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Ethical Issues in Group Work: What Are They? How AreThey Managed?Joanne Gumpert DSW a & Phyllis N. Black DSW ba Lehigh Valley Extension, School of Social Work, Marywood University , Scranton, PA, 18509E-mail:b Lehigh Valley Extension, School of Social Work, Marywood University , Scranton, PA, 18509E-mail:Published online: 08 Sep 2008.
To cite this article: Joanne Gumpert DSW & Phyllis N. Black DSW (2006) Ethical Issues in Group Work: What Are They? HowAre They Managed?, Social Work With Groups, 29:4, 61-74, DOI: 10.1300/J009v29n04_05
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Ethical Issues in Group Work:What Are They?
How Are They Managed?
Joanne GumpertPhyllis N. Black
ABSTRACT. Professional codes of ethics offer little direction for grouppractitioners. The article reports the findings of a study which queried so-cial group work practitioners. Several ethical issues unique to group prac-tice are identified. The frequencies with which specific issues are facedand those resources utilized to manage the dilemmas are identified. Im-plications for professional codes of ethics are discussed. doi:10.1300/J009v29n04_05 [Article copies available for a fee from The Haworth Docu-ment Delivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website: <http://www.HaworthPress.com> © 2006 by TheHaworth Press, Inc. All rights reserved.]
KEYWORDS. Ethical issues, group work, group practice, ethical di-lemmas
INTRODUCTION
An increasing number of social work practitioners use group workwith their clients (Congress, 1999; Henry, 1992). Although a significantbody of literature on social work with groups has emerged (see e.g.,
Joanne Gumpert, DSW (E-mail: [email protected]), is Associate Professor,and Phyllis N. Black, DSW (E-mail: [email protected]), is Professor and Direc-tor, Lehigh Valley Extension, School of Social Work, Marywood University,Scranton, PA 18509.
Social Work with Groups, Vol. 29(4) 2006Available online at http://swg.haworthpress.com
© 2006 by The Haworth Press, Inc. All rights reserved.doi:10.1300/J009v29n04_05 61
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Anderson, 1997; Garvin, 1997; Glassman and Kates, 1990; Henry, 1992;Northen and Kurland, 2001; Shulman, 1999), minimal attention has beenpaid to ethical challenges in group work (Abels, 2001; Loewenberg, Dol-goff and Harrington, 2000; Gambrill and Pruger, 1997; Reamer, 1998;Rothman, 1998).
Social work with groups is a complex, multi-leveled practice modalitythat requires assessment and intervention of interactions among groupmembers, each group member and the worker, each member and thegroup as a whole, and the group and the worker. At a minimum, the grouppractitioner must have a broad perspective and knowledge and skills tointervene in relation to many levels within the group process. Given thecomplexity of group practice, it is logical that ethical issues and dilemmasunique to group process might arise.
LITERATURE REVIEW
Over the last decade, literature has increasingly pointed to the lackof attention to ethical principles, issues and dilemmas related to socialwork practice with groups. Dolgoff and Skolnik (1992) identified ethi-cal issues related to group practice and questioning the relevancy of theNASW Code of Ethics to group practice. These authors documented theprimacy of practice wisdom (80%) as compared to the NASW Code(38%) used in ethical decision making by a population of group practi-tioners (Dolgoff and Skolnik, 1996). Northen (1998) highlighted theomission of “democracy,” a hallmark of social group work, as one ofthe profession’s core values in the recently revised 1996 NASW Codeof Ethics. The author noted that only two of the 51 ethical standards re-late specifically to group practice. Ethical issues and guidelines forwork with task groups were identified (Congress and Lynn, 1997) andfurther developed (Congress, 1999). A recently published text on socialwork with groups (Northen and Kurland, 2001) makes specific note ofthe scant attention paid to the application of ethical principles to grouppractice (p. 17) and makes many methodological connections to ethicalissues and principles throughout the volume.
