THE EFFECTS OF TOP MANAGEMENT SUPPORT ON STRATEGIC INFORMATION SYSTEMS PLANNING SUCCESS by Gerald Elysee APIWAN D. BORN, Ph.D., Faculty Mentor and Chair H. PERRIN GARSOMBKE, Ph.D., Committee Member TAMIR BECHOR, Ph.D., Committee Member William Reed, Ph.D., Dean, School of Business and Technology A Dissertation Presented in Partial Fulfillment Of the Requirements for the Degree Doctor of Philosophy Capella University April 2012 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent on the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. All rights reserved. This edition of the work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 - 1346 UMI 3505727 Copyright 2012 by ProQuest LLC. UMI Number: 3505727 © Gerald Elysee, 2012 Abstract The success of strategic information systems planning (SISP) is of paramount importance to academics as well as practitioners. SISP is a management process that enables organizations to successfully harness the power of current- and next-generation information systems (IS) applications to fulfill their business goals. Hence, by capturing the major constructs that can influence SISP success, the SISP theory has made significant contribution to research and practice. However, the literature shows that, despite this important contribution, the SISP theory has only been used to a limited extent. Aiming to address this scarcity of SISP theory utilization, this study developed a research model that integrates four constructs derived in large part from the SISP theory. The four constructs are: (a) the extent of top management support, (b) the usefulness of the information systems plan, (c) the degree of Information technology infrastructure flexibility, and (d) the degree of SISP success. Based on the contingency theory, the usefulness of the information systems plan (ISP) and the IT infrastructure flexibility (ITIF) were examined as two conditions that can mediate the effects of top management support on SISP success. Data analysis was conducted using Partial Least Squares, which is a type of structural equation modeling that accommodates small sample sizes. From a sample of 57 information systems executives from US organizations, support was found for the hypothesis that top management support has a direct, positive, and significant effect on SISP success. Also supported are the hypotheses that top management support has a significant effect on the usefulness of the ISP, which in turn has a similar effect on SISP success. By contrast, support was not found for the hypotheses that top management su.

1. THE EFFECTS OF TOP MANAGEMENT SUPPORT ON
STRATEGIC
INFORMATION SYSTEMS PLANNING SUCCESS
by
Gerald Elysee
APIWAN D. BORN, Ph.D., Faculty Mentor and Chair
H. PERRIN GARSOMBKE, Ph.D., Committee Member
TAMIR BECHOR, Ph.D., Committee Member
William Reed, Ph.D., Dean, School of Business and Technology
A Dissertation Presented in Partial Fulfillment
Of the Requirements for the Degree
Doctor of Philosophy

2. Capella University
April 2012
All rights reserved
INFORMATION TO ALL USERS
The quality of this reproduction is dependent on the quality of
the copy submitted.
In the unlikely event that the author did not send a complete
manuscript
and there are missing pages, these will be noted. Also, if
material had to be removed,
a note will indicate the deletion.
All rights reserved. This edition of the work is protected against
unauthorized copying under Title 17, United States Code.
ProQuest LLC.
789 East Eisenhower Parkway
P.O. Box 1346
Ann Arbor, MI 48106 - 1346
UMI 3505727
Copyright 2012 by ProQuest LLC.
UMI Number: 3505727

3. © Gerald Elysee, 2012
Abstract
The success of strategic information systems planning (SISP) is
of paramount importance
to academics as well as practitioners. SISP is a management
process that enables
organizations to successfully harness the power of current- and
next-generation
information systems (IS) applications to fulfill their business
goals. Hence, by capturing
the major constructs that can influence SISP success, the SISP
theory has made
significant contribution to research and practice. However, the
literature shows that,

4. despite this important contribution, the SISP theory has only
been used to a limited
extent. Aiming to address this scarcity of SISP theory
utilization, this study developed a
research model that integrates four constructs derived in large
part from the SISP theory.
The four constructs are: (a) the extent of top management
support, (b) the usefulness of
the information systems plan, (c) the degree of Information
technology infrastructure
flexibility, and (d) the degree of SISP success. Based on the
contingency theory, the
usefulness of the information systems plan (ISP) and the IT
infrastructure flexibility
(ITIF) were examined as two conditions that can mediate the
effects of top management
support on SISP success. Data analysis was conducted using
Partial Least Squares, which
is a type of structural equation modeling that accommodates
small sample sizes. From a
sample of 57 information systems executives from US
organizations, support was found
for the hypothesis that top management support has a direct,
positive, and significant

