It’s About Ethics: Maintaining Healthy Boundaries

1. It’s About Ethics: Maintaining Healthy Boundaries Ruben Rivera-Jackman, MNPL, GMHS, PSC Resident Services Director Ruben.Jackman@shag.org(206) 701-5435

2. Why Talk About Ethics and Boundaries? • We work with a diverse and vulnerable group of individuals with a variety of needs who may also present with poor or unhealthy boundaries. • As professionals, we may encounter dilemmas that may create ethical and boundary issues and concerns.

3. Ethics Defined • Greek word “ethos” meaning character. • Study of principles relating to right and wrong conduct. • Standards that governs the conduct of an individual or members of a profession. (ASSC)

4. Ethics Defined • Set of guidelines for conduct. • Are not laws or rules, even though a violation may lead to breaking a law or negative consequences. • Most of the time there is no absolute right or wrong, many grey areas.

5. Principles of Ethics • Autonomy • Beneficence • Non-Maleficence • Veracity • Justice • Respect • Professionalism • Role Fidelity

6. Autonomy • Greek word autos-nomos meaning “self-rule” or “self-determination” • Refers to the capacity of a rational individual to make an informed, un-coerced decision.

7. Autonomy Residents have a right to self-determination even if at times we do not agree with their decisions or choices.

8. Beneficence Refers to actions that promotes well-being and serves the best interests of our residents.

9. Non-Maleficence • Obligation that we act in ways that do not inflict, or cause avoidable, or intentional harm. • “First, do no harm”

10. Veracity • Principle of truth telling, grounded in respect for persons and the concept of autonomy. • Basic expectation that we are honest in our professional interactions.

11. If it is not right, do not do it If it is not true, do not say it. Marcus Aurelius Roman Emperor from 161 to 180 A.D.

12. Justice Requires that we act in ways that treat people equitably and distribute benefits and burdens fairly.

13. Respect • Refers to the concept that all people deserve the right to fully exercise their autonomy. • Afford and treat all people with basic respect.

14. Professionalism Ethics and standards of practice for a particular profession that are typically agreed upon and maintained through widely recognized professional associations. ASSC Code of Ethics

15. Role Fidelity Faithful devotion to duty which entails specific loyalties associated with a particular professional designation.

16. When Do We Use Ethics? • Daily • To determine best practice in meeting the needs of our residents. • When we are unsure of how to proceed or struggling with a dilemma. (grey areas)

17. Ethics Are Influenced by your Values • Personal Values • Professional Values • Cultural Values

18. Lessons Learned • Your ethical orientation and personal and professional values change and evolve as you continue in your career. • With each ethical dilemma you encounter, there is a lesson to be learned.

19. Boundaries Defined Noun, plural -ries. 1. Something that indicates bounds or limits; a limiting or bounding line. II. Working definition: The rules that define the limits of professional behavior.

20. Boundaries Defined A Dividing Line distinguishing between two things This is okay ___________ This is not okay The distinction between right/wrong, good/bad, okay/not okay, appropriate/inappropriate may not always be crystal clear The line that separates the resident from You.

21. Importance of Maintaining Professional Boundaries • Clearly establishes expectations which allows for safe connections and interactions. • Promotes healthier workplace, impacts staff morale, increases productivity and retention.

22. Importance of Maintaining Professional Boundaries • Provides a clear understanding of roles and responsibilities. • Being friendly, not friends.

23. Importance of Maintaining Professional Boundaries • Prevents enabling, codependency behaviors. • Reduces the risk exploitation and acts of abuse.

24. Act of Abuse Any misuse of power, betrayal of trust and respect, or inappropriate intimacy between the housing services professional and the resident that could reasonably be expected to cause physical, emotional, sexual, or financial harm and neglect.

25. Importance of Maintaining Professional Boundaries • Reduces anxiety as roles, responsibilities and expectations are clear. • Avoids or limits the violation of any Federal, State and local laws. • Provides a safe atmosphere where the resident and housing services professionals are mutually respected.

