Substance abuse: causes, effects, and treatment approaches

¶ … High-Risk Population for Group Therapy-Substance Abuse/Addiction

One high-risk population that has been pinpointed when it comes to engaging in therapy with substance abuse are Hispanic and Latino women. "The pattern of illicit drug use among Hispanics/Latinas is influenced by level of acculturation and country of origin. In one study based on the Hispanic Health and Nutrition Examination Survey (HHANES) data, illicit drug use among Hispanics/Latinas generally increased with acculturation (Amaro et al. 1990)" (CSAT, 2009). This research found that overwhelmingly, women from this population were more at risk for opiate use. Another factor which made individuals from these groups more at risk was the socioeconomic status, age and period of time they had lived in the U.S. From this specific group, the most significant risk for substance abuse was the age of when the woman immigrated to the U.S.: this means that the earlier a woman immigrated to the U.S., such as before the age of seven, the more at risk she was for developing a substance abuse habit (CSAT, 2009). A lower socioeconomic class, pronounced unemployment and lower levels of education were all predictors of alcohol consumption and substance abuse (CSAT, 2009). "In a study evaluating racial/ethnic differences among women with co-occurring mental and substance use disorders, Hispanic/Latina women possessed significant social vulnerability characterized by lower socioeconomic and educational status, exposure to violent crimes, and higher rates of criminal justice involvement" (Amaro et al. 2005). These are all factors that a particular substance abuse counselor needs to be aware of before engaging in group therapy with a given population. This can't help but provide the counselor or other professional with a stronger sense of the background of this particular group along with a more accurate snapshot of their needs.

Explain two ethical and two legal considerations in treating this population in group therapy

One of the two legal considerations that needs to be upheld is the obligation to uphold confidentiality to all members of the group. "The group leader is bound by the usual rules of confidentiality in the group as in any other clinical encounter with a patient. With the exception of a threat to a person or persons, this confidentiality holds and is usually elaborated on in the code of ethics of the therapist's professional organization" (Stern et al., 2013). This is indeed an aggravated issue at times in a group setting as the therapist often can't control the things that certain group members say or do outside of the therapy setting. Another ethical responsibility is known as the legal duty to warn. "Legal duty to warn was established in the case of Tarasoff v. Regents of the University of California (1976), where a therapist failed to inform a young woman and her parents of specific death threats made by a client. The young woman was subsequently killed and her family sued the therapy provider" (Cheery, 2013). The patient needs to be informed of this risk and possibility at the beginning, as do all members of the group.

Ethical responsibilities in group therapy are also setting the tone of the group and how members can and cannot speak to one another. Observations about group behavior need to be stated tentatively, rather than dogmatically: members who are behaving in a difficult fashion need to be told how their behavior is affecting others (uidaho.edu). The group leader needs to establish that honesty is the only form of accepted currency and that the group leader will engage in honesty, and that all others are expected to follow suit.

Explain how you might address these considerations as a group therapist

Addressing these considerations as a therapist largely revolves around setting a strong example, stating explicitly and clearly what the expectations are for care and for behavior within the group therapy circle. These expectations need to not only be expressly stated, but the therapist needs to be prepared to also enforce that they be respected. It's the enforcement of these standards which is the most essential aspect of what the therapist does.

Explain how ethical and/or legal considerations might differ for this group if the treatment setting was inpatient vs. outpatient