Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Introduction

One of the fundamental obligations of healthcare professionals is confidentiality. Healthcare professionals should keep a patient’s confidential health information private until the patient approves sharing the information. Healthcare providers frequently receive personal information from patients. Trust in the doctor-patient relationship would suffer if confidentiality is breached. Patients would be less likely to provide private information, which might have an adverse effect on their treatment. The patient is more inclined to ask for assistance and to be as open and honest as possible during a medical visit when a trustworthy environment is established and patient privacy is respected. This paper explores confidentiality as an ethical dilemma in healthcare, the role of interprofessional collaboration in addressing the issue, ethical decisions to make in this dilemma, and how professionalism, integrity, and self-confidence can help resolve the dilemma.

The Ethical Dilemma

Patients share information with health professions to aid their healthcare process and inform diagnosis and treatment regimens. Patients expect healthcare professionals to maintain this information private and confidential and only share it with authorized individuals to third parties like family members after obtaining patient consent (Noroozi et al., 2018). However, some situations might limit confidentiality, creating an ethical dilemma where the principle of confidentiality conflicts with other principles like beneficence and nonmaleficence. An example is when an ex-husband comes to the clinic and inquires for information about his sick ex-wife, who they are co-parenting. The patient’s ex-wife is unconscious in the ICU and cannot provide consent. The ex-husband demands to know about the patient, pointing to his rights to the information because he still loves her, she was his ex-wife, the mother to his children, and they are co-parenting. The healthcare profession has to decide whether to share the information or not because the patient did not provide information about immediate family or person to share information with before undergoing the emergency treatment.

The ethical principles at risk in this dilemma

The principle of confidentiality forbids the healthcare provider from sharing patient information with third parties without the patient’s consent, and it urges providers and healthcare systems to implement security measures to guarantee that only authorized individuals have access (Noroozi et al., 2018). All team members have been permitted to access confidential information regarding the patients they are responsible for and are responsible for keeping that information safe from those who do not have access to provide patients with the appropriate treatment they need. The confidentiality of electronic medical records may face difficulties. Institutions are required by the Health Information Portability and Accountability Act (HIPAA) to establish protocols for computer access and security and policies to preserve the privacy of patient electronic data.

Confidentiality can be threatened when a family member inquires about the patient or wants to access patient records or information. The conditions for establishing an exception to confidentiality may not be met, even though there may be situations where the doctor feels compelled to provide information, for example, in response to a curious spouse or a family member. In general, it is not ethically acceptable to disclose information to family members without the patient’s express consent (Tegegne et al., 2022). The patient (and perhaps local public health officers) is still responsible for informing the spouse, not the doctor unless there is a specific potential of harm associated with the diagnosis or illness.

Additionally, unintended disclosures can also happen in several other ways. For instance, in a hurry, healthcare professionals can be tempted to talk about a patient on the escalator or another public area, yet ensuring patient privacy may not be viable in these situations. Similarly, additional copies of teaching conference handouts that include patient-identifiable information should be disposed of after the meeting to maintain patient privacy (Tegegne et al., 2022). Also, any identifiable patient information that is withdrawn from the security of the healthcare facility should be encrypted. Leaks of this nature constitute a violation of the patient’s confidentiality rights.

How the Christian worldview could be used to apply ethical patient-centered principles, values, and culture to this situation

Christian ethics, which aspires to love God and neighbor across every moral and ethical situation, is governed by God’s revelation in Scripture rather than other schools of thought. Loving God with all of one’s heart, mind, soul, and strength is the ultimate ethical obligation a person may have in Christianity. The obligation to love one’s neighbor as oneself is the second highest ethical obligation (Rheeder, 2018). In order for Christians to fulfil these moral commitments, they must submit to the principles of God’s Word and the Law of Christ. The ultimate aim of anything spoken, done, thought, and felt is to glorify God. Being a blessing to others and being a more virtuous person are two more overarching ethical objectives in Christianity (Rheeder, 2018).

The Bible cherishes secrets and forbids gossip, and God holds high the secrecy in intimate relationships with His people. The ability to have secrets and the decision to reveal them with close contacts is the foundation for confidentiality (Rheeder, 2018). People must stay silent or stick to speaking in an edifying manner in order to protect these secrets. The Old and New Testaments advocate maintaining secrets, edifying others through discourse, and disapproving of gossip (Rheeder, 2018). People should promise and commit to maintaining patient information’s confidentiality because these scriptural instructions are behavioral standards for Christian healthcare professionals, which is fundamental in addressing ethical dilemmas associated with confidentiality.

The importance of interprofessional collaboration when resolving an ethical dilemma

Interprofessional teams that actively collaborate to find, assess, and address ethical difficulties or issues to raise the standard of healthcare are how ethical challenges in the field of medicine are typically addressed. Because it enables the inclusion of all pertinent professional voices in talks about ethical principles in patient care, interprofessional collaboration is perfect for examining ethical issues (Kurtz & Starbird, 2020). Understanding the views and preferences of patients, their families, and the many professional players, such as clergymen, nurses, doctors, and therapists, is necessary to recognize ethical issues and respond to them. Engendering the opinions of all individuals engaged in making decisions, not only the client and families but also all other core professional partners, is fundamental to resolving patient confidentiality dilemmas since perspectives are widened, and solutions are myriad.

The ethical decision I would make in this dilemma

Health professionals have a moral and legal obligation to safeguard patient data from unauthorized exposure. The case established of the ex-husband demanding information about his ex-wife on the basis of loving her, being the mother to his children, and they are co-parenting is challenging because, as a healthcare professional, I would be pressed to inform someone close to the patient regarding the patient situation and treatment progress. However, the patient had not indicated someone close to share information with, and she is not awake to prove if the person presenting at the clinic is the ex-husband or if the information he is sharing is true. Therefore, I would maintain the confidentiality of the patient’s information until she is awakened after undergoing an emergency procedure that prompted her to be put in a comma for three days to fasten recovery.