Initiating an exploration of ethical issues specifically related to grouppractice, Northen (2004) selected group relationships, multiculturalism,empowerment, confidentiality, self-determination and professional com-petence for discussion. The author identified dignity and worth, socialjustice, and mutual responsibility as the major values underpinninggroup practice and brought into clear focus the crucial importance of
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relationships among group members related to ethical issues and dilem-mas that can arise in this practice arena.
Potential ethical issues are identified in the existing social groupwork literature:
1. Worker honesty and integrity (consistently providing honest in-formation to group members about difficult topics),
2. Access to service (providing some type of service for those not in-cluded in the group service during the group formation phase),
3. Informed consent (providing complete information about the po-tential limitations and possible negative effects of group member-ship),
4. Conflicts between agency policy and needs of members (agencypolicies which interfere with group functioning, autonomy or de-cision making),
5. Limits of confidentiality (worker’s inability to assure confidenti-ality from other group members),
6. Self-determination (possible influence of group on individual de-cision making),
7. Appropriate termination (agency discharge of client before termi-nation with group can be accomplished),
8. Professional competence (workers entering into group practicewithout education or training in work with groups),
9. Conflicts between group and societal norms (working with groupswhose norms are counter to those of society as a whole) (Dolgoff andSkolnik, 1992, 1996; Northen, 1998; Congress and Lynn, 1997;Congress, 1999; Northen and Kurland, 2001; Northen, 2004).
An additional review of group psychotherapy literature revealed an ad-ditional number of scattered references to ethical considerations inher-ent in work with groups:
1. Negative power of groups over individuals,2. Limits of confidentiality,3. Good of the group versus good of the individual,4. Unresolved conflicts between co-workers influencing group process,5. Double message of providing group therapy to help members de-
velop lasting relationships but not allowing members to socialize to-gether outside of group meetings (American Group PsychotherapyAssociation, 1989; Glass, as cited in Anderson and Needels, 1998;Haeseler, 1992).
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The extent to which group practitioners experience ethical challenges,however, has not been systematically explored (Dolgoff and Skolnik,1996). The NASW Code of Ethics is intended to “guide the everyday pro-fessional conduct of social workers” (NASW, 1996, p. 1). The fact thatonly two of the many tenets comprising the Code address ethical issuesthat are unique to social group work, prompts the question whether theCode is adequate to meet the needs of practitioners who use this modality.
PURPOSE
This study was undertaken to identify ethical issues reported by groupwork practitioners as germane to social group work and to determine re-sources used for addressing the issues. A related issue concerned theperceived level of adequacy of the NASW/Canadian Code of Ethics inguiding group work practice.
METHODOLOGY
A two-tiered qualitative/quantitative methodology was used. The qua-litative component of the study consisted of two focus groups; one wascomprised of members of a regional chapter of the Association for theAdvancement of Social Work with Groups (AASWG) in a metropolitanarea and a second of experienced group practitioners in rural New Eng-land. The focus group respondents were asked to reflect on their experi-ences with ethical issues in their work with groups, how they dealt withthese issues and what resources were employed to discern resolutions.The qualitative data, emerging from the focus groups, were then used toinform an author-designed inventory for the quantitative investigation.The inventory, an anonymous, self-administered survey, was mailed toa systematic random sample (N = 350) of the AASWG American andCanadian 2003 membership. In addition to demographic informationand group work experience, respondents were asked to rate the extent towhich a series of ethical concerns gleaned from the focus groups andsocial work and group therapy literature were pertinent to their practice;space was provided for write-in issues not included in the series. Theinventory also queried worker management of the identified ethical is-sues, with particular reference to the extent to which the NASW Code ofEthics or Canadian counterpart serves as an effective guide for socialgroup work practice. Finally, respondents were asked what other ethical
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tenets, if any, might be added to the Code, or whether a specific groupwork code should be initiated to more effectively serve the needs ofgroup practitioners. In addition to the first mailing of the inventory, afollow-up postcard encouraging return of the survey was sent to all po-tential respondents.
