One of the most important concepts in clinical practice and group work is confidentiality. All members of the group sign an informed consent form in order to address the rules and parameters of the group sessions. The rules regarding confidentiality are stated in one section of the form. Although every member must sign this agreement, ensuring that all information shared in the group remains confidential can be difficult. As the group leader, the clinical social worker is responsible for developing strategies so that all members feel safe to share. For this Discussion, review the “Working With Groups: Latino Patients Living With HIV/AIDS” case study. ATTACHED Post strategies you might prefer to use to ensure confidentiality in a treatment group for individuals living with HIV/AIDS. Describe how informed consent addresses confidentiality in a group setting. How does confidentiality in a group differ from confidentiality in individual counseling? Also, discuss how you would address a breach of confidentiality in the group. . Working With Groups: Latino Patients Living WithHIV/AIDS The support group discussed here was created to address the unique needs of a vulnerable population receiving services at an outpatient interdisciplinary comprehensive care center. The center’s mission was to provide medical and psychosocial services to adult patients living with HIV/AIDS (PLWH). Both patients and providers at the center expressed a need for a group to address the needs of the center’s Latino population. At the time the group was created, 36% of the center’s population identified as Latino, and 25% of this cohort identified Spanish as their primary language. The purpose of the group was twofold: 1) to reduce the social isolation felt by Latino patients at the center and 2) to create a culturally sensitive environment where Latino patients could explore common medical and psychosocial issues faced by PLWH within a cultural context. Planning for the group consisted of 1) defining a format for the group, 2) recruiting appropriate members, and 3) building an appropriate group composition. When considering the format of the group, I thought about structure, time, place, and language. The group was designated a closed group in that new patients were not admitted once the initial membership was determined. The group was held in the center’s conference room, which was furnished with comfortable seating around a large conference table so that members were visible to each other during group sessions. The group met once a week for 90-minute sessions during which 60 minutes were spent on open discussion and the last 30 minutes were spent on having lunch. Given the importance of food in the Latino culture, I thought members would appreciate the opportunity to share a meal with their peers. I decided to designate the group as Spanish-speaking so that all sessions were held in Spanish. This offered members not only a sense of comfort and an opportunity to e ...

1. One of the most important concepts in clinical practice and
group work is confidentiality. All members of the group sign an
informed consent form in order to address the rules and
parameters of the group sessions. The rules regarding
confidentiality are stated in one section of the form. Although
every member must sign this agreement, ensuring that all
information shared in the group remains confidential can be
difficult. As the group leader, the clinical social worker is
responsible for developing strategies so that all members feel
safe to share.
For this Discussion, review the “Working With Groups: Latino
Patients Living With HIV/AIDS” case study. ATTACHED
Post
strategies you might prefer to use to ensure confidentiality in a
treatment group for individuals living with HIV/AIDS. Describe
how informed consent addresses confidentiality in a group
setting. How does confidentiality in a group differ from
confidentiality in individual counseling? Also, discuss how you
would address a breach of confidentiality in the group. .
Working With Groups: Latino Patients Living WithHIV/AIDS
The support group discussed here was created to address the
unique needs of a vulnerable population receiving services at an
outpatient interdisciplinary comprehensive care center. The
center’s mission was to provide medical and psychosocial
services to adult patients living with HIV/AIDS (PLWH). Both
patients and providers at the center expressed a need for a group

