ETHICS That Sounds so Formal.

1. ETHICS • That Sounds so Formal.

2. Don Streit, LCSW • (501) 416-8334 • Newopportunitiessite.com • don_streit@yahoo.com

3. NASW Code of Ethics • www.socialworkers.org • Careless Use of Facebook Can Jeopardize Your Career Social Networks are Everywhere: Consider the Ramifications- Frances Patterson, PhD, MAC ACA Code of Ethics 2014 SOURCES

4. Act 1170 of 2015 • MSWGuide.org • Ethics Resources: • Ethics Hotline • Ethics Shared Interest Group (formerly COI) • Ethics Education • SWLB Regulations SOURCES

5. Ethics consultation telephone calls are answered on a first come first • served basis and are not pre-scheduled. If you call during consultation • hours and receive a voice-mail response, we request your patience as we • complete earlier member calls, Please leave a brief message clearly stating • your name and contact number and we will return your call. Due to the high • call volume, we ask that you allow 24 hours for a return call. Free Consultation for NASW MEMBERS

6. The American Counseling Association is pleased to help members with inquiries on ethical practice. This service is not designed to function as a real-time hotline; inquiries are prioritized and the ACA standard is to respond within three business days of receipt. • For questions on ethics, contact the ACA Center for Policy, Practice, and Research at (800) 347-6647, ext. 321 or through the online  Ethics Consultation Services

7. Practicing distance therapy, legally and ethically by Tori DeAngelis, March 2012, Vol 43, No 3 • (APA.org) • Is It Ethical to Skype with Patients? Claire Zilber, M.D. Psychiatric News, 2 August 2016 https://doi.org/10.1176/appi.pn.20168a14 • Ethical Resources

8. Remain competent in the field and report suspected abuse • Have compassion, take positive actions to help others and follow through on the desire to do good. • Keep commitments, based on virtue of caring • Respect patients’ wishes, even when you do not agree with them. • Treat patients fairly and equally. • Consider the entire person when deciding, medications, or procedures a patient should receive. 6 Ethical Standards for Nursesresources.nurse.com/6-key-ethical-principles-of-nursing

9. The public association of any individual with any term contained in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases and Related Health Problems(ICD)—without having interviewed and conducted a thorough assessment of the individual and having written permission for such a disclosure—is a violation of the ACA Code of Ethics. Publicly Diagnosing the Mental State of an Individual

10. Be knowledgeable about the laws governing distance counseling and social media. • Only utilize distance counseling after gaining competence through training and supervised experience in this specialty area. • Inform clients about the limits of confidentiality and potential Internet interruptions due to the nature of technology. • Understand the benefits and drawbacks related to distance counseling • Utilize a professional presence if they choose to use social media platforms • Avoid disclosing confidential information through social media. • Utilize informed consent to explain the boundaries of social media. Distance Counseling, Technology, and Social Media (Section H)

11. National Association of Social Workers. (1996, rev. 2008). Code of ethics. Washington, DC: Author. Retrieved June 10, 2012 from http://www.socialworkers.org/pubs/code/default.asp. National Association of Social Workers & Association of Social Work Boards (2005). Standards for technology and social work practice. Washington, DC: NASW. Retrieved June 10, 2012 from http://www.socialworkers.org/practice/standards/NASWTechnologyStandards.pdf ACA Code of Ethics 2014 References

12. It is formal and can be complicated…..but also simple! As formal as an ethical violation…as simple as making eye contact while asking permission to enter a member’s home As simple as listening to a member’s needs before delivering your business with them. • Like a robocall DOES NOT Ethics Sounds so Formal!

