The Importance of Adherence to Ethical Principles and Cultural Responsivity in Counselling Group Work

Cultural diversity is a major aspect in group therapy where cultural differences highlight the expression of marginalization and oppression of people outside one’s culture. Considering these elements and building culturally responsive practices is critical to holding progressive group work practice (Chang-Caffaro & Caffaro, 2018). Awareness of one’s own personal biases, prejudices, values, and beliefs work to build a deeper understanding of the importance of inclusive group guidelines and how this influences the dynamics of groups (Ratts et al., 2015). This understanding works synergistically with the ethical guidelines developed by national associations and sections of law relevant to cultural competence by refining the margins of practice. Legal cases therefore act as examples of potential outcomes of circumstances where codes of conduct or guidelines have not been followed and guide ethical considerations (Linde, 2019; Erford, 2018). In more recent times, an adjacent role of social justice advocate has been attached to the group facilitator where a part of the role as a group leader of a multicultural group is to give attention to the experience of each group member, and this can include emphasizing when participates acting unjustly. The facilitation of such dialogue requires a combination of self-awareness, cultural sensitivity, and courage (Chang-Caffaro & Caffaro, 2018). Developing culturally responsive group practices whilst being socially just is to be applied at each stage of group therapy as therapists work with individuals from diverse cultural backgrounds (Lago, 2010). The consideration of the influence of oppression and marginalization on group members and group outcomes, how privilege influences coherence and how cultural aspects impact group members at each level of community inclusion. Laws, codes of conduct, and association guidelines exists as safe boundaries for healthcare workers to work within, to allow safe practice, inclusion, and support for all clients and counsellors and subsequently, lead to enhanced therapeutic outcomes. This essay will discuss the importance of culturally responsive group work, the ethical and legal obligations of group work, and how these factors are applied in practice.

Culturally responsive group practices involve looking at group therapy through the lens of culture; its importance and its intersecting process as it relates to each group member (Moleiro et al., 2018; Erford, 2018). The process of group therapy is primarily determined by the relationship between the group members, and those members with the facilitator. So, a facilitator who prioritizes social justice within a culturally diverse group, will also prioritize successful relationships between group members, and subsequently minimize segregation and oppression (Singh et al., 2012). As more culturally diverse communities evolve, there is a higher demand for specific interventions, and with that, more specific challenges arise (Gladding, 2016). Certain minority groups experience difficulty accessing particular resources, which requires more explicit and culturally competent frameworks in mental health services (Moleiro et al., 2017). This highlights the disparity of social inequalities of mental health resources and presents itself as a social responsibility of healthcare workers to contribute to social justice issues through their modality of aid. Multicultural competence is evident when facilitators (in this case counsellors within group therapy) possess appropriate awareness of themselves and of others, and also the skills and knowledge to work with people from diverse cultural backgrounds (Lago, 2010; Lago, 2016). People are likely to sense their own ethnicity more in group settings compared to individual therapy and real life seems to resemble reality to a greater extent as if a relational microcosm is created between the group members (Gladding, 2016; Chang-Caffaro & Caffaro, 2018; Whittingham, 2018). More defined, multicultural competence asks facilitators to detach from traditional models of intervention and converge with social justice issues to formulate strategies using a more culturally inclusive lens, for example, the complex intersectionality of each individual’s socio-political ramifications (Lewis-Fernandez et al., 2016). A simple adjustment towards a client-centred approach significantly impacts the dynamic construction of the therapeutic relationship both between the facilitator and the group members (Gladding, 2016; Cooper et al., 2017). Cultural diversity is the broader spectrum explanation of the elements which cause the requirements of cultural competence. Having an awareness of issues of privilege and oppression within the group rather than solely focusing on group dynamics or the treatment modality, whilst simultaneously addressing diversity-related concerns brings a cohesion of therapeutic alignment (Erford, 2018; Chang-Caffaro & Caffaro, 2018). Another element to maintain consistent integrity within practice, is more than cultural responsivity in counselling than understanding what it is. Various highlighted ethical principles and sections of law are used to emphasis specific areas of notation which are the reference point for developing inclusive and ethical practices.