How professionalism, integrity, and self-confidence all have a role in achieving a resolution in this ethical dilemma

Professionalism is among the most essential features of moral judgment and reasoning and a crucial skill for medical staff members to have alongside other technical and scientific abilities. Making healthcare decisions for patients entails being aware of ethical considerations (Kamali et al., 2019). Integrity says that rather than preaching an ideal and then acting in a way that is inconsistent with it, people should conduct themselves by ethical principles. A person’s subjective assessment of their ethical decision-making skills includes their capacity to recognize the competing values at stake, understand the expectations of their role, consider their skill and knowledge level, and assess their capacity to do the right thing in the given circumstance (Kamali et al., 2019). Therefore, professionalism, integrity, and self-confidence enhance an individual ability to make ethical decisions. For instance, in this case, I understand I have a professional duty to ensure patient confidentiality, and I need to work with integrity to uphold the principle of confidentiality and have the self-confidence to address the situation and inform the presenting ex-husband that the information cannot be shared until the patient wakes up to confirm his claims.

Conclusion

Ethical dilemmas present in many clinical situations where two or more ethical principles or personal, cultural, and religious beliefs and perspectives conflict with ethical principles and guidelines at the workplace. Confidentiality is a patient right and a professional obligation to secure patients’ information from unauthorized access. A confidentiality ethical dilemma can arise when a family member inquires about the patient’s information, but the patient has not provided consent or is not in the capacity, at the moment, to provide consent, like in the example above. In such a case, I would uphold the patient’s interest and professional and ethical duty to ensure the patient’s information’s confidentiality.

References

Kamali, F., Yousefy, A., & Yamani, N. (2019). Explaining professionalism in moral reasoning: a qualitative study. Advances in Medical Education and Practice, 447-456.

Kurtz, M. J., & Starbird, L. E. (2020). Interprofessional clinical ethics education: the promise of cross-disciplinary problem-based learning. AMA J Ethics. 2016; 18 (9): 917-924. doi: 10.1001/journalofethics. 2016.18. 9. nlit1-1609. https://journalofethics.ama-assn.org/article/interprofessional-training-not-optional-good-medical-education/2016-09

Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iranian Journal of Public Health47(6), 875.

Rheeder, A. L. (2018). Respect for privacy and confidentiality as a global bioethical principle: Own reasons from a Protestant perspective. In die Skriflig52(3), 1-11.

Tegegne, M. D., Melaku, M. S., Shimie, A. W., Hunegnaw, D. D., Legese, M. G., Ejigu, T. A., … & Chanie, A. F. (2022). Health professionals’ knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study. BMC Medical Ethics23(1), 26.

 
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PA910: Organizational Behavior and Leadership

PA910: Organizational Behavior and Leadership

PA910: Organizational Behavior and Leadership

Self-Reflection and SWOT Analysis

INTRODUCTION

Personal development is a fundamental step in improving oneself and pushing toward self-fulfillment. Individuals are most likely to succeed if they know and understand their strengths and weaknesses and can exploit opportunities or address threats in their external environment. People have unique talents that they should exploit to the full extent and weaknesses that impact realizing their full potential. Understanding individual strengths, weaknesses, opportunities, and threats is a significant quality of an effective leader because they know what to work on and what to take advantage of to improve their leadership qualities. Notably, these aspects of internal strengths and opportunities display in various circumstances, affecting a leader’s approach in various situations. Therefore, leadership is not static, and there is no one approach to addressing all situations that require leadership. This belief aligns with Fidler’s Contingency Theory which posits that non one best style of leadership exists. According to Fiedler, an individual’s environment and circumstances influence the approach to leadership and leadership effectiveness.

DISCUSSION

Impact of Leadership Style

Fiedler’s contingency theory has significantly influenced my approach to and understanding of leadership. It also aligns with my beliefs and take on leadership because I have grown to understand that there is no one particular way a leader responds to all situations they face or all employees they encounter. The approach is different because different circumstances demand different leadership qualities, and flexibility is key to successfully addressing every situation.2 Leaders lead a group of people with different personalities and experience levels in the working environment, demanding different leadership styles when dealing with different types of team members.1 The contingency theory believes that the best way to lead relies on the circumstances and there is no one way to lead a team.

Fielder’s theory stresses that there is no one particular leadership style that fits all situations. Fred Fielder studied a leader’s personality and character and determined that a leader’s style has to match a specific situation to maximize effectiveness. Situations or events are contingent on someone or something, and leaders cannot structure their organization or lead their teams in one particular way.2 Based on the theory, leaders should identify their natural leadership style, often influenced by life experiences. The Least-Preferred Co-Worker (LPC) scale, which asks leaders to rate their feelings about working with specific people, can help determine the natural leadership style.3 I was rated 55-72 on the PLC scale, implying that I am a blend of a relationship-oriented and a task-oriented leader. This understanding is critical because I know how to respond to different types of employees with varying qualities and traits.

Also, Fielder’s Contingency Theory has impacted my situational control capacity and ability.3 I have improved how I relate with team members, the tasks assigned, and the power attached to my position in the team. I tend to focus on the trust level between the team and the leader because I understand that trusting the group influences a leader’s effectiveness. I also understand the importance of clearly communicating tasks and particularly elaborating on tasks’ strengths to bolster my situational control. I utilize a considerate amount of authority based on my positional power in the team to be in a better position to respond to situations and decide between reward and punishment. Generally, I strive to match my leadership style to different circumstances and events.

 

SWOT Analysis

A SWOT analysis is a method for analysis that aids in identifying both internal strengths and weaknesses and external opportunities and threats.1 Self-analysis, regarded as one of the most difficult jobs yet essential for personal development, is guided by SWOT analysis.1 An individual can discover more about themselves and create a plan to find direction in life by building on their strengths and minimizing their shortcomings by using the personal skills and traits of SWOT analysis.1

Strengths 

Various strengths relate to my leadership style and work environment, including self-awareness, situational awareness, and good communication skills. Self- and situational awareness are particularly useful while adopting Fielder’s Contingency theory because they help respond to different situations effectively. I also possess effective negotiation and conflict-resolution skills that allow me to work with employees of varying personalities and traits. I have developed my ability to work with various personal styles and approaches.