13. Values Beliefs, preferences, or assumptions about what we think is good and desirable Ethics reflect our values. What we value….whom we value….how we protect what we value….how we acknowledge and respect what others value. You Couldn’t Steal Them From Me If You Tried

14. What/Whom Do You Value? • Property, relationships, job, keepsakes, meaningful documents, memories, promises, etc. • How do you protect “Valuables”– Objects, property, relationships, information, future opportunities? • “Ethics address what to do with or how to apply those beliefs” (Kirst-Ashman 2007) Ethics Reflect our Values

15. Values- a principle considered worthwhile or important. • “Values determine what beliefs are appropriate.” (Kirst-Ashman 2007) • Ethics are derived from values. Guide people on what is “good” and what is “bad.” • “Ethics address what to do with or how to apply those beliefs” (Kirst-Ashman 2007) • *****Beliefs and Values must be experienced in real life situations or else they are only ink on a page. What good does ink do anyone? DJS Values and Ethics

16. They drive our significant & meaningful choices in relationships and life goals. AND They can create obstacles to impartial, unbiased treatment of others Dual Nature of Values

17. Property • Relationships • Privacy • Keepsakes • Communication (Secrets-Sensitive information) • Traditions • Trustworthy friends • Identity……………Reputation........Self Respect • Future opportunities What Are Your Valuables?How do you preserve– protect?

18. You have been informed that you need to have surgery on your heart. You don’t understand all the “doctor talk” explanation of what the surgeon needs to do to make your heart function correctly, but you DO know you need to have the surgery. How Do You Choose When Your “Heart” is Involved?

19. 1. One has been performing surgery for several year. He has an excellent reputation for successful surgeries, but he has been questioned about the “shortcuts” he uses in surgical procedures. He doesn’t like to be questioned because he is a “pro who’s been doing this for a long time.” • 2. The one who has only been a surgeon for two years. Besides knowing long-time standard procedures, she has also learned new techniques developed in the last couple years. No one is certain about her “success rate” because she is new to the community. Choice of Surgeon

20. **What would you want a client/patient or their family say about how your provided service to them– outside of your hearing? • How do you provide care in a way that might warrant that kind of comment? Your Own Value as Service Provider

21. Permission to engage • Statement/clarification of your role and intention • Ask and listen…..ask and listen….ask and listen • Eye contact • Finding common ground/interest Engagementreflects your respect, interest, capability, dedication…..

22. Property—Who is allowed within boundaries? • Relationships– Inner and outer circle? • Privacy– Who has the right to know family business? • Keepsakes– What is SACRED? • Communication (Secrets-Sensitive information) • Traditions– Who is family contact person? House rules? • Trustworthy friends– Network– Secret keepers • Identity………Reputation........Self Respect What/Who Are Your Valuables?How do you preserve– protect?

23. If/when you are in need of some service….AS A RECIPIENT….. What do you need? • What do you need to experience from/in the person serving your needs? • How does a provider convey • Interest…..caring….competence…respect? • Safe place….attention to needs? Client Needs-Engagement

26. Professionals should inform clients as soon as feasible and in language that is understandable about the nature of the professional relationship, the nature of the professional intervention, the professional’s delegated authority and the limits of that authority, which decisions the client can make and which decisions the child welfare professional will make. • Professionals should inform clients of the role of the court, if any, and of their legal and procedural rights. • Professionals should keep clients informed about the case plan throughout the entire intervention. Informed Consent

27. Webster’s– a choice between equally unfavorable or disagreeable alternatives • When a worker has to choose between and among conflicting duties and values. Weigh which duty/values tip the scale toward one choice rather than another. (Paraphrase from NASW video) SWA Oxygen DILEMMAS

28. Rules of Engagement • How to approach • Enter someone’s turf-privileged boundaries-- • Language & Purpose • No tech talk • Clarify • Listening • Talker-Listener • No Robo-Calls Ethical Principle: Social Workers and Counselors respect the inherent dignity and worth of the person. Treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients' socially responsible self-determination. Social workers seek to enhance clients' capacity and opportunity to change and to address their own needs.  What Does Respecful Engagement Look Like?

