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Ethical and Cultural Issues in Group Work

Ethics and culture have a tremendous therapeutic import in the practice of group therapy, mostly given the rising diversity of substance abuse clients attending group counseling. In recent years, group work counseling has become the leading service delivery approach in psycho-social and behavioral health-oriented programs. Similarly, Group therapy is specifically useful in working with substance abuse users because it permits them to connect with others with the same experiences. This paper discusses the ethical and cultural issues, the skills, and guidelines that I used while conducting this group therapy to substance abuse inmates in Colorado prison.

For this assignment, the chosen group includes inmates who are using illicit drugs and do not have the willingness to stop substance abuse. Group counseling is intended to help the inmates comprehend the correlation of their drug use to the risk factors for HIV infection and collaborate with them to create a plan for risk cutback. I call the group counseling “Beyond Fear Program” or BFP, which is ninety-minute weekly sessions for eight weeks. BFP uses individual and group-level approaches to reach its objectives. Two group sessions are organized to identify the inmate’s HIV risks and the present phase of change. During these sessions, inmates learn from listening to positive risk-reduction narratives, set personal objectives, and identify initial steps in decreasing HIV risk (Leukefeld, Gullotta, & Gregrich, 2011). Similarly, I do organize social events so that inmates can socialize and get support for risk reduction. For example, I do hold HIV linked risk reduction activities such as playing a game that bolsters HIV linked abilities learned in the sessions.

To become a successful facilitator in this group comprising inmates who are substance users, cohesion-building, communication, and problem-solving skills are crucial. Corey, Corey, and Callanan (2019) state that the facilitator plays a vital role in creating rapport and interaction with group members. Besides, it is essential for me as the facilitator to apply communication skills to help advance the group members’ expression of emotions and articulation of thoughts.  Furthermore, communication skills enable me to accurately read non-verbal communication such as eye contact, vocal cues, and emotional response to interpersonal space to decode what a group member is trying to express. Also, I encourage the members to use their native language to articulate their sentiments when another language cannot sufficiently explain how they are feeling. Group cohesiveness skills is also essential for successful facilitation in this group. Through group cohesiveness, members can acquire a sense of belonging, respect, and trust because they share challenges and offer mutual help, support, and encouragement.  Since other individuals significantly impact individual conduct, sentiments, and disposition, I teach the group how to give and get appropriate feedback on their behavior change. Also, feedback increases motivation for transformation, more insights into how one’s conduct affects others, and high ratings of fulfillment with the group experience (Leukefeld, Gullotta, & Gregrich, 2011). Group counseling has challenges such as group labels that cause stigmatization and personality differences of the group members that can cause conflicts. Yet another essential skill or successful facilitation in a group of substance users is problem solving skills. As a facilitator, I use my problem-solving skills to suggest alternative learning options that are practical for the members. For instance, in BFP intervention, I once used recovery success tales on video, and group members were not buying-in to the narratives. Therefore, I decided to use an alternative approach of fellow inmates sharing their recovery stories and the group related more with this approach. Also, renamed the group from “Substance Users Support Group” to “Beyond Fear Program” to change the outsiders’ opinions of the group.

For a dynamic group as the “Beyond Fear Program,” there are specific ethical and cultural problems that must be tackled before engaging with this group. First, justice is a principle that is upheld when interacting in a group. As a facilitator, I treat the inmates fairly because I do not discriminate against members who have substance abuse disorder and are also HIV positive. Some members are uncomfortable expressing their problems in a group setting, and I organized individual sessions to make them feel accommodated. Second, one must uphold respect when interacting in the group and follow the group’s norms. I integrated the members in creating the group norms to encourage collaboration and inclusivity. Third, confidentiality must be maintained in the group (Corey, Corey, & Callanan, 2019). Every member signed a working agreement or contract stating that they will not share the group’s information with third parties.

The three most crucial guidelines for multi-cultural and social justice competence that guides me professionally and ethically when managing the group are confidentiality, reliability, and duty to treat (Flores & Georgi, 2005). First, as a counselor, it is my ethical mandate to protect the members’ identity and process information the members share as private. From the group’s outset, I educated the members on the importance of keeping the group’s matters private to encourage cohesion (Leukefeld, Gullotta, & Gregrich, 2011). Second, I discharge my duty to treat through community advocacy activities like educating the members’ families and fellow inmates about HIV and substance use. Likewise, I create support networks amongst members outside the group because they have encountered isolation due to stigma.

Third, I adhere to the ethical principle of reliability by having members sign consent forms and promise the data provided or shared in the group will remain confidential to anyone not listed in the form. Hence, I chose these guidelines because they promote group cohesion, bonding, and fulfillment with the group experience. Nevertheless, I need to develop more knowledge on how to implement confidentiality guidelines because maintaining confidentiality in a group setting is challenging.  

In conclusion, this paper capably discusses the necessary skills a successful facilitator needs when conducting group therapy for inmates who are substance users. The paper also explained the ethical and cultural issues that must be tackled in such a group setting and the guidelines for multi-cultural and social justice competence a facilitator uses when managing a group therapy.