INVENTORY RESULTS
Return Rate. Of the 350 surveys that were mailed, 14 were returned asaddressee unknown or undeliverable. An additional eight were deemedunusable because of incomplete responses, leaving a final count of 90(return rate, 27%) completed inventories for analysis.
Sample Description. The preponderance of respondents were U.S.members (86%; f = 75) (Table 1). Eighty percent were female (f = 71),and the mean age of across all respondents was 51 with a range of 25 to85 years (SD = 13.3). In terms of educational background, three-quar-ters (f = 66) earned a master’s degree in social work, while approxi-mately one-quarter (f = 21) held a doctorate. The average number ofyears since receiving the terminal degree was 15, with a range of sixmonths to 55 years (SD = 11.7). The respondents reported a mean of 21years of social work experience with a range of six months to 60 years(SD = 13.6). With respect to current work responsibility, approximatelyone-half (f = 44) characterized themselves as practitioners and 28% (f =25) as educators.
Ethics Training. Respondents were queried about the extent of trainingthey had received in ethics at the undergraduate, graduate and postgra-duate level (continuing education), respectively. These three separate tra-ining indices were aggregated to form an overall ethics training measure.The majority of the respondents characterized their level of ethics train-ing as minimal (64%; f = 56) with 33% (f = 29) assigning themselves tothe moderate category and (2%; f = 2) extensive.
Training and Experience in Social Group Work: Similar to the ethicsbackground training index, three separate categories (undergraduate, grad-uate and postgraduate) of social group work training were combinedto create a composite indicator of extent of social group work training.The majority of respondents rated themselves as having had moderatetraining in work with groups (55%; f = 49) with 11% (f = 10) reportingextensive experience and the remaining one/third at the minimal level(31%; f = 28). Slightly less than one/half (46%; f = 39) indicated thatthey had specialized or concentrated in group work in their social work
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education curriculum. Eighty-seven percent (f = 77) described their ex-perience in work with groups as moderate or extensive, and 72% (f = 63)are currently actively involved in group work practice. The average num-ber of groups with which respondents typically work is approximatelythree per week with a range of 0 to 12 (SD = 2.5).
66 SOCIAL WORK WITH GROUPS
TABLE 1. Demographic and Employment Characteristics of Sample
Sex (N = 88*) ƒ %Female 71 80.68Male 17 19.32Education (N = 88*)BSW 1 1.14MSW 66 75.00Doctorate 21 23.86Primary Job Responsibility (N = 89*)Direct Practitioner 44 49.44Educator 25 28.09Other 20 22.47Country (N = 87*)U.S.A 75 86.21Canada 12 13.79Practice Region (N = 70*)Urban 31 44.3Suburban 21 30.0Rural 18 25.7
Age (N = 88*)Mean 50.68Median 51.50Range 25-85SD 13.3Years Since Graduation with Highest Degree (N = 69*)Mean 14.58Median 12.00Range .5-55SD 11.68Years of Social Work Experience (N = 84*)Mean 20.77Median 22.50Range .5-60SD 13.62
*N refers to number that responded to these items which is less than the total N of 90.
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Field of Practice, Work Setting and Types of Groups. The respondentsindicated a spectrum of settings in which they practiced group work.More than 20 different venues were identified, with mental health desig-nated as the most prevalent, followed by higher education, community,health care facilities and school settings. Work with groups occurred inurban, suburban, small community and rural locals with urban the mostfrequent. A range of group work configurations and types were reported,including closed (f = 67) or open-ended (f = 73), natural (f = 27) or formed(f = 47), short (f = 66) or long-term (f = 56), and solo-led (f = 65) or co-ledgroups (f = 74). With respect to group membership, clients (f = 83), clientrelatives (f = 33), committee members (f = 41), agency staff (f = 55), andstudents (f = 52) comprised the most frequently reported group partici-pants. The primary focus of the groups with which the respondentsworked included, in descending order of frequency, growth/enhance-ment, support/mutual aid, education, therapy, task-oriented, supervi-sion and management.
