Psychotherapy is an integral part of mental health treatment. Psychotherapy involves accepted therapies that are capable of producing change or maintain acceptable behavior or function in individuals and families as well as alleviate emotional distress or symptoms that affect individual or family growth and development (American Psychiatric Nurses Association-APNA, 2014). Like in every profession, there are always rules and regulations that guide the actions. Psychotherapy of any type allows the therapists to get to individual’s or families’ confidential issues. Therefore, the legal and ethical rights of the people involved must be considered and respected. However, it is crucial to understand the differences between individual, family, and group therapies.
When it comes to the ethical and legal considerations in psychotherapy, Miller (2018) identified the following essential issues; Responsibility, Confidentiality, personal value as well as informed consent. Responsibility: The therapists must understand her limits in each type of therapy. In individual therapy, the therapist has a one to one relationship with the client; however, the relationship differs in family therapy and group therapy, the therapist views the family or the group as one unit and acts as the group leader, facilitator, environmental manager, educator/teacher, and or cheerleader. The therapist is committed to promoting the welfare of every member involved in the treatment process. Confidentiality, on the other hand is one vital ethical issue in psychotherapy. In individual therapy, the therapist is concerned with keeping the information of the one individual in confidence, whereas in family therapy, confidentiality becomes very crucial. Though the family is considered as one unit, every individual’s secret or information must be kept in confidence. Every member must understand the issue of confidentiality. This issue of confidentiality becomes more difficult in group therapy than individual therapy due to more chances of leakage or breach of confidentiality among the group members. Confidentiality should become one of the most critical group norms, and it should be discussed openly, thoroughly, and often among group members (McClanahan, 2014). Another ethical issue is respect for personal value. It is easy to study and respect individual and family values and culture. However, in group therapy, the counselor has a more significant work of studying every member of the group to avoid offending anyone or be misunderstood.
One important legal consideration in psychotherapy is the issue of informed consent, either individual, family, or group therapy. In individual therapy, therapeutic consent is required from the one individual. Any sharing of information must be consented and signed by the individual. Whereas in family therapy, every member of the family involved or invited must consent for the therapy. The therapist must uphold the individual client’s confidentiality to other family members. The same applies to group therapy, where every member of the group consents to be involved in the group. The level of information shared is determined by each member of the group while the group leader holds everyone’s information in confidence.
As a PMHNP, understanding the importance of confidentiality will help in safeguarding every individual’s information. Building trust and confidence between the therapist and the clients depends on respecting the individual’s family and group values and cultures. For any therapeutic approach, the patient must consent to treatment to avoid breaching professional guidelines and avoid possible lawsuits from patients and families. The PMHNP should address the issue of confidentiality to individual clients, families, and group members before embarking on any therapeutic counseling. Though family therapy members are seen as an entity, the therapist must understand the importance of maintaining the confidentiality of information of every member of the family. Finally, consent must be received and signed for any information to be released or shared to avoid violation of confidence and The Health Insurance Portability and Accountability Act (HIPPA). HIPPA is one of the acts that guide the practices of a nurse when it comes to Group and Family Therapy. Clients benefit when information is kept confidential, and a trusting relationship can be achieved. The disclosure of private information without client consent can harm the therapeutic relationship even when such disclosures are mandated by law (McClanahan, 2014). So as a PMHNP, I must recognize the importance of individual consents both in individual, family, and group therapy, respect each value and maintain the confidentiality of information as part of my work as a therapist.
American Psychiatric Nurses Association-APNA, (2014) Psychiatric-Mental Health Nursing: Scope and Standards of Practice. (2nd ed). Retrieved June 4, 2020, from http://www.apna.org/
McClanahan K.K (July 21, 2014) Can Confidentiality be Maintained in Group Therapy? Retrieved June 4, 2020, from https://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html
Miller A (December 31, 2018) Types of Ethical Issues a Counselor May Face When Working with Families. Retrieved June 4, 2020, from https://careertrend.com/aba-therapist-salaries-13660801.html.