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ETHICAL CHALLENGES AND MANAGING RISK IN SOCIAL WORK PRACTICE

Explore legal and ethical considerations in social work practice. Understand laws impacting social workers and risk management strategies. Learn about liability concerns, client suicide prevention, confidentiality, and boundary issues.

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ETHICAL CHALLENGES AND MANAGING RISK IN SOCIAL WORK PRACTICE

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  1. ETHICAL CHALLENGES AND MANAGING RISK IN SOCIAL WORK PRACTICE 2019 Chicago Social Work Conference September 13, 2019 Oak Brook, Illinois

  2. Joseph T. Monahan, M.S.W., A.C.S.W., J.D. Monahan Law Group, LLC, Chicago jmonahan@monahanlawllc.com

  3. Introduction • Domestic violence acts • Americans with Disabilities Act • NASW Code of ethics • Professional licensing acts • Employment laws • Criminal statutes • Social Security Act • HIPAA • Individuals with Disabilities Education Act • Worker’s Compensation Act • Joseph T. Monahan, MSW, ACSW, JD • Numerous laws affect social workers: • Confidentiality • Civil commitment/outpatient treatment • Child abuse and neglect reporting • Juvenile court • School student records • FERPA

  4. Involvement in Legal Proceedings • Know the law, embrace the law! • Risk management tips: • Records management • Consultation • Identify difficult cases early • Listen to client complaints • Qualifications/credentials • Malpractice insurance • Confidentiality • Understand expectation of privacy • Avoid inappropriate boundaries • Why do social worker’s get sued? • Malpractice • Civil Actions • Theories of liability • Substantive risk areas • Elements • Duty • Breach • Proximate/legal cause • Injury

  5. What to do if You are Sued • In the courtroom: • Know the actors • Know your role • Direct examination • Cross examination • Tips for trial participants • Answer the question that is asked • Do not go farther than what you know as a witness • Do not ignore court papers • Contact supervisor/attorney • Relationship with attorney • Knowledgeable in practice area • Do not speak with opposing parties • Or opposing counsel • Maintain “normal course” of practice • E.g. do not change record-keeping practices

  6. Client Suicide – Big Picture • Risk factors • Behavioral health issues • Personal characteristics • Adverse life circumstances • Risky behaviors • Family characteristics • Environmental factors • Warning signs • Statistics • Major public health concern • 2nd leading cause of death among individuals 10-34 • Risk Management • Policy • Training • Crisis response protocol • Documentation

  7. Client Suicide – Professional Liability Concerns • Speaking with family members • Self-care • Tips for talking about suicide: • Give accurate information • Address blaming and scapegoating • Do not focus on the method • Address anger • Address feelings of responsibility • Promote help-seeking • Survivors are searching for answers • Protecting yourself • Professional liability insurance • Potentially multiple defendants • Records and confidentiality • Just say “no!” • Secure the record • Requests for records

  8. Confidentiality • What records must be maintained? • With consent • Without consent • Subpoenas: • Do not be intimidated • Just say “no!” • Who is asking, on what authority? • Consultation, notification, documentation • Always retain control of the original file • Reasons for and importance: • Privacy • Foundation of the therapist-client relationship • Confidentiality is complex • Involves legal and ethical knowledge and judgment • General rule: • All records and communications are confidential and shall not be disclosed except as provided by law

  9. Boundary Issues & Dual Relationships • NASW Code of Ethics • 1.05 Cultural Competence and Social Diversity • 1.06 Conflicts of Interest • 1.09 Sexual Relationships • 1.10 Physical Contact • 1.11 Sexual Harassment • 1.13 Payment for Services • Risk management strategy to avoid boundary violations • Boundary violations vs. boundary crossings • Identification • Assessment • Risk management • Conceptual framework • Intimate relationships • Personal benefit • Emotional and dependency needs • Altruistic gestures • Unanticipated circumstances

  10. Clinical Supervision & Consultation • Professional supervision • “The relationship between supervisor and supervisee in which the responsibility and accountability for the development of competence, demeanor, and ethical practice take place.” • Common liabilities in the supervision context: • Inadequate and improper supervision or social work guidance • Sexual improprieties • Outside supervision v. supervision in the workplace • Formal supervision agreement or memorandum of understanding

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