The respondents were queried regarding the theoretical or practicemodel that they used to guide their work with groups. Seventy-nine per-cent (f = 71) of sample members responded to this question by citing arange of theories and/or practice models including Schwartz/Shulman,eclectic, Yalom, empowerment, cognitive therapy, strengths-based, psy-chodynamic, and gestalt. The modal response referenced the Schwartz/Shulman model (33%; f = 23), also referred to by the respondents as re-ciprocal, mediating, interactional, and mutual aid model.
ETHICAL ISSUES GERMANE TO SOCIAL WORKWITH GROUPS
Respondents were presented with a list of 17 ethical issues (see Table 2)thought to be relevant to work with groups that were taken from the lit-erature, as well as from the focus group participants. Respondents werethen asked to rate the frequency with which they have confronted eachof these issues in their group practice, using a four-point Likert scale,with 4 representing very often, 3–some of the time, 2–a little of the timeand 1–none of the time. Overall, each of the ethical issues, with somevariation in prevalence, was perceived as occurring in the group experi-ences of the respondents. Twenty-five percent of all the responses by theparticipants were designated as 3 (some of the time) or 4 (very often). Aranking of the ethical issues in descending order, from most frequently
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confronted to least frequent, appears in Table 2. At the top of the list isthe issue concerning communication among group members outsidegroup meetings, with a mean rating of 2.86 (SD .84). Sixty-one percent(f = 49) of 80 respondents who completed this item rated its frequencybetween 3 (some of the time) and 4 (very often). Conflict between bestinterest of the group and best interest of the individual member emergedas the second most commonly cited ethical issue (mean 2.40; SD .73)with 47% (f = 40) of the 84 respondents characterizing the issue as either3 or 4. Conflicts between group norms and values and those of society
68 SOCIAL WORK WITH GROUPS
TABLE 2. Respondents’ Perception of Relevance of Ethical Issues in Workwith Groups Presented in Descending Order of Frequency
Ethical Issue Mean Score SD Rank*
Communication among group members outside groupmeetings
2.86 .88 1
Conflict between best interest of group and best interest ofindividual member
2.40 .73 2
Conflict between group norms and values and those ofsociety
2.36 .95 3
Unanticipated termination of a group member 2.31 .82 4
Conflict between agency policy and best interest ofgroup/group member
2.26 .89 5
Breaches of confidentiality by group members 2.23 .84 6
Conflicts between member independence and inter-dependence among group members
2.12 .81 7
Undemocratic group decision-making 2.04 .84 8
Professional incompetence of worker 2.04 .84 8
Problems between co-workers that interfere with groupprocess
1.92 .79 10
Denial of service by excluding potential members duringgroup formation
1.63 .73 11
Physical contact among members or between worker andmembers
1.62 .73 12
Placement of identifying material about other groupmembers in a member’s chart
1.58 .90 13
Worker’s lack of honesty with group members 1.56 .63 14
Termination of service by requesting member removal fromgroup
1.53 .57 15
Lack of informed consent of group members 1.41 .72 16
Unanticipated termination of group 1.40 .62 17
*The rank of 1 is assigned the issue with the highest frequency.
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ranked 3rd (mean 2.36; SD .95), followed by unanticipated terminationof a group member (mean 2.31; SD .82) and conflicts between agencypolicy and best interest of the group or member (mean 2.26; SD .89). Atthe lower end of the ranking (rank 16 and 17, respectively) were lack ofinformed consent of group members (mean 1.41; SD .72) (mean 1.40;SD .62) and unanticipated termination of the group (mean 1.40; SD.62). Respondents were invited to write-in ethical issues which theydeemed pertinent that were not already included on the list of 17 issues.Twenty-two respondents (24%) offered additional ethical challenges.Many of the suggestions represented reiterations of existing issues andsome were duplicative or each other. Several new issues, however, didemerge including, insufficient group sessions assigned to meet clientneeds based on external constraints such as insurance limits, groupmembers expression of prejudice and discrimination, value conflictsbetween worker and group members, and parental request for informa-tion regarding their children’s group therapy.