Weaknesses

I have individual weaknesses I need to work on to become a more effective leader, including a lack of trust in some team members, excessive connectivity, and failure to set expectations early in the encounter. I have issues trusting particular team members, which prompts me to keep monitoring their activities and requesting feedback constantly. This trait is bolstered by the traits of these employees, including a lack of self-drive. Constant monitoring is a weakness because I lose focus on other events occurring in the team. I am too connected with team members, making me omnipresent, which does not fit well with some members, especially the autonomous ones.

Opportunities

I can exploit various opportunities available to become a more effective leader, including new career paths that bolster leadership skills, knowledge and competencies. Adopting technologies, especially job monitoring and communication technologies, can unlock new opportunities because the work environment is highly digitized, hence the need to respond by adopting new communication technologies. There are many leadership conferences and networking events I can attend to build on my strengths and eliminate weaknesses.

Threats

Many obstacles prevent me from being an effective leader, including poor communication between the team and other teams or management, lack of alignment between some team members’ goals and the organization’s vision and goals, poor performance, and entitled attitudes within the team. Having these traits and personalities within the team is a threat to my leadership and affects the effectiveness of the group. The job environment is also changing drastically technology-wise, which, although is an opportunity, can threaten my leadership because of the need to adapt quickly to the changes.

Future Goals

In the next 2-3 years, my primary aim is to build on my strengths, work on my weakness, take advantage of new opportunities, and address threats in my working environment to become a more effective leader. I also aim to become a better mentor and build stronger, healthier connections with team members that align with various personalities and preferences. In the next 5-10 years, I seek to be more adaptable to change and growth and develop confidence and competence to make smarter decisions. Additionally, I want to enhance my emotional intelligence to help work with dynamic teams and team members. The best approach to realize these goals is continuing to learn to expound my leadership knowledge and skills and gaining experience by engaging in more leadership tasks and taking more leadership roles when working with teams and when opportunities present.

CONCLUSION

Leadership requires relationship-building, agility, adaptability, effective decision-making, critical thinking, problem-solving, and negotiation skills. These skills help a leader respond to various situations effectively because I believe that situations impact a leader’s approach. The contingency theory has been more impactful in my life and my understanding of leadership because it aligns with my belief that no particular leadership style fits all circumstances. I plan to build on my strengths, address my weaknesses, take advantage of opportunities around me, and transform weaknesses into opportunities or address those threatening my leadership effectiveness.

References

  1. Herman M. Creating a Personal SWOT Analysis. MRH Enterprises LLC. Fecha de consulta20. 2019.
  2. Popp, M., & Hadwich, K. (2018). Examining the effects of employees’ behaviour by transferring a leadership contingency theory to the service context. SMR-Journal of Service Management Research2(3), 44-62. https://econpapers.repec.org/RePEc:nms:nomsmr:10.15358/2511-8676-2018-3-44​:contentReference[oaicite:0]{index=0}​:contentReference[oaicite:1]{index=1}
  3. Shala B, Prebreza A, & Ramosaj B. The contingency theory of management as a factor of acknowledging the leaders-managers of our time study case: The practice of the contingency theory in the company Avrios. Open Access Library Journal8(9), 1-20. 2021.
 
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Discussion 2: Quantitative Research

Discussion 2: Quantitative Research

Quantitative research presents information in graphs and numbers. It helps to validate or put to the test hypotheses and presumptions or establish a topic’s generalizable facts. Experiments, quantifiable observations, and surveys with closed-ended questions are examples of quantitative procedures (Wright et al., 2018). Qualitative research relies on current studies or adopts methods that do not involve numbers. It aids in understanding ideas, experiences, or concepts such as cultures, perceptions, religious beliefs, and social constructs. Individuals can gain comprehensive knowledge about poorly understood subjects through qualitative research (Tenny et al., 2017). Typical qualitative techniques include open-ended interview questions, written descriptions of observations, and literature reviews that examine ideas and theories.

Discussion 2: Quantitative Research

The validity and reliability of quantitative research must be supported by evidence. Quantitative research aims at maintaining objectivity or minimizing the researcher’s impact on data collecting. Similarly, some qualitative researchers also seek to establish validity and reliability (Wright et al., 2018). Procedures like cross-referencing and cross-validating sources during observations aim to be as objective as they can be. Qualitative researchers adopt specific frameworks, language, and evaluation standards to assess qualitative research and eliminate issues such as research bias or lack of objectivity (Wright et al., 2018). As an illustration, criteria for rigor such as credibility, transferability, dependability, and confirmability aim to determine the qualitative research’s accuracy, trustworthiness, and believability rather than its validity and reliability (Wright et al., 2018). Additionally, large, randomly selected samples are preferred in quantitative research, especially when the goal is population generalization. Instead, qualitative research or purposive sampling frequently concentrates on individuals likely to provide rich information about the study topic.

The proposed research study is about numerical data, and therefore, quantitative research is the most suitable methodology. The research study explores strategies and interventions to increase IPV victims’ identification, which will be quantified by the number of new cases reported and recorded after implementing the proposed intervention. Quantitative research will also improve the generalizability, validity, and reliability of the research study’s findings.

References

Tenny, S., Brannan, G. D., Brannan, J. M., & Sharts-Hopko, N. C. (2017). Qualitative study.

Wright, S., O’Brien, B. C., Nimmon, L., Law, M., & Mylopoulos, M. (2018). Research Design Considerations. Journal of graduate medical education8(1), 97–98. https://doi.org/10.4300/JGME-D-15-00566.1

 
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NR705-WEEK 2 Discussion-Prescreening Process

NR705-WEEK 2 Discussion-Prescreening Process

Practice Question

The following practice question will serve as the basis of the DNP project: For adults with a history of Schizophrenia (P) in the inpatient setting, does the implementation of technology with motivational interviewing (I), compared with current practice (C), impact medication nonadherence (O) in 8-10 weeks (T)?

