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    Boudaries youth radio Boudaries youth radio Presentation Transcript

    • Sense and Sensibility: Ethical Considerations in the Workplace Debra Guthmann, Ed.D.
    • Developed by
      • Debra S. Guthmann, Ed.D.
      • Director of Pupil Personnel Services
      • California School for the Deaf
      • Fremont, CA
      • &
      • Project Director, Minnesota
      • Chemical Dependency Program for
      • Deaf and Hard of Hearing Individuals
    • What are Ethics??????
      • “ Doing the right thing because it is the right thing to do.” (Aristotle)
      • Theories or systems of moral principles that provide a code of conduct.
      • The beliefs, standards, and values that are adhered to by an individual, a group, or a society, and which reflect a system of moral principles.
      Ethics are …
      • “ What ought to be” in a world of “what is.”
      • Not static; they change and evolve in response to the changes in individuals and their societies.
      Ethics are …
      • One must have ethical perfection to raise ethical issues
      • Everyone knows when they’ve made mistakes
      Myths about Ethics
      • Law
      • Reflects the minimum standards that society will tolerate
      • Ethics
      • Represents the ideal standards set by professionals
      • The basic purpose is to further the welfare of the client
      Law Versus Ethics
      • WHAT HAPPENS WHEN ETHICS AND THE LAW ARE IN CONFLICT?????
        • EXAMPLE OF SOMETHING UNETHICAL AND LEGAL
        • EXAMPLE OF SOMETHING ETHICAL AND ILLEGAL
      Law Versus Ethics
      • A formal statement of the values and business practices of an agency/corporation.
      • A code may be a short mission statement, or it may be a sophisticated document that requires compliance with specific standards and a complicated enforcement mechanism.
      What is a Code of Conduct?
        • Does your Agency have a Code of Ethics??????
        • What are some examples of “groups” of people/organizations that have Codes of Ethics?
        • Why have a Code of Ethics?
      Code of Ethics?
      • On a piece of paper, write down # 1-10 and the word by each
      • statement which is most accurate for you. (None, Little, Average,
      • Much, Always)
      • 1. How much are you threatened by others whose moral views are different than yours? (None, Little, Average, Much, Always)
      • 2. How much are you threatened by others whose political views are different from yours? (None, Little, Average, Much, Always)
      • 3. How much are you threatened by others whose religious views are different from yours? (None, Little, Average, Much, Always)
      • 4. How much do you allow others to determine your values for you?
      • 5. How much do you allow others to set your priorities for you? (None, Little, Average, Much, Always)
      Self-Inventory Boundary Exercise
      • 6. How often do you tell things about yourself to the wrong people? (None, Little, Average, Much, Always)
      • 7. How much are you thrown off base by people who say and do inappropriate things around you? (None, Little, Average, Much, Always)
      • 8. How much do you throw up a wall to protect yourself from others’ abuses? (None, Little, Average, Much, Always)
      • 9. How often do you store up feelings until they explode and then feel you must apologize for the way you expressed them? (None, Little, Average, Much, Always)
      • 10. How much do you allow yourself to become lost in the other persons with whom you choose to connect? (None, Little, Average, Much, Always)
      Self-Inventory Boundary Exercise
      • An answer of “none” indicates a strong healthy
      • boundary.
      • An answer of always” indicates a
      • weak, unhealthy boundary or no
      • boundary at all.
      • Based on your answers,would you say that you
      • have boundaries that are mostly excellent, good,
      • fair, poor, or non-existent?
      Self-Inventory Boundary Exercise
      • Choose the correct answer
      • A. The word boundary, as used today refers to:
      • 1. Physical and sexual limits
      • 2. Emotional and spiritual limits
      • 3. Relational limits
      • 4. All of the above
      • B. The phrase boundary violation indicates:
      • 1. That one’s limits have been breached
      • 2. That one has expanded his or her frontiers
      • 3. A minor infringement of one’s defenses
      • 4. A problem only to the victim of the violation.
      Boundaries Quiz
      • Choose the correct answer
      • C. A boundary violation causes:
      • 1. No particular consequence
      • 2. An emotional shock wave
      • 3. No harm to a really strong relationship
      • D. Boundaries are :
      • 1. Usually flexible
      • 2. Usually rigid
      • 3. Impossible to change
      • 4. Different for different people
      Boundaries Quiz
      • Mark the incidents that are boundary violations
      • 1. Grandpa takes little Jim fishing.
      • 2. Esther tells Betty a secret Mary told her.
      • 3. You are a counselor and invite a client to go for coffee
      • 4. Your boss wants to know information about your personal life
      • 5. Your boss cries on your shoulder about his/her problem.
      • 6. Your counselor accepts an invitation from you to go to coffee
      • 7. Your boss asks if you’d like a hug
      • 8. Your colleague makes a comment about your weight
      Boundaries Quiz
    • Healthy Versus Unhealthy Boundaries
      • What characteristics indicate to you that a person may have healthy boundaries? Examples?
      • What characteristics indicate to you that a person may have unhealthy boundaries? Examples?
