cells, particularly CD4+ T cells, and dysregulated cytokine production contribute to the chronic inflammatory response observed in the disease. Elevated levels of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6), further perpetuate the inflammatory cascade, leading to tissue damage and organ involvement.

Endothelial Dysfunction: Endothelial dysfunction, characterized by impaired endothelial cell function and integrity, is a key feature of Behcet’s Disease. Endothelial cells play a crucial role in maintaining vascular homeostasis and regulating inflammatory responses. In Behcet’s Disease, endothelial dysfunction leads to aberrant expression of adhesion molecules, increased vascular permeability, and enhanced leukocyte adhesion and migration into tissues. These alterations contribute to the development of vasculitis and tissue inflammation observed in Behcet’s Disease.

Vasculitis: Vasculitis, inflammation of blood vessels, is a hallmark feature of Behcet’s Disease and underlies many of its clinical manifestations. Vasculitis in Behcet’s Disease can affect blood vessels of all sizes, including arteries, veins, and capillaries, leading to a wide range of vascular complications such as thrombosis, aneurysms, and vessel occlusion. The inflammatory infiltrates in vessel walls, consisting of T cells, macrophages, and neutrophils, contribute to vascular damage and tissue injury, further perpetuating the inflammatory process.

Overall, Behcet’s Disease is characterized by immune dysregulation, endothelial dysfunction, and vasculitis, leading to systemic inflammation and tissue damage across multiple organ systems. Understanding the underlying pathophysiological mechanisms of Behcet’s Disease is crucial for developing targeted therapeutic strategies aimed at modulating the immune response and reducing inflammation to improve patient outcomes. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

DSM-5 Diagnosis

Behcet’s Disease is primarily diagnosed based on clinical criteria established by the International Study Group for Behcet’s Disease. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the diagnosis of Behcet’s Disease requires the presence of recurrent oral ulcers plus any two of the following:

Recurrent Genital Ulcers: The presence of recurrent genital ulcers, typically observed on the vulva or scrotum, is a common manifestation of Behcet’s Disease and is considered a diagnostic criterion.
Eye Inflammation (Uveitis): Uveitis, characterized by inflammation of the uvea (middle layer of the eye), is a significant complication of Behcet’s Disease. Eye involvement, presenting as symptoms such as eye pain, redness, blurred vision, photophobia, or floaters, fulfills the diagnostic criteria.
Skin Lesions: Various skin lesions, including erythema nodosum-like lesions, papulopustular lesions resembling acne, and pathergy (an exaggerated skin reaction to minor trauma), are characteristic of Behcet’s Disease and contribute to the diagnostic criteria.
Positive Pathergy Test: The pathergy test is a diagnostic procedure in which a small needle prick is made on the skin, typically on the forearm, and the reaction is observed. A positive pathergy test, defined as the development of a papule or pustule at the site of the needle prick within 24 to 48 hours, is considered indicative of Behcet’s Disease.

In addition to these clinical criteria, other diagnostic tests such as laboratory investigations (e.g., inflammatory markers, HLA-B51 genetic testing) and imaging studies (e.g., ocular examinations, MRI) may be performed to rule out other conditions and assess for complications associated with Behcet’s Disease. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Treatment Regimens

Treatment for Behcet’s Disease aims to alleviate symptoms, reduce inflammation, prevent complications, and improve the quality of life for affected individuals. The choice of treatment depends on the severity and specific manifestations of the disease in each individual.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs such as ibuprofen or naproxen may be used to manage pain, reduce inflammation, and relieve symptoms associated with Behcet’s Disease, particularly during mild flares.

Corticosteroids: Corticosteroids, such as prednisone or methylprednisolone, are often prescribed to suppress immune-mediated inflammation during acute flares of Behcet’s Disease. These medications can help alleviate symptoms and reduce the severity of inflammatory manifestations, but long-term use may be associated with significant side effects.

Immunomodulatory Agents: Immunomodulatory agents such as colchicine, azathioprine, methotrexate, cyclosporine, and mycophenolate mofetil may be used to control disease activity, prevent relapses, and reduce the need for long-term corticosteroid therapy. Biologic therapies targeting specific immune pathways, such as tumor necrosis factor-alpha (TNF-α) inhibitors or interleukin-1 (IL-1) inhibitors, may also be considered for refractory cases or severe manifestations of Behcet’s Disease.