NR705-WEEK 2 Discussion-Prescreening Process

Process of Completing IRB Prescreening Supplement Form

Any project involving human participants requires IRB approval (Rooney et al., 2019). Chamberlain’s Institutional Review Board’s permission is needed to collect and or implement the DNP project, which involves schizophrenia patients, at the practicum site. The approval requires the filling of the IRB Prescreening Supplement. To complete the form, personal details are required, including student name, email, ID, project working title, practicum site name, preceptor’s name and contact, and key decision-makers’ contact details. The form is completed in various sections. Section I requires a description of the practice problem and the need for the project. Section II requires the provision of the practice question and the definition of the population. In section III, the student should provide a weekly implementation plan or protocol, generally, what will be done each week of the project implementation phase and the resources needed. Section IV requires describing a plan for educational offerings. Section V is the IRB completion that requires the student to thoroughly explain the data collection plan, measurable outcome identified in the practice question, names of tools and instruments used and their validity and reliability. In this section, the student should also elaborate a data analysis plan, identify statistical tests, plan to ensure participant’s confidentiality and safeguard data over time, and results dissemination plan.   The steps for the IRB prescreening review form include determining whether the project is “Research” as defined by the IRB, whether the project involves human subjects, whether the practice setting requires IRB review, and whether the project interacts with a vulnerable population. The last section of the IRB Prescreening Supplement Form involves confirmation of the various project aspects after completion.

(NR705-WEEK 2 Discussion-Prescreening Process)

Project Status

The project is still in the approval stage, but the research team is working with participants towards data collection, which will only be completed after IRB approval. However, the preparation is necessary, including explaining to participants what is expected of them, the method, instruments and duration of data collection. Generally, the team is in the initial stages of the implementation, and the organization I am working with is already aware of the project implementation, the intervention, and the involvement of schizophrenia patients in the study.

References

Rooney, L., Covington, L., Dedier, A., & Samuel, B. (2019). Measuring IRB Regulatory Compliance: Development, Testing, and Use of the National Cancer Institute StART Tool. Journal of empirical research on human research ethics: JERHRE14(2), 95–106. https://doi.org/10.1177/1556264619831888

 
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Discussion Rebuttal 2

Discussion Rebuttal 2

Discussion Rebuttal 2

 The author offers a satisfactory and compelling argument on the importance of an abstract in research work publishing. The primary role of an abstract is to summarize, describe, sort, and index a scientific paper or research work. It highlights the key sections or points from the major sections of the paper and explains what the paper includes with sufficient detail to expedite categorizing the paper as relevant to readers’ interest and clinical work. Abstracts are vital because they help index articles in online biomedical and clinical databases and also facilitate retrieval and review of research papers.1 Effective abstraction is challenging because it must be sufficient and compelling enough to attract journal editors who screen hundreds to thousands of abstracts yearly to screen research work and clinical papers for preliminary consideration.1

Editors reviewing the manuscript focus on the abstract, and poor-quality abstract can dissuade the best experts from taking their time and effort to review and improve a paper because it would take more time to complete the peer review.1 The abstract gives the initial impression about the paper, although other parts of the paper are equally important, and a poor abstract can relegate the research work to literature search obscurity or discourage readers from putting the paper on their reading list.1 Also, potential referees concentrate on the abstract when invited by editors to review a paper. I would also stress the need to develop attractive and compelling titles because readers begin with the title before moving to the abstract.

References

  1. JoAnn G A. Writing for Publication 101: Why the Abstract Is So Important. Crit Care Nurse1 August 2017; 37 (4): 12–15. doi:https://doi.org/10.4037/ccn2017466
 
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NR705-WEEK 3 Discussion-The DNP Practice Change Project

NR705-WEEK 3 Discussion-The DNP Practice Change Project

The Data Collection and Analysis Plan

Practice Question

The following practice question will serve as the basis of the DNP project: For adults with a history of Schizophrenia (P) in the inpatient setting, does the implementation of technology with motivational interviewing (I), compared with current practice (C), impact medication nonadherence (O) in 8-10 weeks (T)?

NR705-WEEK 3 Discussion-The DNP Practice Change Project

Plan to Protect Participant’s Confidentiality and Identity

Confidentiality involves the protection of human participants’ personal identifiers or personally identifiable data. It is an agreement between the researchers and the participants provided via informed consent as a guarantee that the participant’s identity and private or personal details and responses are not disclosed to unauthorized individuals or people outside the research team without consent (Purdue University, 2019). It is difficult for researchers to guarantee confidentiality when collecting identifiable details because there are limitations to confidentiality, including mandatory reporting laws and inspection of research data and records by IRB or the sponsor (Turcotte-Tremblay et al., 2018). Nonetheless, participants should know how their information will be stored during and after research (Purdue University, 2019). To protect participants’ data in this research and protect their identity, the project team will encrypt computer-based files, store documents like signed consent forms in locked file cabinets, and avoid using personal identifiers in study documents. Additionally, codes will be substituted for participant identifiers.

The information collected during the project development and implementation will be used over time and stored for future reference. The project team will establish a data management plan to protect and maintain the data over time. Physical documents will be stored in an environment with controlled access and under industry regulations such as HIPPA, SOC-2, and PIPEDA (University of Nevada, 2021). Staff authorized to access and utilize the data will receive routine security training to ensure best practices regarding participants’ data protection, including identifying new security threats, enforcing data protection regulations, and identifying better ways to secure the data (Turcotte-Tremblay et al., 2018). The data will be backed up to protect it from loss, system failure, or potential destruction. The data will be stored securely after this project, and it can be retrieved in future for similar projects.