29. Demographic data regarding an individual’s past, present, or future physical or mental health conditions and payment for the health care provided to the individual. • Information related to the provision of health care to the individual. HIPAA PROTECTED INFORMATION

30. The Purpose of The Health Insurance Portability and Accountability Act of 1999 is to protect individually identifiable health information while increasing the flow of information between health care providers, health plans, and health care clearinghouses. • Pics HIPAA

31. Mrs. Cranley! You need to sign this HIPAA privacy form before the doctor can look at those warts on your stomach. Hospital buzz

32. I didn’t have a dual relationship………… • A dual relationship had me! Dual Relationships

33. Text the Wrong Person? • What were– or COULD BE- the consequences? • It’s just a text, right?

34. Privacy- • Meeting times • Rooms/space • Engagement- eye contact; acknowledge the value of their “turf” 1.07 Privacy and Confidentiality(NASW) Workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client. Workers should take reasonable steps to protect the confidentiality of electronic communications, including information provided to clients or third parties. ACA– B.1.b Counselors respect the privacy of prospective and current clients. Coun- selors request private information from clients only when it is beneficial to the counseling process. What Does Code Standard Look Like?

35. Communication (Sensitive-Secret) • Conversation w/trusted friend • Emails to or about significant people • Protection- Passwords & Codes • Locked access Protection of records B.6.b ACA Confidentiality of records and documentation What Does It Look Like?

36. Conflict of Interest(1.06) • Dual Relationships • The mother of one of your clients expresses gratitude for the way you have managed her daughter’s case. She says should would like to discuss this further and to “show my gratitude” by having coffee sometime. • Build rapport??? Social workers/counselors should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, workers/counselors should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. What Does Code Standard Look Like?

37. Non-discrimination 4.02 • Social & political action-Social workers should engage in social and political action that seeks to ensure that all people have equal access to the resources, employment, services, and opportunities they require to meet their basic human needs and to develop fully. (6.04) • Protection of Records– Protection through electronic communication • Privacy and Confidentiality • Competence (4.01) (ACA) C.2.a • Sexual intimacy with Clients (1.09) (ACA) A.6.e • Private conduct(4.03) Social W should not permit their private conduct to interfere with their ability to fulfill their professional responsibilities. RANK- Your PrioritiesThe Most(1) to Least(5) Important

38. Impairment-Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. (NASW 4.05) (ACA C.2.g) • Conflict of interest(NASW) 1.06 (a) Social workers should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgment.  • Solicitations-Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client’s prior statement as a testimonial endorsement) (4.07) • (NASW 1.03) ACA A.2.a Informed Consent Rank 1-5

39. Competence • Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience. Social workers who use technology in the provision of social work services should ensure that they have the necessary knowledge and skills to provide such services in a competent manner. • Nondiscrimination • Do not condone or engage in discrimination against propospective or current clients, students, employers,..based on age, culture, disability, ethnicity, race, religion/spirituality, gender identity, sexual orientation, language preference, socioeconomic status, immigration status, etc. • Protection of Records—Privacy & Confidentiality • Through electronic communication Social workers/counselors should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or others. 

40. Sexual Relationships • Social workers should under no circumstances engage in sexual activities, inappropriate sexual communications through the use of technology or in person, or sexual contact with current clients, whether such contact is consensual or forced. should not engage in sexual activities or sexual contact with clients' relatives or other individuals with whom clients maintain a close personal relationship when there is a risk of exploitation or potential harm to the client. Sexual activity or sexual contact with clients' relatives or other individuals with whom clients maintain a personal relationship has the potential to be harmful to the client and may make it difficult for the social worker and client to maintain appropriate professional boundaries. • 4.03 Private Conduct • Social workers should not permit their private conduct to interfere with their ability to fulfill their professional responsibilities. • Social & Political Action • Social workers /Counselors should engage in social and political action that seeks to ensure that all people have equal access to the resources, employment, services, and opportunities they require to meet their basic human needs and to develop fully. (6.04) • A Social justice perspective suggests that counselors ae called to action to assist those experiencing marginalized and/or oppression.