Topical Treatments: Topical treatments such as corticosteroid creams or ointments may be used to manage oral and genital ulcers and skin lesions associated with Behcet’s Disease. These topical therapies can help reduce pain, promote healing, and improve local symptoms. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Patient Education and Self-Management

Patient education is essential for empowering individuals with Behcet’s Disease to understand their condition, manage symptoms, and make informed decisions about their health. Key components of patient education and self-management include:

Understanding the Disease: Educating patients about the nature of Behcet’s Disease, its chronicity, and the potential impact on various organ systems helps individuals develop realistic expectations and cope with the challenges associated with the condition.
Medication Adherence: Emphasizing the importance of adhering to prescribed medications as directed by healthcare providers helps optimize treatment outcomes and reduce the risk of disease flares and complications.
Lifestyle Modifications: Encouraging patients to adopt healthy lifestyle habits such as regular exercise, balanced nutrition, adequate sleep, stress management, and smoking cessation can help improve overall well-being and potentially reduce disease activity.
Monitoring and Self-Assessment: Teaching patients how to monitor disease symptoms, recognize signs of flares or complications, and seek prompt medical attention when necessary empowers individuals to actively participate in their care and collaborate with healthcare providers to optimize treatment outcomes.
Disease-Specific Education: Providing tailored education about specific manifestations of Behcet’s Disease, such as oral and genital ulcer management, eye care, skin lesion care, and joint protection strategies, helps individuals manage symptoms and minimize the impact of the disease on their daily lives.

By providing comprehensive education and support, healthcare providers can empower individuals with Behcet’s Disease to effectively manage their condition, improve their quality of life, and achieve better long-term outcomes. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

Conclusion

Behcet’s Disease is a complex autoimmune disorder characterized by recurrent oral and genital ulcers, skin lesions, and inflammation of the eyes. While the exact cause remains unknown, a multifactorial etiology involving genetic predisposition, environmental triggers, immune dysregulation, and abnormal responses to microorganisms is implicated. The pathophysiology of Behcet’s Disease is characterized by systemic inflammation, vasculitis, and endothelial dysfunction. Diagnosis is based on clinical criteria, and treatment aims to alleviate symptoms, reduce inflammation, and prevent complications through a combination of NSAIDs, corticosteroids, immunomodulatory agents, and biological therapies. Patient education is crucial for empowering individuals to understand their condition, adhere to treatment regimens, and adopt self-management strategies to improve their quality of life. By providing comprehensive education and support, healthcare providers can help individuals with Behcet’s Disease effectively manage their condition and achieve better long-term outcomes. (Nursing Paper Examples on Behcet’s Disease: Understanding a Complex Disorder)

References

https://www.ncbi.nlm.nih.gov/books/NBK470257/

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Nursing Paper Example on Understanding Barth Syndrome

February 6, 2024/in Assignment Help, Assignment Help Nursing, BLOG, Homework Help, Nursing Exam Help, Nursing Paper Help, Solved Nursing Essays /by Aimee Grace

Nursing Paper Example on Understanding Barth Syndrome

Barth Syndrome, a rare genetic disorder, presents complex challenges to affected individuals and their families. This condition, characterized by mutations in the TAZ gene, disrupts mitochondrial function, leading to a range of debilitating symptoms. Despite its rarity, Barth Syndrome profoundly impacts various bodily systems, particularly the heart, muscles, and immune system. Understanding the causes, signs, and symptoms of Barth Syndrome is essential for accurate diagnosis and effective management. This paper aims to explore the intricacies of Barth Syndrome, including its causes, signs, and symptoms, etiology, pathophysiology, DSM-5 diagnosis criteria, treatment regimens, patient education, and potential avenues for future research. By shedding light on this condition, we can enhance awareness, improve diagnostic accuracy, and provide better support for individuals living with Barth Syndrome. (Nursing Paper Example on Understanding Barth Syndrome)

Nursing Paper Example on Understanding Barth Syndrome

Causes

Barth Syndrome arises from mutations in the TAZ gene located on the X chromosome. These mutations disrupt the normal functioning of mitochondria, the cell’s powerhouse responsible for generating energy. The TAZ gene encodes a protein called tafazzin, essential for maintaining the structure and function of mitochondria. When mutations occur in the TAZ gene, tafazzin production is impaired, leading to mitochondrial dysfunction.

The exact mechanism by which TAZ gene mutations affect mitochondrial function is not fully understood. However, it is believed that tafazzin plays a crucial role in remodeling cardiolipin, a phospholipid found in the inner mitochondrial membrane. Cardiolipin is essential for various mitochondrial processes, including oxidative phosphorylation, the process by which cells generate energy.

Mutations in the TAZ gene disrupt cardiolipin remodeling, affecting mitochondrial function and energy production. As a result, cells, particularly those in tissues with high energy demands such as the heart, muscles, and immune system, are unable to function properly. This disruption in cellular energy metabolism contributes to the characteristic symptoms of Barth Syndrome, including cardiomyopathy, muscle weakness, growth delays, and neutropenia.

Since Barth Syndrome is an X-linked genetic disorder, it primarily affects males. Females who carry a single copy of the mutated TAZ gene are typically asymptomatic or may exhibit mild symptoms due to random X-chromosome inactivation.

Barth Syndrome is caused by mutations in the TAZ gene, leading to mitochondrial dysfunction and disruption of cellular energy metabolism. These mutations impair tafazzin production and cardiolipin remodeling, affecting various bodily systems and resulting in the characteristic symptoms of the disorder. (Nursing Paper Example on Understanding Barth Syndrome)

Nursing Paper Example on Understanding Barth Syndrome