References

Purdue University. (2019). Important considerations for protecting human research participantshttps://www.purdue.edu/research/dimensions/important-considerations-for-protecting-human-research-participants/

Turcotte-Tremblay, A. M., & Mc Sween-Cadieux, E. (2018). A reflection on the challenge of protecting confidentiality of participants while disseminating research results locally. BMC medical ethics19(Suppl 1), 45. https://doi.org/10.1186/s12910-018-0279-0

University of Nevada. (2021, July 13). 410. Maintaining Data Confidentialityhttps://www.unr.edu/research-integrity/human-research/human-research-protection-policy-manual/410-maintaining-data-confidentiality

 
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Topic 5 DQ 2 Clinically significant results

Topic 5 DQ 2 Clinically significant results

 Clinically significant results are those that advance medical treatment and enhance a person’s physical function, mental health, and capacity for social interaction. The phrase “improving quality of life” in relation to medical care covers both subjective and objective concepts. Here, the terms “objective” and “subjective” improvements in quality of life are used to describe changes in performance status, the length of a disease’s remission, and the lengthening of life (Sharma, 2021). Subjective improvements in quality of life refer to changes in mood, attitude, physical and social activity, feeling generally well, and the relief of discomforting symptoms like pain, frailty, and distress.

Topic 5 DQ 2 Clinically significant results

Results with statistical significance do not always translate into therapeutic relevance or an improvement in the subjects’ quality of life. As a result, many outcomes may be statistically significant but not necessarily clinically relevant (Sharma, 2021). Hence, clinical and statistical significance should both be valued by researchers and doctors. A clinically relevant intervention justifies its effects by outweighing the costs, harm, and difficulties it causes to the people it is intended to help. The primary distinction between statistical and clinical significance is that the former looks for differences between two groups or two treatment modalities, whilst the latter asks whether the results of the carried-out analysis of the data have any mathematical significance (Armijo-Olivo, 2018). For instance, if a drug has a demonstrable, beneficial impact on a person’s daily activities, it may be said to have a high clinical significance. Statistical significance, in this case, would help determine whether the effects of the drug are real or due to chance. For the DPI project, the clinical significance is preferred because the aim is to develop an intervention that will have beneficial effects on the patients that outweigh the costs and inconveniences.

References

Armijo-Olivo S. (2018). The importance of determining the clinical significance of research results in physical therapy clinical research. Brazilian journal of physical therapy22(3), 175–176. https://doi.org/10.1016/j.bjpt.2018.02.001

Sharma H. (2021). Statistical significance or clinical significance? A researcher’s dilemma for appropriate interpretation of research results. Saudi journal of anaesthesia15(4), 431–434. https://doi.org/10.4103/sja.sja_158_21

 
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Discussion Rebuttal

Discussion Rebuttal

The author presents a compelling argument on group cohesiveness and how leadership can ensure group success. Cohesiveness is an essential factor in a group, and it helps ensure continued functionality and successful completion of group activities. Leaders play the primary role in ensuring the group remains together and members work like a team to realize group objectives.1 However, I posit that group members are more critical in promoting group cohesiveness under the leader’s guidance. The leader creates a plan and facilitates a collaborative environment, while group members play the other part of working collaboratively, communicating effectively, sharing knowledge and information, and helping each other grow and become better to realize group and individual goals and objectives.

Discussion Rebuttal

Leaders cannot be everywhere at the same time monitoring activities and ensuring group members link and develop bonds with one another and with the whole group. Members must be willing to establish social relations, task relations, perceived unity, and emotions to build cohesiveness. Therefore, the primary role of a leader in ensuring the group grows closer and becomes more collaborative is offering and supervising best practices for group work, facilitating an environment that fosters relationship building between members, and by this, leaders should be easily approachable, provide positive feedback, match skills with the job, communicate effectively, and most importantly develop leadership in others. Chen and Rybak argue that cultivating leadership in group members is critical to ensuring group cohesiveness and success as a collective action.1 By empowering group members to develop relationships and work at their full potential, a leader is able to ensure a successful group process.

References

  1. Chen M W, Rybak C. Group leadership skills: Interpersonal process in group counseling and therapy. Sage Publications. 2017  https://www.chegg.com
 
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Identification and Contextual Assessment Planning for the Group

Identification and Contextual Assessment Planning for the Group

 

  1. Identify and briefly describe a population you are working with in the field that could benefit from a group-based intervention. What are some challenges potential members face? How did this population come to your attention?

Identification and Contextual Assessment Planning for the Group

The group has six individuals, African American youth and adolescents, including two Caribbean girls aged 15 and 17, two African Americans, a boy aged 14 and a girl aged 16, one African girl aged 17, and one Jamaican boy aged 17. I worked with these individuals at the clinic I went to for my clinical. All have been diagnosed with generalized anxiety and depression from different circumstances. Both Caribbean girls are Christians, but the others do not identify with a religion, although they grew up religious. They all live in Nassau County, Long Island, NY, and are receiving therapy from the same agency. Their pain points are verbal abuse, neglect, and ongoing trauma.

These individuals are up against cultural practices they do not wish to be part of, including religious beliefs, high dependency by family members due to close nit families, and stereotypes associated with African Americans like crime and poverty, as they feel powerless and unheard of because they are minors. I encountered and worked closely with these individuals during my internship. These clients share common circumstances and have been diagnosed with anxiety and depression. They perceive their families as toxic which is beyond their ability to change because they are minors. They all face isolation, and loneliness and feel misunderstood for wanting to dissociate from the cultural practices and beliefs associated with their family background. These individuals will undergo group therapy to help them relate to one another by sharing experiences and establishing common goals for behavioral changes and coping strategies to help them through their everyday ordeals.

  1. Using the required readings and course syllabus to guide the literature, what are the three key values or benefits of using a group approach with this population?