MANAGEMENT RESOURCES FOR ADDRESSINGETHICAL CHALLENGES
Respondents were asked to indicate the primary means that they re-lied on for resolving ethical issues in their group practice. Table 3 pre-sents a hierarchical list of resolution resources from the most to the leastfrequently used. Eighty-percent of the respondents (f = 72) reportedpractice wisdom/previous experience as the modal ethical resolution
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TABLE 3. Resources Used by Respondents to Address Ethical Issues in TheirGroup Practice in Descending Order of Frequency
Resource ƒ* %
Practice wisdom/previous experience 72 80.00
Social work peers 66 73.00
Social Work Code(s) of Ethics 62 68.88
Supervision 58 64.44
Gut feeling/intuition 53 58.89
Agency/institution policy manua 42 46.67
Books, journal articles, other social work publications 36 40.00
Ethics Committee 10 11.11
*ƒ exceeds sample size because respondents could select more than one resource.
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management source. This was followed by social work peers (73%; f =66) and Social Work Codes of Ethics (69%; f = 62). In this latter con-text, the most referenced code of ethics was the NASW Code. Whenqueried as to the extent to which respondents refer to an ethical code, forguidance regarding ethical perplexities, two-thirds reported that theyconsulted ethical codes either not at all (13%; f = 12) or a little (54%; f =46). A similar two-thirds of the respondent pool described the ethicalcodes as “not at all” or as “a little helpful” (14%; f = 12. 54%; f = 46) inaddressing ethical challenges in group work.
Respondents were asked to designate which on the list of 17 groupwork relevant ethical issues were deemed to be insufficiently addressed incurrent ethical codes. Each of the 17 ethical issues were identified by somemembers of the sample as inadequate in their coverage in current socialwork codes of ethics. In descending order of prevalence (see Table 4),communication among group members outside group meetings andconflicts between agency policy and the best interest of the group ormember tied for first place (36%; f = 32). These were closely followedby a second tied pair, breaches of confidentiality by group members andprofessional incompetence of worker (34%; f = 31).
A final item on the inventory concerned respondent suggestions as tohow ethical codes might best address ethical issues pertaining to groups.As shown in Figure 1, the highest percentage of respondents favoredadding supplemental ethical standards to existing codes (43%; f = 35)with a second cohort recommending a separate ethical code specificallyfor social group work practice (38%; f = 31) and the remaining smallcluster of 15 (19%) reported that the existing codes adequately addressethical challenges in group practice.
DISCUSSION
The sample was composed of a well-seasoned group of social workpractitioners and educators with minimal formal training in ethical is-sues, and moderate to extensive background in work with groups. Thesesocial workers reported having practiced in a varied array of settings,with the spectrum of group configurations and group purposes. Althoughthe relatively low survey return rate and the self-selected nature of thesample preclude generalizability of the findings beyond the parameterof the sample responses, the breadth and depth of the group work expe-rience of the respondents lends credence to the findings.
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Analysis of the data suggest a modicum of consensus confirming the17 ethical issues identified in the literature and from the focus groupmembers as germane to the practice of social work with groups. Each ofthe 17 ethical issues was designated, with varying prevalence, as confront-ing the cohort of respondents. These data support the notion that there is aset of ethical issues that are specific to the group modality of practice.