5. effect on SISP success. Also supported are the hypotheses that
top management support
has a significant effect on the usefulness of the ISP, which in
turn has a similar effect on
SISP success. By contrast, support was not found for the
hypotheses that top management
support has a significant effect on ITIF, which in turn is
significantly related to SISP
success. Top management support was shown to influence the
degree of SISP success
both directly and indirectly through the usefulness of the
organizations’ ISP, but not
through their IT infrastructure flexibility (ITIF). Unlike ITIF,
the usefulness of the ISP
was confirmed to be a significant mediator of the effects of top
management support on
SISP success.
iv
Dedication

6. I wish to dedicate this dissertation to my wife, Evelyn, for the
love, patience, and support
she provided me during the entire Ph.D. program; to my
daughter, Victoria, who
provided me with a sense of purpose and responsibility; to my
parents, Sainsalio and
Marie, for instilling in me the value of hard work and the
importance of education; to my
uncle, Frank, for being a great role model.
v
Acknowledgments
I wish to acknowledge several individuals who have contributed
to the successful
completion of this dissertation. First of all, I am forever
grateful to Dr. Apiwan D. Born,
my dissertation advisor, for the expert guidance, support, and
encouragement she
provided me throughout all the phases of my dissertation. I
would like to thank my other

7. dissertation committee members, Dr. Henry Garsombke and Dr.
Tamir Bechor, whose
feedback and inputs helped improve the quality of this
dissertation in a significant way. I
wish to acknowledge Dr. Nurul Aman for his valuable
comments and suggestions on
earlier draft of my dissertation proposal.
vi
Table of Contents
Acknowledgments....................................................................
........................................... v
List of Tables
............................................................................. ..................
....................... x
List of Figures
...............................................................................................
.................... xii
CHAPTER 1. INTRODUCTION
....................................................................................... 1

8. Introduction to the Problem
...............................................................................................
. 6
Background of the Study
...............................................................................................
..... 8
Statement of the Problem
...............................................................................................
... 12
Purpose of the Study
...............................................................................................
.......... 12
Rationale
...............................................................................................
............................ 13
Research Questions/Hypotheses
....................................................................................... 14
Significance of the Study
...............................................................................................
... 15
Definition of
Terms.....................................................................................
...................... 16
Assumptions and Limitations
...........................................................................................
18
Nature of the Study

9. ...............................................................................................
............ 19
Organization of the Remainder of the Study
.................................................................... 20
CHAPTER 2. LITERATURE REVIEW
.......................................................................... 22
Introduction
...............................................................................................
........................ 22
SISP
Definitions..............................................................................
.................................. 23
SISP Theory
...............................................................................................
....................... 25
Selection of Constructs for the Research
Model........................................................... 28
Top management support construct (TPORT).
......................................................... 30
Information systems plan construct (ISP).
................................................................ 35
vii

10. IT infrastructure flexibility construct (ITIF)..
........................................................... 36
SISP success construct (SES).
.................................................................................. 44
Conclusion
...............................................................................................
......................... 48
CHAPTER 3. METHODOLOGY
.................................................................................... 53
Examination of Research Model and Development of
Hypotheses ................................. 53
Hypotheses Related to Top Management Support (TPORT)
Construct ....................... 55
Hypothesis Related to Information Systems Plan (ISP)
Construct ............................... 61
Hypothesis Related to IT Infrastructure Flexibility (ITIF)
Construct .......................... 63
Research
Design....................................................................................
............................ 66
Sample....................................................................................
........................................... 68
Sampling Frame
...............................................................................................
............. 68

11. Sample Size
...............................................................................................
.................... 69
Operationalization of Research Constructs
....................................................................... 72
Extent of Top Management Support (TPORT)
............................................................ 73
Usefulness of Information Systems Plan (ISP)
............................................................. 74
Degree of IT Infrastructure Flexibility (ITIF)
.............................................................. 74
Degree of SISP success (SES)
...................................................................................... 74
Data Collection
...............................................................................................
.................. 76
Non-respondent Bias
...............................................................................................
...... 77
Data Analysis
...............................................................................................
..................... 77
Validity and Reliability
...............................................................................................
...... 79
Ethical Considerations

12. ...............................................................................................
....... 81
viii
Summary
...............................................................................................
............................ 82
CHAPTER 4. RESULTS
...............................................................................................
... 83
Survey questionnaire
...............................................................................................
.......... 84
Field Test
...............................................................................................
....................... 85
Data collection
...............................................................................................
................... 87
Response Rate
...............................................................................................
................ 90
Sample Size Adequacy
...............................................................................................
.. 90