The group therapy approach is preferred to individual or one-on-one therapy for this group of individuals because of related experiences, challenges, and struggles. Members have been diagnosed with anxiety and depression, are in a toxic environment, and face isolation, loneliness, and feeling misunderstood. Despite having related experiences, the clients have individual differences, and members can benefit from the broadly varying clusters of therapeutic factors typical in group settings (Yolom & Leszcz, 2005). According to Wayne and Cohen (2001), high-quality group work education facilitates effective group work practice. Therefore, the practitioner should help members develop interactional skills for group work practice and facilitate a healthy and relatable environment where members can benefit from the group work approach.

By engaging in group work, members can benefit from interpersonal learning. Individuals in the group have related experiences and can help members acknowledge their struggles and issues and feel less alone, offering support and encouragement (Yolom & Leszcz, 2005). The group members interact with each other and receive feedback from other group members or the therapist, which helps them gain a greater understanding of themselves and how they can improve their behaviors and attitudes. Group members are also each other’s role models, helping one another successfully cope with the problems they experience, feel encouraged and inspired about their recovery process, and establish a culture of support and motivation.

Group members will also benefit from mutual support to promote social skills, enhance self-reflection and awareness, and receive support and encouragement from a wide range of individuals (Brandler & Roman, 2016). Members will interact to build communication skills and engage others’ feedback to learn more about themselves to enhance self-awareness. The group approach will offer a safe environment where members can share their personal life and information, display natural behaviors, and express themselves without feeling discriminated against or unheard (Brandler & Roman, 2016). Members can observe each other’s behaviors through social interactions or situations and help the practitioner respond better than if it was individually expressed in a one-to-one session.

Group members can also gain from the installation of hope. Individuals selected join a group of individuals struggling with similar issues, and they have a remarkable chance to experience or witness changes in others while also experiencing their own small wins as they are acknowledged and celebrated by peers (Yolom & Leszcz, 2005). Group members react differently to treatment, and the group might include members at various levels of recovery at some point. Members can see other individuals cope and recover from their illnesses, which gives them hope to begin or continue the process.

  1. Using course literature on models and theories of group practice, what type of group approach do (or did) you propose?

Successful group practice requires the leader or the leading practitioners to adopt group practice best practices and values that inform and guide interpersonal interactions between group members and between group members and the practitioner (Wayne & Cohen, 2001). The group has six members, and new memberships will be limited as it might disrupt the progress if new members are allowed to join at any time. In this case, by the time a new member joins, the group will have undergone several staging of group practice, which will be seen as disruptive. The sessions will be two times a week, two hours long, for six months to ensure members completely recover from their anxiety and depression and feelings of loneliness, isolation, and misunderstanding. The leader will be less active, facilitating interpersonal interactions, balancing support and confrontation, managing the working process and tasks, and encouraging member-to-member empathy. The group sessions will be in a circle, and icebreakers will be the primary approach in helping members integrate and connect.

The primary aim of the practitioner is to establish working and constructive relationships between group members using group activities. The remedial model is ideal for this group as it focuses on addressing individual dysfunction, utilizing the group as context and means to alter deviant behavior (Alissi, 1980). Individuals involved in group work have behavior disapproved by society, including the desire to dissociate from cultural practices attached to their ethnic backgrounds. The remedial model can help remove the adverse conditions from group members whose behavior is unacceptable in society. This approach is also suited for isolated and alternated persons, which is the case with group members selected for this group work. The model will guide attempts to bring change in these individuals, especially adjusting personal and social relations.

  1. Using the required readings and course syllabus to guide the literature, identify at least two key opportunities, challenges, or obstacles in group interventions in each of the contexts below. How would you address each of these challenges?

Discuss at least two challenges or obstacles for each of the following: Use, cite, and reference at least one source in each subsection (A, B & C) – sources may be used in more than one)

  1. In the agency context?
  2. How will the agency\’s organizational mission, structure, and activities influence the group?

The agency’s primary purpose and mission is to help individuals recover and promote group cohesiveness. However, the agency has a leadership structure, policies, requirements for membership, and activities such as relationships with local governments, funding sources, and other partners that influence the agency’s operations. The government plays a critical role in the continuity of the agency through yearly funding. Apart from government funding, the agency depends on payment for services to continue operating, which in this case, parents are paying because group members are teenagers. Therefore, group sessions can only be sustained with membership fees. The agency policies would see a group member discontinued if they fail to pay the required fee, affecting group dynamics and the established cohesion (Brandler & Roman, 2016). Also, the agency continued operation depends on funding from the local government, implying political interference in the leadership and running of the agency (Brandler & Roman, 2016). Local government involvement in the running of the agency means that government policies impact the agency’s operations. Sometimes the budget is cut or the funding is late, affecting the operations of the agency and group sessions. To address this problem, a potential solution would be the agency seeking other reliable or timely funding sources, including charitable funding, community-based funding, or partnership with non-profit organizations addressing mental health in the community and alternatives to curb the inconveniences caused by lateness or budget cuts from local government funding.

  1. How will they affect the way you develop and work with the group?

Therapists have a signed contract and work agreement with the agency to promote the agency’s mission, vision, values, and policies. Therapists enforce these policies in the group, which affects working with the group because strict adherence is needed. For instance, I have to enforce the level of discipline required in the agency, including regulations for lateness, absenteeism, membership payment, and discrimination policies. In such cases, agency interest might come before the group’s interests, negatively affecting how I develop and work with the group. When forming the group, the therapist must explain and clarify agency policies and rules and help members understand and apply them for continuity.

  1. In the community context?
  2. What communities influence the development of this group?

The selected group members are from the African American community, although from different regions, including the US, Africa, Caribbean Island, and Jamaica, meaning they share common characteristics. Working with this group is a social work practice that needs the involvement of the community where these individuals come from. The African American community influence the development of this group through its beliefs, values, and cultural practices. For instance, African Americans emphasize family closeness, community bonding, and solidarity, and any altered values are considered deviance from community values and cultural beliefs. Group members would have to show adjustment to acceptable behavior if they want to be part of the community, including dissociating from not wanting to be involved in cultural practices and values of the African American community. For successful integration back into the community, the community has to facilitate an accepting environment for the individuals who have adjusted their behavior. As a therapist, I will consider the values, culture, beliefs, and social perception of the African American community when developing the group to ensure I attend to these backgrounds and promote cultural sensitivity with the group. The group dynamics will not be complicated because all members are African Americas. Notably, the members’ countries of origin differ because I have some from Africa, America, Jamaica, and Caribbean Islands. The specific cultures and values of these different sub-communities will influence group development. The difference in values and backgrounds will be key in establishing and sustaining cohesiveness in the group.