Prior to any group formation, there is a critical screening process which is used to ensure the group is dynamic and inclusive. Risk assessments are used to determine whether a person may impact the group negatively or whether two group participants would not work well together. Ethics and law provide a scaffold to build a supportive environment for participants and group leaders. Following the ethical code of conduct under an accredited body clearly outlines how counselling practice can be conducted (Erford, 2018). This critical element develops culturally competent group sessions is the appropriate legislative frameworks. These legal obligations provide structure for governance and accountability and assist the process of decisions and actions of an ethical nature (Linde, 2019; Cottone & Tarvydas, 2021). The National Code of Conduct for Healthcare Workers is the first legislative guideline for developing safe practice. Privacy laws available through the Privacy Act (1988) and more specifically, the Equal Opportunity Act (2010), and the Racial Discrimination Act (1975) provide further support to ensure provisions of healthcare are executed ethically. States and territories also provide their own legislation surrounding access to a safe therapeutic environment for both clients and counsellors (facilitators). Underneath these laws and national codes of conduct are the accredited body and their ethical guidelines. Psychotherapy and Counselling Federation of Australia (PACFA, nd), and Australian Counselling Association (ACA, 2023) are two examples of associations with developed service guidelines and limitations of treatment that can be drawn from when practicing in healthcare services. Guidelines create safety for clients and direction for the practitioner. It also means harm can be minimised if not avoided and cultural sensitivity can be practiced (Corey, 2012). There are many ways to integrate these legal requirements into practice. Formal written consent forms provide clear instructions to group member about the expectation of them and of the facilitators (Cottone & Tarvydas, 2016). Facilitators can display codes of conduct with other resources in the room of the session and provide clear instructions for how to make a complaint or comment about the program. Once the group is formed, providing additional options and services for those who choose not to engage can still be of assistance. By recognising limitations of treatment and referring clients when needed is a part of ethical practice. Allowing those who wish to leave the freedom to make that decision is also a part of ethical practice. Ethical practice is creating a safe and supportive environment for clients to heal at their own pace as they need it.

Working with culturally diverse groups requires specific culturally competent and relevant frameworks (Cottone & Tarvydas, 2016). In considering the necessary elements for group work, one must consider initially what has brought each member of the group to the group, but also the impact of the individual’s complex personality and lived experiences, as they differ within a specific group (Lewis-Fernandez et al., 2016). Though working with groups consists of broad expectations, adding the element of culture will alter these expectations towards the requirements and expectations of that particular group and therefore the facilitator must have an awareness of these expectations and requirements (Moleiro et al., 2017). Corey (2012) notes using techniques of competency, and techniques which are congruent with the group’s purpose. These techniques must reflect the group’s stage of development and must be in the best interests. Items such as having overarching group purposes as well as subgoals and personal goals for group members which they can link with the overarching group purpose (Greif & Knight, 2017). Working from a framework protects the facilitator from potential countertransference. Social justice certainly becomes an element of counselling and psychotherapy where community outreach and distribution of resources adds to the vision of a society with equitable safety and security for all members. In this context, social justice refers to the influences of oppression and privilege as it shapes individuals, groups, and communities (Singh et al., 2012; Erford, 2018). Because social justice often operates at an unconscious level, the addition of social justice within the counselling and psychotherapy realm can contributes to the broader structure of developing multicultural competence (Moleiro et al., 2017). It is likely that authentic relationships will develop between group members shaped by cultural, ethnic, religious, and socioeconomic factor however in group therapy, the facilitator has the ability to use these connections as examples of how sociocultural issues arise within the broader community through relational diversity (Gladding, 2016; Chang-Caffaro & Caffaro, 2018). This would involve a focus on the group dynamic as it relates to privilege and oppression and how the individual’s role within a group context influences the construction of the overall emergence of group identity. Recognising this reality is identifying group differences but for the purpose of addressing intercultural conflict. When it comes to identifying culturally inclusive approaches that can be integrated into multicultural counselling and psychotherapeutic groups, it is less about the type of therapeutic approach and more emphasis on the application of the therapeutic approach. Elements that foster cohesiveness and constructive and productive group dynamics include the application of a particular approach within a given context. The context that the approach is executed is primarily what allows cultural inclusivity.