13. Demographic Data
...............................................................................................
............. 91
Profile of Respondents
...............................................................................................
... 91
Non-respondent Bias Analysis
...................................................................................... 98
Research Model
Assessment.............................................................................
................ 99
Measurement Model
...............................................................................................
...... 99
Initial PLS Analysis - Reliability and Validity
........................................................... 101
Preparation for Final PLS Analysis - Indicator Removal and
Retention .................... 106
Final PLS Analysis - Model Fit with the Data
............................................................ 109
Structural Model and Hypothesis
Testing................................................................... 110
Direct Effect
...............................................................................................
................. 110

14. Mediating Effects
...............................................................................................
......... 111
Path Analysis
...............................................................................................
............... 112
Significance of Mediating Effects
.............................................................................. 115
Effect Sizes
...............................................................................................
.................. 116
Presence of Full or Partial Mediation
......................................................................... 119
ix
Summary
...............................................................................................
.......................... 121
CHAPTER 5. DISCUSSION, IMPLICATIONS,
RECOMMENDATIONS ................. 123
Findings and Implications
...............................................................................................
123
Contributions..........................................................................

15. ......................................... 125
Limitations
...............................................................................................
....................... 127
Recommendations
............................................................................................ ...
............ 128
REFERENCES
...............................................................................................
................ 130
APPENDIX. SURVEY OF STRATEGIC INFORMATION
SYSTEMS PLANNING
SUCCESS
...............................................................................................
........................ 141
x
List of Tables
Table 1. IT Infrastructure Management Actions for Different
Types of Events .............. 38

16. Table 2. Summary of Study
Hypotheses...........................................................................
67
Table 3. Description of SISP Constructs and Variables
................................................... 75
Table 4. Respondents’ Job Titles (N = 57)
....................................................................... 92
Table 5. Respondents’ Years of Experience with Current
Organization (N = 57) ........... 93
Table 6. Respondents’ Years of Experience in Industry (N = 57)
.................................... 94
Table 7. Respondents’ Industry (N =
57).......................................................................... 95
Table 8. Annual Information Technology (IT) budget (N = 57)
...................................... 96
Table 9. Number of Employees (N = 57)
......................................................................... 97
Table 10. Number of Information Technology (IT) Employees
(N = 57) ........................ 98
Table 11. Initial PLS Analysis - Reliability and discriminant
validity coefficients ....... 103
Table 12. Initial PLS Analysis - Latent variable correlations and
square root of AVE . 104
Table 13. Initial PLS Analysis - Combined loadings and cross-

17. loadings....................... 105
Table 14. Final PLS Analysis - Reliability and Discriminant
Validity Coefficients ...... 106
Table 15. Final PLS Analysis - Latent Variable Correlations and
Square Root of AVE 107
Table 16. Final PLS Analysis - Combined Loadings and Cross-
loadings ...................... 108
Table 17. Final PLS Analysis - Variance Inflation Factors
............................................ 109
Table 18. Final PLS Analysis - Model fit indices and P values
..................................... 110
Table 19. Summary of Hypothesis Testing Results
........................................................ 112
xi
Table 20. Final PLS Analysis - Path Coefficients
.......................................................... 115
Table 21. Final PLS Analysis - P Values for Path Coefficients
..................................... 115
Table 22. Final PLS Analysis - Standard errors for path
coefficients ............................ 116

18. Table 23. Test Result Showing Significance of ISP Mediating
Effect (N = 57) ............ 117
Table 24. Test Result Showing Significance of ITIF Mediating
Effect (N = 57) .......... 118
xii
List of Figures
Figure 1. Conceptual model.
...............................................................................................
6
Figure 2. SISP theory.
...............................................................................................
........ 26
Figure 3. Research model and hypotheses.
....................................................................... 56
Figure 4. Direct model.
...............................................................................................
.... 111
Figure 5. Mediating model.
.............................................................................................
114

19. 1
CHAPTER 1. INTRODUCTION
Since 1980, information systems executives have consistently
ranked strategic
information systems planning (SISP) improvement as one of
their top ten concerns
(Brancheau, Janz, & Wetherbe, 1996; Hevner, Berndt, &
Studnicki, 2000; Luftman &
Ben-Zvi, 2010; Moynihan, 1990). The SISP improvement
concern has resonated with
many researchers who have become interested in identifying and
investigating the
constructs that influence the success of SISP.
SISP is defined in the literature as "the process of identifying a
portfolio of
computer-based applications that will assist an organization in
executing its business
plans and realizing its business goals" (Hartono, Lederer, Sethi,
& Zhuang, 2003; Lederer
& Sethi, 1988, 1992; Phillip, 2007). This definition has been
widely used in SISP

