First, I would acknowledge to the group that Alejandro is talking about something very important. He is expressing concerns that Lucy broke his confidentiality by telling her husband the reason he was in therapy, and the husband went and informed his wife. Lucyâ€™s act is totally unacceptable. Although every member in the group signed informed consent to maintain confidentiality, the therapist cannot guarantee compliance (Corey, 2016). This is one of the psychological risks of group therapy. A breach of confidentiality can lead to mistrust, non-participation, or even dropping out of the group (Corey, 2016).
Lucy tries to rationalize her action by saying that her husband was worried about Alejandroâ€™s safety. She also felt it was her job to notify Alejandroâ€™s son. According to Wheeler (2020), rationalization is when someone attempts to explain or cover-up behaviors/feelings that are unacceptable. She even tries to minimize her action by downplaying the significance of what she did.
I would allow Sung and Barry to express how they feel about Lucyâ€™s behavior. Because of Lucyâ€™s behavior, at the beginning of each session, I would remind everyone of the ground rules, including the importance of maintaining confidentiality (Corey, 2016). By doing so, Alejandro and the rest of the members will feel safe and willing to continue with group sessions, and Lucy will not feel too embarrassed or ashamed of her behavior.
Jennifer supporting Lucyâ€™s behavior poses another psychological risk in groups. Members can learn a strategy from another member that might create turmoil later (Corey, 2016). However, group therapy is all about members sharing their different viewpoints. So, I would ask Jennifer to discuss how she will feel if all members break boundaries and discuss membersâ€™ issues with outsiders. Iâ€™m sure she wouldnâ€™t feel safe sharing in the group.
I would acknowledge Montyâ€™s concern and stress the importance of maintaining and respecting confidentiality. Doing so allows the group members to have in-depth reflection, appreciate the meaning of trust, and feel safe sharing in the group.
Group Therapy Leadership Techniques:
I would actively listen to each member as they speak, giving them time to express their feeling toward the conflict. Active listening encourages trust and allows the member to explore and self-disclose (Corey, 2016).
I would empathize with Alejandro, Sung, Barry, and Monty. I would identify with their feelings toward Lucyâ€™s behavior by assuming their frames of reference. Doing so ensures and encourages deeper levels of self-exploration and fosters trust in the therapeutic relationship (Corey, 2016).
At the end of the group session, I would summarize all the vital elements discussed. This helps to prevent fragmentation and provides direction for the progression of the group (Corey, 2016).
I would politely encourage Lucy and everyone in the group to become more self-aware and recognize the needs of other members. Finally, I would always ensure that the group process issues as a whole. This fosters open communications among all members and reduces the feeling of being attacked by members. Offering feedback to group members increases a memberâ€™s self-awareness. It also provides the member an external view of how they relate to others (Corey, 2016).
HELLO WRITER, JUST ANSWER TO THIS STUDENT. YOU CAN TALK ABOUT CONFIDENTIALITY AND STUFF. DON’T COMPLICATE YOURSELF IS JUST AN ANSWER TO A STUDENT.
NOW I WILL PASTE ANOTHER STUDENT’S RESPONSE, PLEASE JUST ANSWER BACK TO HER/HIM AS WELL.
In this scenario, Alejandro confronts Lucy about the fact that she shared information from the group with her husband. Her husband then approached Alejandroâ€™s wife out in public and discussed Alejandroâ€™s situation with her. Alejandro and Daniâ€™s son was present during this exchange and was unaware of why his father had been in the hospital.â€™
Lucy says that she discussed the situation with her husband because she wanted her input on whether or not she should reach out to Alejandroâ€™s son, Dario at school or not. Alejandro tells her that that is not her job.
This is my dialogue for this scenario:
Me: I think Alejandro is talking about something very important.
Sung: Lucy, Iâ€™m so disappointed about you breaking our confidentiality. Now I donâ€™t trust that you wonâ€™t talk about me to people outside of the group. I have not told anyone about having depression, much less that I am seeking help through therapy. I would lose face in the community! And Iâ€™ll never get a boyfriend!
Lisa: Oh, geez, itâ€™s not like we signed something legally binding. And itâ€™s my husband! Who keeps secrets from their husband? Not me! Gerald knows everything I know.
Barry: WAIT, Lucy!
Alejandro: Then you should have said so right away. What we say isnâ€™t a secret, itâ€™s our personal information. You have no right to share it with ANYONE. I donâ€™t tell Dani anything about this group. She didnâ€™t even know you were in it.
Barry: WAIT! Lucy, my son goes to West, too! Have you told Gerald anything about me being in this group? Or anyone else? Arenâ€™t we supposed to keep everything confidential?
Me: Does anyone remember our ground rules about confidentiality?
Jennifer: Lucy, I think you did the right thing. I know youâ€™re worried about Alejandroâ€™s son, Dario, since you are one of his teachers. And Alejandro, you should have told your son what happened already. Heâ€™s old enough to see whatâ€™s going on around him. Keeping secrets isnâ€™t good. My children know all about whatâ€™s happened to me.
Me: So we can see there are varying opinions about Lucy speaking with her husband about Alejandroâ€™s experience. Can you talk about how this experience has affected your ability to trust the group and to feel safe when sharing within the group?
