Flying Without a Safety Net

Karen M. Nielsen, PhDAthabasca UniversityEdmonton, Alberta

Flying Without a Safety Net1Building a Safety Net: Why?Private practitioners work aloneWhen there are competing demands, ethical decision making is not always easy

2Ethical Decision MakingThe process of ethical decision-making may be influenced by a number of factors such as:internalization of professional valueseducationexperience ethics training professional identification3Process of Ethical Decision MakingPractitioner 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

4Process of Ethical Decision MakingResolutionChoose course actionAssess priorityIdentify possible course action/projected outcomesIdentify principles incode ethics which bear on case Identify value tensionsIdentify ethical componentsBackground information/case details 5Family 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 therapyDisparate feelings of hopeImpact of system demands on case management 6Family Violence, Ethical Dilemmas and Non-offending Spouses and ChildrenWorking with systems that may have competing obligations, mandates and ethical principles Pressure from Legal SystemVulnerable child testifying Pressure from Child Protection Services to:Use therapy as an investigatory toolUse assessment/therapy to support family dissolution or to facilitate premature family reintegration

7Ethical Dilemmas and Non-offending Spouses and ChildrenPressure from family/non-offending spouse to:Reintegrate due to financial hardshipSocial function/status reasoning (keeping secrets)Belief System:Children need an intact family

8Building the Safety Net: Peer Consultation with Interdisciplinary TeamVoluntary collaboration of peersClients are aware of process & give informed consentPsychologists (counseling & forensic), Clinical Social WorkersDeliberately chosen for peer status & diversity of practice area

9ProcessSelf-directed: Participants express needsCase presentationsResearch presentationsPractice strategies Formal structureMonthly meetingOne year commitmentGroup decision making re new member10Peer Consultation & Multidisciplinary Responses to Ethical DilemmasMaintain professional perspectiveDevelop expanded perspective on competing needs.Bring diversity of thought and different ethical decision making models 11Peer Consultation as an Ethical ActFocus 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.12Meeting Demands for CompetencyLegislation (Health Professions Act) demands that professionals have a continuing competency program.Consultation /clinical supervision is one strategy of meeting the demands 13EvaluationGroupIs this helpful?Are members needs being met? IndividualSelf Reflection14Group EvaluationPeer Supervision Group Session Rating Scale (PSGSRS), based on Group Session Rating Scale (Barry L. Duncan and Scott D. Miller, 2007)

RelationshipNeedsFormatOverall

15Personal ReflectionHow 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?

16Building a Safety Net: Why?Private practitioners work aloneWhen there are competing demands ethical decision making is not always easy

17The End

18ReferencesAbramson, 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.

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