Practice wisdom/previous experience was most frequently reportedas the primary mode for managing ethical matters. This is compatiblewith previous studies which similarly report respondent reliance on
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TABLE 4. Ethical Issues Deemed Insufficiently Addressed in Ethical Codes inDescending Order of Frequency
Ethical Issue ƒ % Rank*
Communication among group members outsidegroup meetings
32 35.55 1
Conflict between agency policy and best interest ofgroup/group member
32 35.55 1
Breaches of confidentiality by group members 31 34.44 3
Professional incompetence of worker 31 34.44 3
Conflict between best interest of group and Best interest ofindividual member
29 32.22 5
Problems between co-workers that interfere withgroup process
28 31.11 6
Conflict between group norms and values and those ofsociety
.24 26.67 7
Denial of service by excluding potential membersduring group formation
23 25.56 8
Placement of identifying material about Othergroup members in a member’s chart
22 24.44 9
Conflicts between member independence andinterdependence among group members
20 22.22 10
Undemocratic group decision-making 18 20.00 11
Unanticipated termination of group 17 18.89 12
Worker’s lack of honesty with group members 16 17.78 13
Unanticipated termination of a group member 16 17.78 13
Physical contact among members or betweenworker and members
15 16.67 15
Termination of service by requesting memberremoval from group
14 15.56 16
Lack of informed consent of group members 14 15.56 16
*The rank of 1 is assigned the issue with the highest frequency
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personal experience for addressing ethical perplexities (Dolgoff and Skol-nik, 1996). There was agreement that the NASW Code of Ethics fallsshort as a guide for group practice. All of the 17 ethical issues were iden-tified, with varying degrees of frequency, as receiving insufficient cov-erage in extant ethical codes. Respondents, however, were equivocalregarding how to upgrade ethical standards for group work, with some fa-voring the addition of group specific tenets to the NASW Code and oth-ers recommending a separate code. These findings point to the need forincreased attention to ethical issues as they relate to group work, both inthe practice arena as well as in the educational curricula of schools ofsocial work. Northen’s (2004) identification of underlying values andspecific issues and dilemmas provides direction for further analysis.Studies focused on how practitioners deal with specific ethical prob-lems would expand our knowledge in this area.
Although knowledge of group process was included in Bartlett’s groundbreaking Working Definition of Social Work Practice almost a half cen-tury ago (Bartlette, 1958) only two standards of 51 in the currently usedNASW Code of Ethics pertain to group practice. The absence of “de-mocracy” within the Code’s values and the dearth of attention to grouppractice issues in the principles and standards (Northen, 1994) joins the
72 SOCIAL WORK WITH GROUPS
Code of Ethics: Adequate for Group Work? (N=90)
40
35
30
25
20
15
10
5
0
19%
43%
38%
Current Code Adequate Add Supplementary Tenets Separate Code for Group Work
FIGURE 1. Code of Ethics: Adequatevfor Group Work? (N = 90)
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lack of group practice curricula in graduate social work education(Birnbaum and Auerback, 1994) to attest to the neglect of this practicemodality by the profession. The frequency of this study’s findings of con-flict between agency policy and best interest of the group may also con-firm this neglect.
The frequent identification of “Communication among group mem-bers outside of group meetings” as an ethical issue by practitionerswho identify themselves as social group workers is a curious finding.Such responses may support research findings on the use of grouppractice texts in schools of social work that are written by psycholo-gists rather than professional social workers (Birnbaum and Wayne,2000). Although not totally embraced by social group workers, theearly identification of a social group work model (Papell and Rothman,1996) states encouragement of interaction outside of group meetings asa principle of social work practice with groups. Another explanationfor these results may reflect the findings of Birnbaum and Wayne(2000) that while professionals assigned themselves high self-ratingin teaching practice, they were unable to identify key concepts ingroup work. Perhaps, although practitioners and educators view them-selves as knowledgeable about ethical issues in group practice, theirfamiliarity with the group practice modality from a related professionlimits their ability to identify ethical issues within social group work.
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MANUSCRIPT RECEIVED: 10/20/05MANUSCRIPT REVISED: 01/12/06
MANUSCRIPT ACCEPTED: 01/12/06
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