20. research. In order to embed this study within the existing SISP
literature, this widely
accepted SISP definition is adopted in this study. SISP also
includes exploiting and
exploring current- and next-generation information systems (IS)
applications and
opportunities to enable the company to gain a competitive
advantage, outperform its
competition, and achieve sustainable profitability.
This study involved developing a SISP research model to
investigate the direct
and indirect effects of top management support and SISP
success. This study is
important because, according to a 2009 survey of IT executives
by the Society for
Information Management, the strategic planning of information
technology and systems
2
remains a top concern of IS executives. Explaining this finding,
Lufman and Ben-Zvi
(2010) pointed out that:

21. Unlike previous recessions, when IT was the first place that
business executives
looked to reduce costs, during this recession, many business and
IT leaders have
been working closer together to identify strategic opportunities
for leveraging IT
to reduce costs and improve productivity throughout the
organization. (p. 52)
In today’s marketplace, SISP is vital to a firm’s competiveness
because it
provides “the strategic thinking that identifies the most
desirable IS on which the firm can
implement and enforce its long-term IT activities and policies”
(Bechor, Neumann,
Zviran, & Glezer, 2010, p. 17). Consequently, SISP continues
to be an important area for
both research and practice.
To advance research in this area, Lederer and Salmela (1996)
developed the SISP
theory to express SISP as a system whose success or failure can
be influenced by the
direct linkages among seven planning constructs: internal
environment, external

22. environment, planning resources, planning process, information
plan, plan
implementation, and plan alignment. In 2004, Brown extended
on the SISP theory
through extensive literature review and meta-analysis, and
found other linkages and
hypotheses beyond those identified by Lederer and Salmela.
The continuous application of the SISP theory and its
derivatives is vital to the
success of SISP research and practice because it enables the
relationships between the
constructs to be investigated and presented in a rigorous,
coherent, parsimonious, and
comprehensive manner (Lederer & Salmela, 1996). However,
the SISP literature reveals
that very little effort has been made to use the SISP theory to
provide a comprehensive
3
representation of the constructs that can influence SISP success.
For instance, Brown
(2004) found the application of the SISP theory to be very
sparse.

23. To address this sparsity, the SISP theory was used in large part
to specify a
comprehensive model of SISP. Model specification is a
significant part of this study.
Schumacker and Lomax (2010) suggested that the extant
literature in terms of theory,
research, and published studies can be used to determine which
constructs to include in
the model and which ones not to include. Based on the literature
review, the four
constructs selected for inclusion in the model are (a) top
management support, (b)
information systems plan, (c) information technology (IT)
infrastructure flexibility, and
(d) SISP success.
The model was used to investigate the direct and indirect effects
of top
management support on SISP success. Top management support
is the independent
variable concerned with the level of senior management’s
interest, understanding, and
participation in SISP and information systems-related efforts.
Whereas, SISP success is

24. the dependent variable focusing on the impact the SISP exercise
has on the overall
effectiveness of the firm. Following a contingency approach,
this study also examined the
usefulness of the information systems plan and the flexibility of
the Information
Technology (IT) infrastructure as two conditions under which
the direct relationship
between top management support and SISP success can change.
Consistent with this
approach, the information systems plan and the IT infrastructure
flexibility were
considered potential mediating constructs in this study. The
information systems plan
documents the selected applications needed to be implemented
to enable firms to achieve
their business goals. Whereas, the IT infrastructure flexibility
provides the capabilities to
4
enable firms to quickly and economically implement the
recommended applications in
order to be able to adapt to an ever changing business

25. environment.
The flexibility of IT infrastructure has been heralded as the new
competitive
weapon that is needed in the contemporary business
environment to enable quick and
easy implementation of business strategies (Byrd & Turner,
2001). To represent a
dynamic aspect of contemporary business environment, IT
infrastructure flexibility was
selected as one of two mediating constructs that can affect the
relationship between top
management support (independent variable) and SISP success
(dependent variable).
This study hypothesized that top management support (the
independent variable)
directly influences the degree of SISP success (the dependent
variable). Adopting a
contingency perspective, this study also hypothesized that top
management support
indirectly influences SISP success through the mediating
variables of information
systems plan and IT infrastructure flexibility. A conceptual
model is presented in Figure
1 to start framing the research. The full research model and