Initially, this screening process would be implemented to determine appropriate group members, ones that would work coherently together and foster growth within each other. For example, maintaining equal group members from different ethnic backgrounds to ensure subgroups are not formed within the group or that one person may be excluded from others. Ensuring each participant is competent in speaking the language that the course will be delivered in, and that they are aware that there will be people from diverse cultural backgrounds in the group. The screening process is used for one main objective: to conduct a risk assessment of potential group members so there is coherence within the group dynamic and successful completion of the course for all members together. A group facilitator who continually examines their own cultural biases and how they might influence the facilitation of the group will improve their ability to remain emotionally regulated in a dysregulated group setting (Ratts et al., 2015; Champe, Okech, & Rubel, 2013; Toseland & Rivas, 2016; Chang-Caffaro & Caffaro, 2018). Once the group is formed, a set of rules or agreements would be identified so members are aware of the expectations from them including proper behaviour and moral codes of conduct. Following agreements creates safety for clients and direction for the practitioner (Corey, 2012; Cooper et al., 2017). These agreements would consider the practical elements of group work and weave in cultural inclusivity such as attendance, encouragement to take appropriate risks and engage in appropriate self-disclosure, feedback, confidentiality, turn-taking, being culturally sensitive, and taking responsibility for working towards personal goals (Cottone & Tarvydas, 2016; Wheeler & Bertram). By working in close alignment with these agreements, the facilitator fosters cohesiveness and create constructive and productive group environments. Furthermore, developing group agreements with the members of the group act to minimize harmful impacts by assessing the evolving stage of development and healing within the group using techniques in the groups best interest (Corey et al., 2012). It ensures personal goals aligns with the group’s main objective and remains congruent which enhance the competencies of members (Greif & Knight, 2017; Toseland & Rivas, 2016).

Cultural competency is a critical element of assessment when working in group therapy. With diversity impacting almost all areas of counselling practice, the ability to provide therapeutic practices to a variety of individuals in any setting proves to be highly necessary. The primary goal of considering implications of cultural diversity when working in group counselling is to minimize the likelihood of oppression and marginalization of minority group members by other group members. Such practices promote inclusivity and availability of resources for all members of the broader community (Lewis-Fernandez et al., 2016). Adherence to ethical guidelines, codes of conduct and subsections of law, make the process of inclusivity less vague and more structured, allowing counsellors and healthcare professionals to work more confidently within the parameters of the association they choose to align with. These associations aim to support practitioners in practice and in times where ethical dilemmas arise. One element that has only recently impacted the sphere of group therapy practice, is the underlying requirement to provide both counselling support and social justice advocacy. This is because social justice, where it relates to the influence of oppression and privilege within a group setting, impacts the coherence of group members in group therapy. However, though this has not always been a consideration for therapists, it is another element which only enhances multicultural competency within counselling practice. Such considerations are the foundations of modern group therapy frameworks (Moleiro et al., 2018). The ability to discern which people would foster group healing within a culturally diverse group can potentially be the key factor which leads to the success in group therapy. Structuring effective and specific group agreements, adhering to the guidelines and codes of conduct as determined by the specific chosen national association, developing culturally sensitive group objectives, and remaining aware of the nature of diversity will all contribute to the group outcome (Greif & Knight, 2017; Corey, 2012). It will also concomitantly assure that should issues related to social justice, oppression or privilege arise, they are able to be navigated in the most appropriate manner. Cultural diversity exists, and there will always be issues that arise within a culturally diverse context, so having the awareness of this fact but also having the capability to address them will assure culturally sensitive responsivity.