Monty: I canâ€™t believe this is happening! Oh my God! I could lose my job! You know I work hourly at the senior day care center. If my boss finds out why I took all that time off last year, he could fire me completely. I donâ€™t have any protection against that. I told him my Mom needed some extra care, which they totally understood, of course. What the hell are you thinking, Lucy? I donâ€™t feel safe sharing in this group and I donâ€™t know if I want to come back anymore!
Me: So what I am hearing Monty say is that he is feeling vulnerable and fearful that the group is not a safe place for him to share. He is worried other group members will violate his confidentiality when he does share. What do others of you have to say to Monty about his concerns?
Monty: Thank you all. I do feel a little better about trusting you. But I donâ€™t think Alejandro and Lucy have resolved anything yet. How can we move on?
Alejandro: I still think Lucy should apologize for talking to her husband outside the group. You know what Dario thinks of me now? I used to be his hero and now he knows that my life sucks and I donâ€™t really want to be here. I also think she needs to tell the group that she will respect our confidentiality. And mean it.
Lucy: I am sorry my husband talked to your wife in front of your son. That was wrong. But I am still concerned about how your suicide attempt is affecting your son.
Me: Lucy, I am curious what you heard Alejandro ask for in his response to you?
Lucy: He said that he thinks I should apologize for talking to my husband outside of group, and I did!
Me: That was part of it. Alejandro, can you express your concerns to Lucy?
Alejandro: My son used to see me as his hero. Now, he thinks I donâ€™t want to be here. He thinks that I think my life sucks, and he thinks that he is part of the reason for what I did. I want you to respect our confidentiality when we are here in group, and I want you to mean it.
Me: Lucy, what did you hear Alejandro say?
Lucy: His son is placing blame on himself for what Alejandro did, and no longer sees his dad as a hero figure. He wants me to keep things that we discuss in group within the group.
Me: Alejandro, is that correct?
Alejandro: Yes, thatâ€™s correct.
Me: How come we participate in group?
Sung: It is comforting to be around others who are going through the same thing that we are. It helps us to know that we arenâ€™t alone.
Monty: Itâ€™s supposed to be a safe place where we can discuss what we are going through without judgement. You guys get what Iâ€™m going through. We can all relate. But now, I donâ€™t know if I want to share anything personal anymore.
Me: Iâ€™m sorry that you are second guessing whether or not you should share with the group now, Monty. This is a safe place for everyone. We should all feel welcome to be here, and comfortable sharing. Maintaining confidentiality is essential if we want the group to be effective.
Me: Letâ€™s all envision someone in our lives. Someone whoâ€™s opinion of us matters to us â€“ a coworker, a boss, a client, a student. Now, imagine that individual approaches you, and they begin talking about a story that you shared in group. How would you feel if that person knew of your experiences that you had shared when you were with the group in confidence?
Lucy: I guess I can see what youâ€™re saying. I would be taken aback if one of my students approached me, like if Alejandro had told Dario that his teacher was in the same group.
Me: How do you imagine that would make you feel, Lucy?
Lucy: Embarrassed in a way. I am not embarrassed that I have depression, but it isnâ€™t exactly something that I want my students knowing.
Me: If a student approached you about your depression, how would you feel about sharing in group from that point on?
Lucy: I probably wouldnâ€™t, because I would know that that student may find out what I was talking about in group.
Me: If we all thought that what we discussed in group was being spoken about outside of here, and people were finding out our business, would we be apt to share in group?
Me: Is group effective if we are all just sitting her, not talking?
Me: Exactly. We all want an effective group experience; that is why we are here. Confidentiality is essential if we want our group work to be effective (Corey, 2016). Group work offers understanding and support (Corey, 2016). This should be a supportive atmosphere.
Me: I am ethically and legally bound to maintain confidentiality, with the exception of when your safety, or someone elseâ€™s, is in foreseeable harm (Corey, 2016). That means that I keep whatever it is that we discuss in group here, between us.
Jennifer: How do we ensure that members of the group keep things confidential though? I mean I get that you have to, but if we donâ€™t, itâ€™s not like anything happens to us.
Me: That is true, Jennifer. There are no legal ramifications or things of that nature if you donâ€™t maintain confidentiality. However, the success of group sessions could suffer.
Alejandro: Can we all make a commitment to not break confidentiality?
Me: How do you all feel about committing to not breaking confidentiality?
Me: I will write up a contract that everyone will sign (Corey, 2016).
WRITER ANSWER TO THE STUDENT ANSWER BELOW:
3. Reflect on the role change from expert RN to novice NP.The role change from expert RN to novice NP is still continuously changing. Leaving the comfort zone of being an experienced RN for a new career as an inexperienced advanced practice registered nurse (APRN) is one of the greatest difficulties of the APRN transition to practice. However, I must say with the material that Iâ€™m learning in class has been making this transition more transparent. I do feel that the more practice I received the more comfortable I will feel with the transitions.
WRITER ANSWER TO THE STUDENT ANSWER BELOW:
- Share tips, resources, and techniques that you have found useful in the clinical setting.
Learning the documentation program is so vital for it enables you to be able to access patientsâ€™ information easily, especially when you have patients back to back.
AND… THAT WILL BE ALL. TOTAL OF 4 RESPONSES. THANK YOU