Differences Within the Group Discussion

Differences Within the Group Discussion
There will always be differences within a group, and it is the group leader’s responsibility to address struggles within the group. Some clients may be vocal about their struggles, while others may not. During my career in working with those that struggle with substance use disorder, I have had clients express their frustration about not seeing an LGBT group within this context. These clients would voice their frustration individually, in group, and in writing through satisfactory surveys. These concerns would be discussed individually, in the group, and with management. Research does suggest that “discussion of LGBT strengths within the psychological practice extends itself to unique life experiences, challenges and opportunities,” which must be acknowledged and processed in treatment (Lytle, Vaughan, Rodriguez, & Shmerler, 2014, p. 335).

Specialty groups are important if it is important to the patient. Treatment is patient driven, therefore, their strengths, needs, abilities, and preferences should be taken into account. Also, specific populations will face challenges that others do not. There are also different treatment models which can better serve particular populations as well. “Positive psychology and strengths-focused LGBT work is the minority stress model” which addresses “minority status, identity as experienced by LGBT individuals, prejudice, expectations, and concealment” (Lytle, & et al., 2014, p. 336).
In any group that I have facilitated, I try and hear what the patient is really asking for. And, I have always helped teach empowerment and advocacy. Teaching individuals how to ask for what they need, how to go about facilitating change, and accessing resources is vital within the treatment context, as it is in life outside the group. Supporting and promoting patients during this process helps them learn more about themselves, what they want, and encourages their willingness to engage in their treatment. They become more vested in what they believe in. I think that therapists should “promote the health and well-being of individual clients” and teach them the importance of how they matter and how they can exercise their rights, needs, and wants (Kelland, Hoe, McGuire, Yu, Andreoli, & Nixon, 2014, p. 75). Discussion of advocacy includes “advocacy initiatives, learning, and collaboration” (Kelland, & et al., 2014, p. 75).
When providers and patients stop asking questions and become frustrated without being heard, failure and disparities occur. However, when mental health, treatment, and differences are discussed, change can be facilitated to provide health equity. This helps promote “equitable health outcomes for patients, families, and communities” (Andermann, & CLEAR Collaboration, 2016, p. 475). Individuals that feel particular challenges because of sexual orientation, age, sex, gender, or language are social determinants which influence – The World Health Organization (WHO) defines these social determinants of health, “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (Andermann, et al., 2016, p. 476). Therefore, clinicians should acknowledge, support, and refer if necessary – because intervention can start earlier, thereby “broadening the scope of interventions, thus making individuals, families, and communities healthier” (Andermann, & et al., 2016, p. 477).
References
Andermann, A., & CLEAR Collaboration (2016). Taking action on the social determinants of
health in clinical practice: a framework for health professionals. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 188(17-18), E474–E483. https://doi.org/10.1503/cmaj.160177
Kelland, K., Hoe, E., McGuire, M. J., Yu, J., Andreoli, A., & Nixon, S. A. (2014). Excelling in the
role of advocate: a qualitative study exploring advocacy as an essential physiotherapy competency. Physiotherapy Canada. Physiotherapie Canada, 66(1), 74–80. https://doi.org/10.3138/ptc.2013-05
Lytle, M. C., Vaughan, M. D., Rodriguez, E. M., & Shmerler, D. L. (2014). Working with LGBT
individuals: Incorporating positive psychology into training and practice. Psychology of Sexual Orientation and Gender Diversity, 1(4), 335–347. https://doi.org/10.1037/sgd0000064
Kristin C
As a group leader, this writer will have groups with members of all ages, religions, genders, races, SES, languages, and sexual preferences. Although this student has not worked in a counseling setting yet, she can recall a time when her younger cousin struggled with feeling different. As a half Hispanic, half white individual, this writer has many cousins of varying shades of skin. While her father is Ecuadorian and bears a Native American look in color, her mother is fair-skinned and light-eyed. A younger cousin on her father’s side, who is full Ecuadorian, made comments one day when she was around 6 or 7 years old that really took this writer aback. She told this writer, “I want to be white!”, and then turned to this student’s mother and said, “I want to be white and have blue eyes like you”. This was an extremely shocking and disturbing statement for this student to hear out of her young cousin’s mouth, as she never considered that her cousin could be feeling different based on her skin color. Not only was her cousin feeling different because of her darker skin, but she obviously internalized the narrative that light skin is the better skin, and therefore wished to be so. Both this writer and her mother assured her young cousin that she was beautiful the way she was and did not need to change anything about her.