2. to address the needs of the center’s Latino population. At the
time the group was created, 36% of the center’s population
identified as Latino, and 25% of this cohort identified Spanish
as their primary language. The purpose of the group was
twofold: 1) to reduce the social isolation felt by Latino patients
at the center and 2) to create a culturally sensitive environment
where Latino patients could explore common medical and
psychosocial issues faced by PLWH within a cultural context.
Planning for the group consisted of 1) defining a format for the
group, 2) recruiting appropriate members, and 3) building an
appropriate group composition. When considering the format of
the group, I thought about structure, time, place, and language.
The group was designated a closed group in that new patients
were not admitted once the initial membership was determined.
The group was held in the center’s conference room, which was
furnished with comfortable seating around a large conference
table so that members were visible to each other during group
sessions. The group met once a week for 90-minute sessions
during which 60 minutes were spent on open discussion and the
last 30 minutes were spent on having lunch. Given the
importance of food in the Latino culture, I thought members
would appreciate the opportunity to share a meal with their
peers. I decided to designate the group as Spanish-speaking so
that all sessions were held in Spanish. This offered members not
only a sense of comfort and an opportunity to explore issues in
their native tongue, but it also addressed the langua ge barrier
that often isolates Latino PLWH.
I used several strategies to recruit members. I hung flyers
throughout the center, and I informed my colleagues about the
group during interdisciplinary staff meetings. Referrals
ultimately came from physicians, social workers, and even
administrative staff who had developed relationships with
patients at the center. When considering group composition, I
focused on creating balance in group size and the characteristics

3. of individual members. I worked to create a group with enough
members so that discussions would be fruitful and differing
opinions could be presented, but at the same time, individual
members would have an opportunity to discuss their unique
feelings, thoughts, and opinions. When it came to member
characteristics, I strove to create a balance between
homogeneity and heterogeneity across such domains as age, sex,
sexual orientation, socioeconomic status, etc. The goal was to
create a group where no member felt isolated by uniqueness
while simultaneously promoting diversity between members.
Prior to being admitted to the group, potential members were
interviewed/screened in person or by phone. The focus of these
interviews was to 1) assess the patient’s ability to communicate
in Spanish, 2) describe the purpose of the group, 3) discuss
individual expectations for the group, and 4) answer questions
about group process and function. A total of 15 patients were
referred. Four declined to participate before the group started
and two did not show up after the first session. Of the remaining
nine members, three were women and six were men. All of the
men had a significant history of intravenous drug use (IVDU).
Two of the men identified as gay, one identified as bisexual,
and three considered themselves to be heterosexual. All of the
women were heterosexual, identified a risk factor of
unprotected heterosexual sex, and denied a history of IVDU.
Members’ ages ranged from 36 to 60.
The group ran successfully for 18 months. Throughout the life
of the group, several recurrent themes were discussed, including
1) stigma of HIV and homosexuality, 2) disclosure of HIV
status, 3) safer sex practices, 4) adherence to HIV treatment,
and 5) the doctor–patient relationship. Each of these themes was
discussed within a cultural context giving light to issues such as
familialism, collectivism,
simpatia, machismo
(gender roles), and Latino culture’s tendency to rely on a folk
model of medicine.

4. As in most groups, certain members adopted roles within the
group. For example, Anna, a 46-year-old female member,
adopted the role of the “silent member.” She repeatedly came to
sessions and sat in silence, only responding when she was
prompted by direct questions from me or other members. The
challenge with Anna was that as this behavior continued, other
members tended to ignore her and leave her out of the
discussion. In turn, it became my role to try to engage Anna as
much as possible and draw her into the discussion. Another
example is Diego, a 60-year-old male, who adopted the role of
the “help-rejecting complainer.” Throughout group sessions,
Diego repeatedly presented a problem or issue and engaged the
entire group by asking for help. When members responded with
suggestions or solutions, he came up with a myriad of excuses
why none of them would work. I will admit I was not successful
at altering Diego’s behavior in any way. I attempted to point out
the pattern, and I tried to ask other members how it felt to
constantly have their input rejected, but nothing seemed to
work. Group members did express frustration and boredom with
Diego. This was manifested in their body language and during
group sessions when Diego was not present. When members
spoke about Diego in his absence, I always encouraged them to
bring these issues to his attention when he was present, but
members were not able to do this because they were fearful of
hurting his feelings.
Ultimately, the group served as an arena for mutual support and
commonality. Group members forged relationships with peers
with whom they would not have had contact in the absence of
the group. They also had the opportunity to reflect on their
illness and personal experiences within a safe and culturally
sensitive environment. While a scientific evaluation of the
group was not performed, I witnessed and members reported
positive outcomes from the experience.