26. How are Boundary Decisions Made? Depends on many variables, including: • Title and position • Skills • Length of time in the profession

27. How are Boundary Decisions Made? Depends on many variables, Including: • Location of the work • Organization’s risk tolerance • Organizational values

28. How are Professional Boundaries Established and Enforced? • By Law (Federal, State, Local) HUD, Fair Housing Laws, Tenant/Landlord Laws, etc. • By licensing and certifying bodies. (National Association of Residential Property Managers www.narpm.org, HUD, NAHRO, FHA, HFC, etc.

29. How are Professional Boundaries Established and Enforced? • National Housing Associations (AASC, AHMA, LeadingAge, etc.) • By your agency’s policies & procedures (ACOP, PH Policies, HR Policies, etc.)

30. Power Differential There is an inherent power differential and imbalance in the relationship between the housing services professional and the resident.

31. Examples of Power Differential Relationships • Parent/Child • Teacher/Student • Supervisor/Employee • Therapist/Client

32. Examples of Power Differential Relationships • Doctor/Patient • Housing Professional/Resident • Police/Citizen • Other examples?

33. Power Differential Maintaining healthy boundaries helps us to control this power differential and promotes safe connections with our residents and allows us to meet their needs.

34. Power Differential The responsibility for maintaining healthy boundaries is the responsibility of the housing services professional even if the resident doesn’t want boundaries.

35. Tips for Creating and Maintaining Healthy Professional Boundaries • Do No Harm. (Benevolence) • Request and participate in training, ask questions (Knowledge) • Ask for assistance & support. (Supervision) • Do the best YOU can. (Competence) • What you do for one, you do for all. (Fairness)

36. Tips for Creating and Maintaining Healthy Professional Boundaries • Establish clear agreements and expectations with your residents right from the beginning. • Clarify your roles & responsibilities frequently. • Address all boundary violations and warning signs early.

37. Tips for Creating and Maintaining Healthy Professional Boundaries • Disclose personal information only related to resident’s goals. (appropriate self-disclosure) • Utilize professional resources. • When in doubt, consult with your Supervisor and refer to your Human Resources Handbook

38. Characteristics of Unhealthy Boundaries • Sharing too much information about self before establishing mutual trust in a relationship. • Avoiding conflict. • Possessing no clear identity or sense of self.

39. Characteristics of Unhealthy Boundaries • Having few or no close relationships. • Having difficulty identifying wants, needs or feelings. • Giving residents personal cell phone number, home address, friends on Face Book, etc.

40. Possible Warning Signs • Offering assistance outside of role. • Frequently thinking about a resident when away from work. • Making inappropriate requests of the resident.

41. Possible Warning Signs • Sharing work concerns or venting about other residents or team members. • Asking residents t keep secrets. • Developing personal relationship or physical attraction toward resident.

42. Possible Warning Signs • Engaging in inappropriate physical touching. • Providing residents with special attention or treatment. • Denying they have violated boundaries when brought to their attention.

43. Possible Warning Signs • Referring to residents as a friend. • Giving expensive/valuable gifts. • Socializing with residents outside of work. • Others? Refer to HR manual

44. Behaviors That Can Weaken Boundaries • Pushing yourself beyond your limits. • Working long hours, no time off. • Insufficient sleep. (6-8)

45. Behaviors That Can Weaken Boundaries ANNUAL CONFERENCE LEADINGAGE OREGON • Concealing your true feelings. • Lack of Work/Life balance. • Lack of social support network.

46. Behaviors That Can Weaken Boundaries • Doing too much for others while neglecting your own needs. • Allowing people too much closeness or touching when you are uncomfortable. • Using chemicals to avoid yourself: caffeine, alcohol, sugar, nicotine, and illicit drugs.

47. Consequences • Compassion fatigue and burnout. • Potential for splitting on teams. • Risk management/liability.

48. Consequences • May lead to acts of unethically behavior. • Compromised reputation. • Physical and emotional trauma.

49. Commitment to Resident Informed Consent • Disclosure with valid consent (ROI) • Third party consent • Legal considerations • Imminent danger • Illegal activity • Lease violations

50. Issues shared with Property Management • Illegal Activity (Federal Law prevails) • Abuse of self or others • Lease violations • Need to know basis