41. Impairment-Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. (NASW 4.05) (ACA C.2.g) • Conflict of interest(NASW) 1.06 (a) Social workers should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgment.  • Solicitations-Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client’s prior statement as a testimonial endorsement) (4.07) • (NASW 1.03) ACA A.2.a Informed Consent • Most basic right: Clients have the right to know what they are getting into. Freedom to choose whether or not to enter into or remain in the counseling relationship. • Include counselor’s qualifications, techniques, procedures, limitations, limits of confidentiality, potential risks and benefits of services. PUT THESE IN WRITING. • Counselors must be aware of and avoid imposing their own personally held values on clients. (ACA A.4.b)

42. Be sure to get clarification about Release of Information documents. Schools???? • “If there are multiple people that you will be dealing with (e.g. a case worker at a facility and a family guardian) then you may need multiple HIPAA Authorization Forms.” • Check with your ____ to specify who has permission to see documents. • If at schools….. Is it administrator, counselor? Just a Reminder

43. You have long been a friend with Merlita who has a large extended family that she sees only once a year for a family reunion. She has introduced you to several of those family members when they have been in town. In fact one family member(Natasha) thinks so highly of you that she asked Merlita to ask you if you would be her counselor now that Natasha is divorced and will move into the Little Rock area to help her adjust to the divorce. • Is it ethical for you to be her counselor? What do you need to consider to make that decision ACA (A.5.d) Friends of Family Members

44. With all the honesty you can muster……….What kind of client/client population is your favorite to work with? • What are the traits in them you prefer? • What kind is your least favorite to work with? • Traits you dislike or are threatening? • In your own “professional inventory,” how does (if it does) your preference potentially affect your professional effectiveness with those clients? 4.02 Non-Discrimination

45. How do you provide service in a respectful, professional, compassionate, and competent way… when you’re tired, paperwork is tedious, your client doesn’t cooperate with your agreed-upon goals or the client’s case is overwhelming you? Which standards are applicable? How might these kinds of client cases challenge your ethical practice? “Loving” Your Clients

46. Standards Challenged • Self-determination • Respect for client • Nondiscrimination • “Ethical love” • Dual relationship

47. 3.09 Commitments to Employers • (a) Social workers/counselors generally should adhere to commitments made to employers and employing organizations. • (b) Social workers/counselors should work to improve employing agencies' policies and procedures and the efficiency and effectiveness of their services. • (c) Social workers/counselors should take reasonable steps to ensure that employers are aware of social workers' ethical obligations as set forth in the NASW Code of Ethics and of the implications of those obligations for social work practice. • (d) Social workers/counselors should not allow an employing organization's policies, procedures, regulations, or administrative orders to interfere with their ethical practice of social work. Social workers should take reasonable steps to ensure that their employing organizations' practices are consistent with the NASW Code of Ethics.

48. The case was opened in March 2014 for Educational Neglect because Melanie had already missed ten days. The school reported that eight year old Melanie had missed twelve days of school during the first semester. The limit per semester is 13 days. The only parent involved is Melanie’s mother, a 33 year old Caucasian female (Sasha). The previous worker had determined that the case should be monitored because there is a pattern of absences. Sasha is an exotic dancer. Her sister (Katrina) stays with Melanie until Sasha returns home from work around midnight on week days, 2 AM on weekend nights. AND

49. The previous worker made weekly home visits. He noted the following in his contact notes: “Usually found several empty beer bottles in the trash; even when Melanie made it to school Sasha was still asleep at 9:00 AM.” “Teachers reported that Sasha was a loud and aggressive mother—often challenging their discipline of Melanie when she failed to turn in homework; Sasha also had a reputation for blatantly criticizing teachers at PTO meetings.” • The previous worker noted that Sasha does not have men stay overnight when Melanie is present. What Are the Strengths and Limitations of Adults in Melanie’s World?

50. You and your client- Jeanette- have agreed that she has achieved the primary goals of her treatment. You have a mutually respectful relationship and, therefore, a healthy therapeutic bond. Even though she will terminate individual counseling with you, she will begin group therapy provided by another counselor at your office. • Jeanette has been making her own jewelry. She knows the market value of her jewelry. To show her gratitude, she gives you a piece worth $20. • Will you/can you ethically accept her gift? Advantages??? Disadvantages?? Ethical principles? Receiving Gifts(ACA) A.10.f