  1. How may/will communities influence and/or support the ongoing development of this group?

These group members are part of the community, and community values and interests will influence its development. Members have shared experiences and feelings of isolation, loneliness, and misunderstanding. Members also claim to be in a toxic environment where they must conform to specific values and practices they disagree with but have no choice because they are minors. According to Berman-Rossi and Miller (1994), individuals act on the environment, but its influence on individuals is greater, influencing choices, actions, and ideas. Therefore, their communities have influenced and played a critical role in developing mental health issues like anxiety and depression and how they feel. At the end of group therapy, the members must integrate into the community and develop healthy interpersonal relationships. Members are also minors are will require consent and direction from seniors, particularly family members, to be part of the group. Therefore, community members, including their families, social workers, and community leaders, who have a better understanding of the community’s cultural practices, values, and acceptable behavior will be involved to inform and support the group’s ongoing development. There will be interactive sessions with these community members at different stages of the group process to help access individual development and behavior adjustment per the community values and acceptable behavior.

  1. In the potential members\’ and worker context?
  2. How are your identities similar or different from the client or system potentially represented in the group?

The group members experience isolation and loneliness, feel misunderstood, and have recently been diagnosed with anxiety and depression. These individuals have a commonality that I do not identify with or share experience with, but only at the professional level. I have professional knowledge and experience in addressing such cases and recognize how individuals feel. However, I lack personal experience or firsthand experience at a personal level on anxiety and depression symptoms or feeling disconnected from the community and family members. I need high-level empathy to understand what the clients are going through and help them throughout the recovery process.

  1. What assumptions or biases may you need to be aware of?

After the norming or middle stages, it is assumed that members will have no conflict, interact openly and freely, and acknowledge individual differences, working towards a common goal. I need to be aware that this is not always the reality and expect conflict or individual differences to sustain throughout therapy. I should also be keen on hidden personalities that only appear in particular circumstances, for instance, members’ reactions when one of them is overwhelmed by feelings. I should also be aware of in-group biases where some individuals feel smarter, in a better position, or more important than others. It can happen when individual members rival for attention or superiority in the group and tend to belittle or embarrass others (Brandler & Roman, 2016). Conclusively, I should expect individual versus individual and individual versus group confrontations at any point in the process.

  1. How might culture and identity impact the power dynamics in your relationship with group members and/or client system?

Culture affects group dynamics and the relationship between group members and between the therapist and group members. The cultural characteristics of group members influence how group members interact and might lead to the formation of sub-groups within the group. Although all group members are African Americans, their origin countries differ, meaning cultural practices, values, and beliefs are different to some extent for the different sub-groups. For instance, African Americans from the US might develop a superiority complex over African Americans from other countries, which might impact group dynamics. Culture influence habits, preferences, and values and the differences in the cultures of the sub-groups might be a source of conflict between group members or between group members and the therapist, affecting group cohesiveness. For instance, American pop culture is integral to the culture of African Americans from the US, which might impact a close relationship with African Americans from other countries and continents like Africa, Jamaica, Caribbean Islands that have their unique cultural practices. To address this problem, I should understand every team member’s cultural characteristics and identity and develop initiatives to ensure cultural sensitivity, eliminating any potential superiority complex that might impact the group’s cohesiveness and work process.

References

Alissi, A.S. (1980). Social Group Work Models: Possession and Heritage. Perspectives on Social Group Work Practice: A Book of Readings. NY: The Free Press. Chapter 9

Berman-Rossi, T., & Miller, I. (1994). African-Americans and the settlements during the late nineteenth and early twentieth centuries. Social Work with Groups17(3), 77-95. https://www.swarthmore.edu/SocSci/rbannis1/Progs/Bibs/SS.html

Brandler, S. & Roman, C.P. (2016). Group Work: Skills and Strategies for Effective Interventions. Third Edition. NY & London: Routledge.

Wayne, J. L., & Cohen, C. S. (2001). Group work education in the field (Vol. 2). Council on Social Work Education.

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. Basic books.

 
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Analyzing Group Techniques

Analyzing Group Techniques

Introduction

The primary aim of group therapy is to facilitate a high-functioning, comfortable, and functional environment. Engaging in group therapy allows members to benefit from the various mechanisms, including universality, altruism, instillation of hope, imparting information, socialization techniques development, imitation behavior, cohesiveness, existential factors, interpersonal learning, and self-understanding. It is suitable for individuals with relatable experiences. This paper analyzes a video on group therapy techniques, what the therapist did well, where I would have handled it differently, and the benefits and challenges of group therapy.

Analyzing Group Techniques

Group Therapy Technique in the Video

The video selected for this analysis is “Interpersonal group therapy for addiction recovery demonstration.” The video portrays an interpersonal group therapy technique in action as group members talk and share personal struggles. Others provided material and emotional support to aid in the recovery process. Addicts frequently experience isolation, which they must overcome by learning to form relationships and exhibit constructive interactions. One of the group members talks about taking medicine from his sick mother, and to help the protagonist feel at ease, several other characters actively listen while also reflecting on the circumstances together (Cats Cats, 2016). Another group member talked about a comparable incident of robbing his grandfather’s pension money. The person who shared his story of robbing his mother’s medication feels that once people find out what happened, they will no longer trust or desire to surround themselves with him. But the therapist and other group members get along well with him, reassuring him that no one will hold his past behavior against him and that it is good to talk about his struggles (Cats Cats, 2016). By opening up, he may escape the alienation his worries and insecurities caused, which encouraged his addiction. Importantly, Jimmy claims that he trusted the group members and was interested in connecting more with them. The foundation of interpersonal group therapy is mutual respect, trust, and deep connections made in a supportive setting.