If this student was facilitating a group where others are not accepting of differences she would work to eliminate the bias or prejudice present. Group counselors are ethically responsible to recognize and respect differences among group members, whether that difference is cultural, racial, religious, or lifestyle-related (Berg et al., 2013). While counselors have an ethical responsibility to respect clients and their worldviews, we also have the responsibility to social justice and advocacy. Additionally, if the counselor does not address the prejudice or bias statements by members then it can be perceived as the group leader colluding with the client’s attitudes (MacLeod, 2014). There are a few aspects for the group leader to consider before proceeding such as the group’s goals and if the prejudice is related to the goal, the members’ racial identities, clarifying one’s own motivation and reaction to the prejudice and assessing the members’ motivation for change in this area (MacLeod, 2014). If the bias or prejudicial statements made by members are offensive and abusive, it is the group leader’s responsibility to intervene and cease the verbally abusive or inappropriate comments (Berg et al., 2013). Group counselors are responsible for spreading awareness of the impact of stereotyping and discrimination in order to guard the individual rights and dignity of all group members (Berg et al., 2013). It is not always feasible for counselors to expect clients to resolve all their discriminatory or biased views, but it can be helpful for the group leader to begin a discussion into the origin of the belief and what these beliefs serve for the member in their life. Beginning a discussion regarding prejudicial comments and beliefs for members can be useful for members to begin gaining awareness of their own beliefs, especially if it is evident that a member is affected by such comments. Additionally, the counselor must intervene if the comments are abusive to uphold the ethical duty of nonmaleficence, or preventing harm (Jungers & Gregoire, 2013).
References:
Berg, R. C., Fall, K. A., & Landreth, G. L. (2013). Group Counseling : Concepts and Procedures: Vol. 5th ed. Routledge.
Jungers, C P. L.-S. N., & Jocelyn Gregoire, C. E. L. N. A. (2013). Counseling Ethics : Philosophical and Professional Foundations: Vol. 1st ed. Springer Publishing Company.
MacLeod, B. (2014). Addressing clients’ prejudices in counseling. Retrieved from https://ct.counseling.org/2014/01/addressing-clien…

DQ#2 Specialty Groups
Liz P
Specialty population or topic groups should be facilitated by a clinician who has undergone training to understand the clinical nature of the population being served, as well as the evidence based treatment modality. The provider should be well versed in recognizing symptoms as they manifest, treatment recommendations, resources, and psychological treatments.