26. hypotheses are depicted in
Figure 3.
Survey research methodology was used to collect the data,
which were analyzed
using Partial Least Squares (PLS). According to Chin, Marcolin,
and Newsted (2003),
“The use of PLS has been gaining interest and use among IS
researchers in recent
years…because of its ability to model latent constructs under
conditions of nonnormality
and with small to medium sample sizes” (p. 197). Because of
these features, Partial least
squares (PLS) was selected to conduct a Structural Equation
Modeling (SEM) based
analysis for this study. According to the guidelines provided by
Cohen (1992), Chin
(1998), Gefen, Straub, and Boudreau (2000), and Newkirk,
Lederer, and Johnson (2008),
5
the minimum sample required to analyze this study’s research
model should be at least

27. 34.
The sample size of 57 resulted from the data collection was
found to be adequate
to conduct the partial least squares (PLS) analysis on this
study’s research model. This is
because the sample size 57 exceeds the minimum sample size
requirement of 34. Chou
(2010), Khanlarian (2010), Tomaszewski (2010), and Garza
(2011) employed similar
guidelines to determine the sample size requirement for the
specific models in their
dissertation research. Likewise, Jung, Chow, and Wu (2003)
used PLS in their article
because they had a small sample size of 32.
The results of the PLS analysis show support for the hypothesis
that top
management support directly influences the degree of SISP
success. Also supported are
the hypotheses that the usefulness of the information systems
plan (ISP) is influenced by
top management support, which in turn influences the degree of
SISP success. By
contrast, PLS analysis did not reveal support for the hypotheses
that top management

28. support influences the IT infrastructure flexibility (ITIF), which
in turn influences the
degree of SISP success.
The findings of this study have important implications for
business and IS
executives who conduct SISP exercises as well as researchers
who study SISP
phenomena. Theoretically, the findings of this study confirm
prior research about the
critical role of top management support in influencing the
degree of SISP success both
directly and indirectly. The usefulness of the organizations’
information systems plan
was found to be a significant, but partial mediator of the
relationship between top
management support and SISP success. To achieve an even
deeper understanding of
6
SISP success, additional research is needed to identify other
possible mediators such as
top management leadership styles, quality of ISP process,

29. organizational culture under
which the relationship between top management support and
SISP success can change.
As for the IT infrastructure flexibility (ITIF), it was found to be
an insignificant
mediator of the effect of top management support on SISP
success. Taken together, the
findings of this study practically mean that training of senior
executives in top
management support should emphasize the importance of ITIF.
Also, efforts to improve
ITIF should be exerted through the information systems plan
(ISP) because the latter was
found to be a significant vehicle with which top management
support can help the
organization achieve SISP success.
Figure 1. Conceptual model.
Introduction to the Problem
Achieving strategic information systems planning (SISP)
success is of paramount
importance to practitioners and researchers. This is because
SISP success enables

30. corporations to successfully utilize IS applications to gain
organizational effectiveness
and efficiency and achieve a competitive advantage. However,
SISP success is a difficult
and elusive concept that can be influenced by a variety of
constructs (Basu, Hartono,
Lederer, & Sethi, 2002; Bechor, Neumann, Zviran, & Glezer,
2010; Doherty, Marples, &
MEDIATORS
Top Management
Support of SISP
SISP Success
7
Suhaimi, 1999; Raghunathan and Raghunathan, 1994; Segars &
Grover, 1998). Referring
to Raghunathan and Raghunathan’s (1994) planning success
measurement model, Segars

31. and Grover (1998) asserted that “Within the context of general
IS planning, this work
demonstrates that planning success seems to be a complex
system of interrelated
constructs” (p. 140). Consistent with this assertion, Lederer and
Salmela (1996)
developed the SISP theory to depict the predominant SISP
constructs that can influence
SISP success, and explain the relationships between them as
primarily a system of input-
process-output. However, a closer examination reveals that this
system of constructs
conceived by the SISP theory also extends to other boundaries
such as the
implementation and outcome domains, as illustrated in Figure 2.
The SISP theory represents a significant contribution to
research and practice
because it provides a comprehensive representation of the entire
SISP process as well as
key insights into the complexity of the relationships between
the constructs. However,
despite this very significant contribution, the use of the SISP
theory is very scarce. To

