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

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

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

Process of Ethical Decision Making 1. Practitioner recognizes that an ethical dilemma exists 2. 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

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

Family Violence, Ethical Practice and Non-offending Spouses and Children 3 rd 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

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

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

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

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

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

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.

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

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

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

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?

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

The End

References Abramson, M. (1989). Autonomy vs. paternalistic beneficence: Practice strategies. Social Casework, 70, Abramson, M. (1996). Reflections on knowing one-self ethically: toward a working framework for social work practice. Families in Society, 77, 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 ). 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 ). 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)