Therapists working with a specific populations must be able to “provide their patients with the best possible care or treatment” (Fairburn, & Cooper, 2011, p. 373). This means understanding and providing the most up to date evidence based approach in a “competent manner” (Fairburn, & Cooper, 2011, p. 373). Also, therapists need to “deliver treatment competently, implementing treatment fidelity and treatment integrity” (Fairburn, & Cooper, 2011, p. 373). This means that a professional needs to ‘adhere’ to the most appropriate procedures and that the ‘optimal’ procedures were delivered in a ‘skillful manner’ (Fairburn, & Cooper, 2011). In order implement competence, one must be trained and be well versed in a specific training/modality.
Therapist competence refers to “an attribute of the therapist, not the treatment,” and is defined, “the extent to which a therapist has the knowledge and skill required to deliver a treatment to the standard needed for it to achieve its expected effects” (Fairburn, & Cooper, 2011, p. 374). Also, evidence based practice refers to “clinical practice that is informed by evidence about interventions, clinical expertise, and patient needs, values, and preferences” (Waelde, Thompson, Robinson, & Iwanicki, 2016, p. 624). Findings suggest that increased therapist knowledge and expertise, “increases client trust, improves attitudinal change, and increases engagement” (Beidas, & Kendall, 2010, p. 1).
Specialty groups need facilitators who are able to sustain focus and follow through with an informed philosophy/model in order to maintain well-being (Center for Substance Abuse Treatment, 2014). Therapists engage in a study program that aligns with their interests. This training provides formal education, supervision, and experience which leads itself to counselor competence. The mastery of “clinical skills, targeted learning, knowledge, and treatment proficiency” help provide and promote competency (Center for Substance Abuse Treatment, 2014). Additionally, it is important to note that competency is an on-going concept throughout one’s professional career. In order to remain current in the field, professionals should engage in continued education, trainings, and supervision due to new research and findings about what evidenced based practice is.Differences Within the Group Discussion
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I would like to become certified in trauma seeking safety training. I see an increased need for clinicians who are certified in working with this population. Working with patients struggling with substance use disorders, we see and hear about trauma. This is a population within a population that I need to learn more about.
References
Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A Critical
review of studies from a systems-contextual perspective. Clinical Psychology : a Publication of the Division of Clinical Psychology of the American Psychological Association, 17(1), 1–30. https://doi.org/10.1111/j.1468-2850.2009.01187.x
Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health
Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 2, Building a Trauma-Informed Workforce. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207194/
Fairburn, C. G., & Cooper, Z. (2011). Therapist competence, therapy quality, and therapist
training. Behaviour Research and Therapy, 49(6-7), 373–378. https://doi.org/10.1016/j.brat.2011.03.005
Kristin C
Counseling groups that focus on one particular problem or population are called specialty groups. One specialty group that this writer would be interested in facilitating is a group for adolescents suffering from depression. About two-thirds of adolescents suffer from poor health behaviors and social challenges associated with depression and have a higher risk of suicide (Straub et al., 2014). Additionally, the WHO or World Health Organization deemed depression one of the most debilitating disorders worldwide (Straub et al., 2014). Due to the highly fluid and stressful period of adolescence, it is no wonder that teens struggle with depression. Group therapy is a great avenue to target depression in adolescents as it was found to have advantages over individual therapy. For example, group members are able to learn from one another and give each other feedback (Straub et al., 2013). Therefore, this writer believes this specialty group would be beneficial in helping many struggling adolescents and possibly can help prevent self-harm and suicide.Differences Within the Group Discussion

Ethically, this writer believes that counselors should have specialized training in order to facilitate this type of group. Specialized training is necessary due to the ethical obligations laid out for counselors in the ACA Code of Ethics and the corresponding ASGW for group counseling. The problem of counselor competence permeates every aspect of conducting groups (Jungers & Gregoire, 2013). Competence refers to the need for counselors to only practice within the boundaries of their competence such as their training, education, and credentials (Jungers & Gregoire, 2013). Counselors must always continue to evolve their competence by continuing training and education throughout their careers. Group workers should only practice in areas in which they meet the training criteria established by the ASGW standards (Berg et al., 2013). For this writer’s specialty group, she would be required to have sufficient training and knowledge of depression and conducting adolescent groups to meet the ethical responsibility of competence.
References:
Berg, R. C., Fall, K. A., & Landreth, G. L. (2013). Group Counseling : Concepts and Procedures: Vol. 5th ed. Routledge.
Jungers, C P. L.-S. N., & Jocelyn Gregoire, C. E. L. N. A. (2013). Counseling Ethics : Philosophical and Professional Foundations: Vol. 1st ed. Springer Publishing Company.
Straub, J., Sproeber, N., Plener, P. L., Fegert, J. M., Bonenberger, M., & Koelch, M. G. (2014). A brief cognitive-behavioural group therapy programme for the treatment of depression in adolescent outpatients: A pilot study. Child and Adolescent Psychiatry and Mental Health, 8. https://doi-org.postu.idm.oclc.org/10.1186/1753-20…Differences Within the Group Discussion