32. address this scarcity, this study built upon the work of Bhatt,
Emdad, Roberts, and Grover
(2010), Brown (2004), Chung, Rainer, and Lewis (2003),
Doherty, Marples, and Suhaimi
(1999), Hann and Weber, (1996), Lederer & Salmela (1996),
Premkumar and King
(1994a, 1994b), Ragu-Nathan, Apigian, Ragu-Nathan, and Tu
(2004), and many others
by developing a comprehensive model of SISP for investigating
the direct effects of top
management support on SISP success derived largely from the
SISP theory.
Following the contingency theory, the usefulness of IS plan, and
the IT
infrastructure flexibility were viewed as potential mediating
variables that can alter the
relationship between top management support (independent
variable) and SISP success
8
(dependent variable). The direct and mediated (indirect) …
8 hours ago

33. Idalmis Espinosa
Week 1- Main discussion
COLLAPSE
Top of Form
NRNP 6650: Psychotherapy With Groups and Families
Initial post
HIPPA is an act that is used to guide the practices of the nurses
in the group and family therapy. It requires considerations of
the ethical and legal aspects like the confidential information of
the patient based on the guidelines of HIPPA. The discussion of
this paper is therefore aimed at looking at the variations in the
legal and the ethical aspects concerning family and individual
therapy and how these variations can affects the therapeutic
approaches for the patients in the group and family therapy
(Wheeler, 2014).
The differences in the legal and ethical considerations for the
group and family therapy and the individual therapy
The ethical considerations in the group therapy are
focused on the family system therefore it is based on the
relationship. There are some ethical and legal considerations to
be made and they are focused on responsibility, informed
consent, and confidentiality. The differences in the ethical
consideration in group and family therapy and individual
therapy are on the responsibility. It is the responsibility of the
therapists to consider the interest of the parties while creating
interventions since the group and the family therapy is always
characterized with several dilemmas as opposed to individual
therapy. A therapeutic plan for the family or group involves
some conflicting objectives and different interests from the
parties involved. This is contrary to individual therapy where
the therapist is motivating the clients to exhaust the potential
ramifications of their actions (Nichols & Davis, 2020).
The individual therapy and the group and family
therapy also differ in terms of the content of the interactions.
Individual therapy is characterized by the process whereby a

34. single patient is talking about his or her feeling and there is
higher maintenance of privacy. On the other hand, the group or
family therapy is involving two or more individuals and there is
no observation to the privacy and it is possible to criticize the
individual perception thus making another person have a feeling
that his or her feelings are not being considered or respected
(Nichols & Davis, 2020).
There is a lower level of confidentiality in the group or
family therapy as compared to individual therapy. This is
contrary to the promises being made during the therapeutic
process that there is higher maintenance of confidentiality.
Therefore, there are higher chances of breaching confidentiality
in group and family therapy as compared to individual therapy.
Based on the legal perspectives, the two therapies
require informed consent before the start of the therapeutic
procedure. In the family or the group and individual therapy, it
is expected that the therapists explain the dos and the don'ts of
the session, the objectives, and the expected outcome after the
therapy lesson. The client is expected to sign a confidential
form before the start of the program (American Psychiatric
Nurses Association, 2014).
The impact of the differences on the therapeutic approaches for
the clients in the group or family therapy
Individual therapy is more likely to be successful as
compared to group and family therapy. This is basically due to
the greater observation of the privacy and confidentiality of the
information shared during the treatment. Therefore, these
differences concerning confidentiality are likely to affect the
overall outcome of the patients in the group and family therapy
due to a high possibility of failure to reveal the detailed
information by the clients as a result of fear of his or her secrets
being shared with other people. There is some confidential
information that might play an important role in the success of
the group and family therapy. Nevertheless, due to the fear of
poor confidentiality during the therapeutic process, the client
might choose not to share such information thus making the

35. entire therapeutic process not to be successful. It is also
possible that the group and family therapy might not end due to
the withdrawal of the client. This is because a client might
consider the group to be disrespectful and sharing their private
information with others (Wheeler, 2014).
References
American Psychiatric Nurses Association. (2014). Psychiatric
Mental Health Nursing. Silver Spring, Maryland.
Nichols, M., & Davis, S. D. (2020). The essentials of family
therapy (7 ed.). Boston, MA: Pearson.
Wheeler, K. (2014). Psychotherapy for the advanced practice
psychiatric nurse (2 ed.). New York, NY: Springer Publishing
Company.