Evidence-based Support of the Group Therapy Technique

According to Rajhans et al. (2020), interpersonal group therapy is an effective treatment for mental disorders and drug misuse, allowing group members to gain the communication and interpersonal skills necessary for successful, long-lasting recuperation and healthy growth. It is a potent tool for helping people understand themselves and their connections with others (Rajhans et al., 2020). The people speaking about their experiences think that hurting persons closest to them through robbing damaged their bond with them. According to Cuijpers et al. (2018), people can address relationship problems that lead to psychological suffering or a lack of satisfaction in interpersonal interactions through interpersonal group therapy. For those who find it difficult to express or convey their needs, feelings, and opinions in a direct manner to others, this strategy might be helpful. The participants in the video are guilty and ashamed for taking from their loved ones and needed interpersonal therapy to successfully resolve these relational problems.

What the Therapist Succeeded In

Throughout the film, the therapist’s primary function is to promote interaction and encourage Jimmy to keep talking about his encounter. The therapist maintained the conversation, encouraging Jimmy to share more and engaging the other group members in understanding his position, assuring him that talking about his relationship problems or robbing his mother would not change the way they perceived him (Cats Cats, 2016). Also, the therapist used suitable questions, and delivered in a quiet, polite tone that complemented the atmosphere of the space.

What I would have done differently

I found how the therapist asked Jimmy to continue sharing at the beginning of the video demanding and pressuring, not giving him adequate time to handle his emotions. Jimmy feels awkward talking about his experience, especially stealing from his mother, which makes him feel bad and embarrassed. Before urging Jimmy to resume, I would give him enough time once he stopped speaking to take a breath, collect his thoughts, and control his feelings and emotions. While it is essential to maintain the talk, it is also crucial that the people who are speaking do not feel compelled to do so.

Insights gained from how the therapist conducted the group session

To make Jimmy relax and be at ease to share, the therapist managed the session skillfully by allowing everyone to speak in turns, offering assistance when required, and recounting their stories. Also, the therapist sees to it that everyone in the group gives Jimmy their full attention (Cats Cats, 2016). She has succeeded in building an environment based on trust where Jimmy feels free to share his most heinous acts. I would use these beneficial ideas I learned from the video to guide my instructional practice in the future.

Conducting my group session

Individuals are prepared to take part in a secure and collaborative setting, which is the foundation of effective group therapy. The characteristics of a productive group environment are compromised when there is a problematic group member. Setting guidelines and going through them with attendees to make sure everyone understands the difference between unacceptable and acceptable behavior is the most crucial step in managing a problematic group member. According to Finkle (2017), establishing trust within the group is essential to fostering a supportive environment for bonding and interaction. I would let participants interact at their own rhythm, use affirming, sympathetic language and statements rather than pertinent questions, talk with participants about the group process, and repeatedly emphasize each participant’s duty to both the group and other participants to encourage active participation. I would also routinely ask participants to evaluate their impressions and encounters periodically.

What to expect in Different Stages of Group Therapy

Each phase of group therapy has a goal that must be achieved to successfully implement group work. I anticipate that during the group-forming phase, members will get to know group members’ names and the problems they deal with. According to Richard (2020), conflict amongst group members during the storming stage is to be expected due to the variety of characters, attitudes, and objectives. I believe that throughout the norming phase, participants will become accustomed to one another, forge significant connections, and engage in productive communication. I anticipate that when people are on stage performing, they will start talking about their problems and supporting one another. I expect that by the time the meeting adjourns, participants will have overcome their issues and be able to successfully reintegrate into society and resume leading regular lives.

Benefits and Challenges of Group Therapy

Group therapy helps address addiction, alcoholism, and mental health problems. It connects users with others going through similar or related situations, giving them a sense of comfort and belonging. People feel a sense of belonging since they are encircled by people who are also dealing with relatable problems. According to Wendt and Gone (2018), p People greatly benefit from having a support system, and by hearing and exchanging ideas with others, they can acquire new perspectives. However, talking before an audience or sharing embarrassing experiences might be uneasy. Additionally, the conflict between personalities is common, and group members may sense a violation of confidentiality. The therapist may have trouble establishing a high-functioning group of patients to assist them to recoup and dealing with planning issues, especially scheduling conflicts.

Conclusion

Group therapy allows a practitioner or a group of practitioners to treat multiple patients at once. It is used in various healthcare settings, adopting different techniques based on the needs of patients or group members. The video analyzed in this paper adopts the interpersonal group therapy technique suitable for individuals with relatable experiences. The therapist maintained the session skillfully, allowing individuals to share their experiences, learn from others, and encourage recovery. If I was handling this session, I would avoid probing questions and allow time for members to deal with their feelings and emotions while sharing their experiences before asking them to resume.

References

Cats Cats. (2016, September 29). Interpersonal group therapy for addiction recovery demonstration. Links to an external site. [Video]. YouTube. https://youtu.be/szS31h0kMI0

Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2018). Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis. The American journal of psychiatry173(7), 680–687. https://doi.org/10.1176/appi.ajp.2017.15091141

Finkle, L. (2017, July, 16). How to deal with difficult and disruptive team members. https://www.linkedin.com/pulse/how-deal-difficult-disruptive-team-members-linda-finkle

Rajhans, P., Hans, G., Kumar, V., & Chadda, R. K. (2020). Interpersonal Psychotherapy for Patients with Mental Disorders. Indian journal of psychiatry62(Suppl 2), S201–S212. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_771_19

Richard, P. (2020). 6: Group Therapy: Stages of Group Development. Springer Publishing.

Wendt, D. C., & Gone, J. P. (2018). Complexities with group therapy facilitation in substance use disorder specialty treatment settings. Journal of substance abuse treatment88, 9–17. https://doi.org/10.1016/j.jsat.2018.02.002

 
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