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This discussion focusses on the explanation of legal and ethical considerations of providing therapy to an individual and to a group or family. It also addresses the differences between these issues and their influence on the provisions of therapy by me to individuals and to groups as an advanced practice nurse.
As an advanced practice nurse, we have responsibilities that uphold our standards in the provision of care to our clients. Care is not only in the form of medication administration but in therapy as well. According to the American Nurses Association (2014), the advanced practice nurse organizes community resources for individual patients, or groups to have care that they do desire. Psychotherapy is care. Wheeler (2014), explained that psychodynamic therapy helps individuals to live a more satisfying and useful life, it helps them to make more conscious decisions and could be done individually and in groups. These approaches have ethical and moral considerations that govern them. For individual therapy, Garrison & Eckstein (2013), explained that informed consent is one ethical consideration that should be sought, and it does not only take place at the start of the therapeutic process but continues throughout therapy. This is true because the therapeutic process is a continuum. The patient has the right to choose whether they need the counseling, they need to have knowledge of the process and the counselor. Sori and Hecker, (2015), supported the need for informed consent and stated that information gathered in counseling should be kept private, and the only time they are not is when there is the duty to protect and issues of abuse and neglect. They went on to explain that, in group counseling, there is also the issue of confidentiality, informed consent, sharing of information and court requested documents that are to be presented when needed (Sori and Hecker, 2015). There is always a difficulty in working with groups than with individuals because with families, for instance, there are certain information that could be disclosed to the counselor by a member of the group that they may not want others to know, it is, therefore, the responsibility of the therapist to know the legal implications of maintaining that information as long as it is not in the category of duty to report such as harm or neglect. In individual counseling, confidentiality is a problem, but it is more of a problem in group counseling because in the group you have various individuals and there is no guaranty that what is being discussed or talk about will be kept as confidential by every member of the group (McClanahan, 2014).
Having outlined these differences here in this presentation, as a practitioner, I will be cognizance of the legal and ethical implication of my practice that when I am counseling groups and families, I will maintain confidentiality among them especially with children and adolescents. The Health insurance and Portability Act (HIPAA), Cited in Sori and Hecker, (2014), explained that parents have the right to their children’s health records and gave the exception of this being the psychotherapy notes of the child.
