You are leading a long-term cognitive behavioral therapy group for adults with a

You are leading a long-term cognitive behavioral therapy group for adults with a diagnosis of depression. This closed group has been meeting for 6 months on Tuesday evenings. Attendance has been very good: everyone has come to more than 95% of the group sessions. The group is moving into the working phase/stage of group therapy.
Group members:
Alejandro Escobar-Vega
Alejandro is a 34-year-old man with a history of depression. Alejandro is a regular patient of yours who you first saw in clinic and then at the ER for a suicide attempt prior to the forming of this group. He was recently discharged from a two-week hospital stay after a second suicide attempt. He resisted joining the group, but has become a regular attendee, because his wife Dani insisted on it. His son Dario attends West High School, where Lucy Edwards teaches.
Lucy Edwards
Lucy is a 57-year-old married woman who has twin daughters who are 20 and attend college in another state. Lucy was recently diagnosed with breast cancer. She has a 15-year history of depression. She has been on medication and involved in individual therapy for several years but due to social isolation her therapist recommended she join this therapy group. Lucy teaches at West High School, where Barry’s and Alejandro’s sons attend.
Barry Van Dyke
Barry is a 43-year-old divorced man who has a son who is a junior at West High School. Barry has suffered with depression for three years, ever since his parents were killed in a motor vehicle accident. They were hit head-on by a drunk driver and were killed instantly. Barry is an only child.
Sung Park
Sung is a 38-year-old single woman. Sung is social worker at a local Korean service agency where she provides community support services to Korean families. The community is home to a large Korean population. Sung has had depression since high school and has been in treatment for more than eight years. She takes medication as well as being in individual and group therapy.
Jennifer Jones
Jennifer is a 49-year-old African American woman and the mother of three children, aged 11, 12, and 15. Her long-term partner is their father. Jennifer has a history of depression, which began when she was 13, and sexual trauma. She has been in treatment since her late teenage years. She attempted suicide once at the age 18 after being sexually assaulted.
L’Antonee “Monty” Montgomery
Monty is a 40-year-old single gay man who has major depression. He has been hospitalized four times in the last two years for suicidal ideation. He works at the local day care center for seniors.
Group Therapy Confrontation:
Alejandro and Lucy
Alejandro:
I’ve gotta talk first tonight. Lucy! You talked about stuff from this group with your husband! And then he saw my wife at the grocery store last week and he told her he was sorry to hear I tried to kill myself. My son Dario was there with Dani. And my son DIDN’T KNOW WHY I WAS IN THE HOSPITAL!
Lucy: Calm down! My husband was just worried about you.
Alejandro: But he shouldn’t even know anything about me!
Lucy: I was just trying to get a little help thinking through whether I should reach out to Dario at school or not. You know I teach at West.
Alejandro:That’s not your job!
Lucy: But it is! As a teacher, every kid is my “job!”
Sung, Lucy, Barry, and Alejandro Confrontation
Sung: Lucy, I’m so disappointed about you breaking our confidentiality. Now I don’t trust that you won’t talk about me to people outside of the group. I have not told anyone about having depression, much less that I am seeking help through therapy. I would lose face in the community! And I’ll never get a boyfriend!
Lucy: Oh, geez, it’s not like we signed something legally binding. And it’s my husband! Who keeps secrets from their husband? Not me! Gerald knows everything I know.
Barry: WAIT, Lucy!
Alejandro: Then you should have said so right away. What we say isn’t a secret, it’s our personal information. You have no right to share it with ANYONE. I don’t tell Dani anything about this group. She didn’t even know you were in it.
Barry: WAIT! Lucy, my son goes to West, too! Have you told Gerald anything about me being in this group? Or anyone else? Aren’t we supposed to keep everything confidential?
Jennifer: Lucy, I think you did the right thing. I know you’re worried about Alejandro’s son, Dario, since you are one of his teachers. And Alejandro, you should have told your son what happened already. He’s old enough to see what’s going on around him. Keeping secrets isn’t good. My children know all about what’s happened to me.
Monty: I can’t believe this is happening! Oh my God! I could lose my job! You know I work hourly at the senior day care center. If my boss finds out why I took all that time off last year, he could fire me completely. I don’t have any protection against that. I told him my Mom needed some extra care, which they totally understood, of course. What the hell are you thinking, Lucy? I don’t feel safe sharing in this group and I don’t know if I want to come back anymore!
Monty: Thank you all. I do feel a little better about trusting you. But I don’t think Alejandro and Lucy have resolved anything yet. How can we move on?
Alejandro: I still think Lucy should apologize for talking to her husband outside the group. You know what Dario thinks of me now? I used to be his hero and now he knows that my life sucks and I don’t really want to be here. I also think she needs to tell the group that she will respect our confidentiality. And mean it.
Lucy: I am sorry my husband talked to your wife in front of your son. That was wrong. But I am still concerned about how your suicide attempt is affecting your son.
How will you help Lucy and Alejandro resolve their conflict? Do Jennifer, Monty, Barry, and Sung have more to say? Now it’s your turn to decide! Write about 10 minutes of further group dialogue, including yourself as the group leader. Draw upon your knowledge of group therapy leadership techniques, including feedback (as in the scenario), with references to course materials.