Flying Without a Safety Net

1. Flying Without a Safety Net Karen M. Nielsen, PhD Athabasca University Edmonton, Alberta

2. Building a Safety Net: Why? • Private practitioners work alone • When there are competing demands, ethical decision making is not always easy

3. Ethical Decision Making • The process of ethical decision-making may be influenced by a number of factors such as: • internalization of professional values • education • experience • ethics training • professional identification

4. Process of Ethical Decision Making • Practitioner recognizes that an ethical dilemma exists • Identifying the ethical components of a situation • Identification of ethical dilemmas can be influenced by personal value preferences or intuitive thinking rather than on a reflection of ethical principles and code of ethics • The value system of the decision maker shapes and influences the ethical decision-making process • For example, family re-unification and a belief system that view some actions as beyond redemption

5. Process of Ethical Decision Making • Resolution • Choose course action • Assess priority • Identify possible course action/ projected outcomes • Identify principles in code ethics which bear on case • Identify value tensions • Identify ethical components • Background information/case details

6. Family Violence, Ethical Practice and Non-offending Spouses and Children • 3rd party expectations, demands and pressures. • Management of contracted service agreement while managing the evolving needs of the direct client. • Lack of balance in knowledge • Third party may unclear on role of therapy • Disparate feelings of hope • Impact of system demands on case management

7. Family Violence, Ethical Dilemmas and Non-offending Spouses and Children • Working with systems that may have competing obligations, mandates and ethical principles • Pressure from Legal System • Vulnerable child testifying • Pressure from Child Protection Services to: • Use therapy as an investigatory tool • Use assessment/therapy to support family dissolution or to facilitate premature family reintegration

8. Ethical Dilemmas and Non-offending Spouses and Children • Pressure from family/non-offending spouse to: • Reintegrate due to financial hardship • Social function/status reasoning (keeping secrets) • Belief System:Children need an intact family

9. Building the Safety Net: Peer Consultation with Interdisciplinary Team • Voluntary collaboration of peers • Clients are aware of process & give informed consent • Psychologists (counseling & forensic), Clinical Social Workers • Deliberately chosen for peer status & diversity of practice area

10. Process • Self-directed: Participants express needs • Case presentations • Research presentations • Practice strategies • Formal structure • Monthly meeting • One year commitment • Group decision making re new member

11. Peer Consultation & Multidisciplinary Responses to Ethical Dilemmas • Maintain professional perspective • Develop expanded perspective on competing needs. • Bring diversity of thought and different ethical decision making models

12. Peer Consultation as an Ethical Act • Focus is maintained on: • Who is the client? • Who is working harder/hardest in this case situation? • What are the competing agendas that put my ethical practice at risk? • Where is my involvement in this case going? • Whose needs are best served by my actions with this family.

13. Meeting Demands for Competency • Legislation (Health Professions Act) demands that professionals have a continuing competency program. • Consultation /clinical supervision is one strategy of meeting the demands

14. Evaluation Group • Is this helpful? • Are members needs being met? Individual • Self Reflection

15. Group Evaluation • Peer Supervision Group Session Rating Scale (PSGSRS), based on Group Session Rating Scale (Barry L. Duncan and Scott D. Miller, 2007) • Relationship • Needs • Format • Overall

16. Personal Reflection • How aware was I of my personal biases or preferences? • To what extent did my personal values or philosophy influence choice of action? • To what extent did I attempt to keep these from unduly influencing the outcome. • If outside agency policy/demands conflicted with other obligations to the client, what was the ethical dilemma; how did I get stuck? • If the case involved a conflict between client self-determination and paternalism, which value did I judge to be more essential to honor foremost?

17. Building a Safety Net: Why? • Private practitioners work alone • When there are competing demands ethical decision making is not always easy

18. The End

19. References Abramson, M. (1989). Autonomy vs. paternalistic beneficence: Practice strategies. Social Casework, 70, 101-105. Abramson, M. (1996). Reflections on knowing one-self ethically: toward a working framework for social work practice. Families in Society, 77, 195-202. Callahan, J. (1988). The role of emotion in ethical decision making. Hastings Center Report, 18, 914. Joseph, M. V. (1985). A model for ethical decision making in clinical practice. In C. B. Germain (Ed.), Advances in clinical social work practice (pp. 207-217). Silver Spring, MD: National Association of Social Workers. Keith-Lucas, A. (1977). Ethics in social work. In J. B. Turner (Ed.-in-Chief), Encyclopedia of social work (17th ed., pp. 350-355). Silver Spring, MD: National Association of Social Workers. Loewenberg, F., & Dolgoff, R. (1996). Ethical decisions for social work practice (5th ed.). New York: F. E. Peacock. Ethical Decision Making: The Person in the Process. Mattison, M. (2000). Ethical Decision Making: The Person in the Process. Social Work. 45 (3).201-212.