References

Australian Counselling Association. (2023). https://www.theaca.net.au/

Champe, J., Okech, J. E. A., & Rubel, D. (2013). Emotional regulation: Processes, strategies, and applications for group work training and supervision. Journal for Specialists in Group Work, 38, 349-368. DOI: 10.1080/01933922.2013.834403

Change-Caffaro, S. & Caffaro, J. (2018). Differences that make a difference: Diversity and the process group leader. International Journal of Group Therapy, 68, 483-497. https://doi.org/10.1080/00207284.2018.1469958

Cooper, E. J., Hudson, J. S., Kranzberg, M. B., & Motherwell, L. (2017). Current and future challenges in group therapy. International Journal of Group Psychotherapy, 67, S219-S239. DOI: 10.1080/00207284.2016.1238750.

Corey, G. (2012). Theory and practice of group counseling (8th ed.). Brooks/Cole.

Cottone, R. R., & Tarvydas, V. M. (2016). Ethics and decision making in counselling and psychotherapy (4th ed.). Springer Publishing Company.

Cottone, R. R., Tarvydas, V., & Hartley, M. T. (2021). Ethics and decision making in counselling and psychotherapy (5th ed.). Springer.

Erford, B. T. (Ed.). (2018). Group work: Processes and applications, 2nd edition. Taylor & Francis Group.

Equal Opportunity Act (2010)

Gladding, S. T. (2016). Groups: A counselling specialty (7th ed.). Pearson. 

Greif, G. L., & Knight, C. (2017). Group work with populations at risk (Fourth edition. ed.). Oxford University Press.

Lago, C. (2006). Race, culture and counselling: The ongoing challenge, 2nd ed. Open University/Mc.Graw-Hill.

Lago, C. (2010). On developing our empathic capacities to work inter-culturally and inter-ethnically: Attempting a map for personal and professional development. Psychotherapy and Politics International, 8(1), 73-85.

Lewis-Fernandez, R., Aggarwal, N. K., Hinton, L., Hinton, D., & Kirmayer, L. J. (2016). DSM-5 handbook on the cultural formulation interview. American Psychiatric Association.

 Linde, L. E. (2019). Ethical, legal, and professional issues in school counselling. In B. T. Erford (Ed.), Transforming the school counselling profession (5th ed., pp. 188– 225). Pearson. 

Moleiro, C., Freire, J., Pinto, N., & Roberto. (2017). Integrating diversity into therapeutic proesses: The role of individual and cultural diversity competences in promoting equality of care. Counselling and Psychotherapy Research, 18(2), 190-198.

Privacy Act (1988)

Psychotherapy and Counselling Federation of Australia. (nd). https://www.pacfa.org.au/

Racial Discrimination Act (1975).

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural and social justice counselling competencies. Retrieved from: http://www.multiculturalcounseling.org/index.php?option=com_content&view=article&%20id=205:amcd-endorses-multicultural-and-social-justice-counseling-competencies&%20catid=1:latest%20&Itemid=123

Singh, A. A., Merchant, N., Skudrzyk, B., & Ingene, D. (2012). Association for specialist in group work: Multicultural and social justice competence principles for group workers. The Journal for Specialists in Group Work, 37, 312-325. DOI: 10.1080/01933922.2012.721482.

Toseland, R., & Rivas, R. (2016). An introduction to group work practice (8th edition, Global edition.). Pearson Education Limited.

Whittingham, M. (2018). Interpersonal theory and group therapy: Validating the social microcosm. International Journal of Group Psychotherapy, 68(1), 93-98. Doi: 10.1080/00207284.2017.1375345