      • The line that separates where I end and where the client begins
      • Emotional and physical space that gives our clients room to focus on their own development and not on us
      • Limits that control the professional’s power so that clients aren’t hurt
      Professional Boundaries
      • Dictate our interactions with clients
      • Fluid limits that change depending on the client’s vulnerability and our role
      • Parameters that keep the professional as objective as possible
      • Put a limit on professional’s power so clients aren’t hurt
      Professional Boundaries
    • Signs of Unhealthy Boundaries
      • Telling all
      • Not noticing when someone invades your boundaries
      • Touching a person without asking
      • Taking as much as you can get for the sake of getting
      • Letting others direct your life
      • Gift giving
      • Touching/hugging
      • Confidentiality
      • Self-disclosure
      • Power differential
      • Boundaries between colleagues
      Issues Related to Boundaries
      • A client of your agency comes with a request to borrow money. She goes into details of why she needs the money and when you would be repaid. Would you always, sometimes, or never lend a client money?
        • Rationale:
      Boundary Scenario
      • One of your clients is interested in earning some extra money and has offered to wash your car. Would you always, sometimes, or never ask a client to wash your car? Rationale:
      Boundary Scenario
      • Physical Boundary Transgressions
      • Emotional Boundary Transgressions
      • Psychological Boundary Transgressions
      • Sexual Boundary Transgressions
      Boundary Transgressions
      • A client comes into your office and picks up papers on your desk.
      • You are meeting with a co-worker and a colleague opens the closed door, sits down, and begins talking about a crisis.
      • Your supervisor hugs you without your permission after a negative performance review.
      Physical Boundary Transgressions
      • A client shares memories of sexual abuse with members of the support staff in a crowded program office.
      • A staff member shares the gruesome details of his divorce during a staff meeting.
      • A staff member acts as therapist for a supervisor.
      Emotional Boundary Transgressions
      • A white client calls a black client a racist name.
      • Your supervisor answers the phone three times during a meeting that you requested.
      • A staff member shames a co-worker by indirect criticism, ridicule, or sarcasm, such as, “Your clients sure have a lot of problems. What’s that say about you?”
      Psychological Boundary Transgressions
      • A client winks at you seductively during class.
      • A staff member tells off-color stories or makes references to sex that make you very uncomfortable.
      • A supervisor wants to know details about your students’ sex lives. Each time you try to discuss other relevant information, your supervisor steers the topic back to sex.
      Sexual Boundary Transgressions
      • Your agency policy states that it is okay for employees to accept homemade gifts from clients. A client gives you an ornately carved cradle that sells for $800 each. Would you always, sometimes, or never accept a gift like this from a client?
        • Rationale:
      Gift Giving Accept or Decline?
      • A client asks you for a ride to an appointment since you are driving in a similar direction. Would you always, sometimes, or never give a client a ride in your car?
        • Rationale:
      Boundary Scenario
      • A former client owns an auto repair shop and offers to fix your car for the same cost as any other shop would charge, but the client will “take good care of your car.” Would you always, sometimes, or never take your car to this auto repair shop?
        • Rationale:
      Boundary Scenario
      • An interpreter scheduled for a meeting in your agency is sick and you have no coverage. Would you (or a colleague) always, sometimes, or never offer to interpret for the meeting?
        • Rationale:
      Boundary Scenario
      • 4,800 psychologists, psychiatrists and social workers
      • were surveyed (return rate of 49%) to examine attitudes and
      • practices regarding dual relationships, social involvements,
      • financial involvements and incidental involvements.
      • ** 800 male and 800 female clinicians were randomly selected from the membership directory for: American Psychological Association, American Psychiatric Association and the National Association of Social Workers
      • ** Survey forms sent out and 1,108 individuals returned surveys that could be used.
      Dual Relationships: A National Study
    • Dual Relationships: A National Study .2% .4% 5% 40% 38% 13% 3% Accept gift worth under $10. 0% .4% .6% .1% 0% .5% 98.3% Engage in sexual activity with client .7% 2.6% .3% .6% 4.2% 23.2% 68.4%% Sexual activity after termination .5% 2.3% .8% 1.4% 13.1% 37% 44.9% Accept gift over $50 Item in % 1-never NR NS 5-always 4-most 3-sometimes 2-rare
    • Dual Relationships: A National Study .5% 1.4% .8% 2.4% 13.6% 37.9% 43.2% Go out to eat after session with client .2% 1.2% .5% .7% 4.6% 29.2% 63.5% Invite client to social event .5% 2.1% .3% .9% 7.5% 18% 70.8% Sell product to client .5% .5% 1.3% 2.9% 29.5% 39.3% 26% Disclose details of personal stresses with client Item in % 1-never NR NS 5-always 4-most 3-sometimes 2-rare
    • Dual Relationships: A National Study .1% .8% 4.6% 20.8% 41% 26.3% 6.3% Accept invite to special event .7% 4.2% 2.7% 12.7% 28.2% 30% 21.4% Accept service as payment for therapy .6% 1.9% 2.1% 10.2% 32% 38.4% 14.8% Become friends after termination Provide therapy to relative or friend of client Item in % 12.6% 1-never NR NS 5-always 4-most 3-sometimes 2-rare .5% 1% 4.2% 21.4% 38.8% 21.4%
    • Self Reported rates of Boundary-Related Behaviors
      • Description
      • Telling a client you are angry with him or her
      • Using self-disclosure
      • Hugging a client
      • Accepting a client’s gift worth at least $50
      • Accepting a gift worth less than $5 from a client
      • Accepting favors (e.g. a ride home) from clients
      • Lending money to a client
      • Inviting clients to a party or social event
      • Reported Rate
      • 42.5% responded –“sometimes to “very often”
      • 69.4% responded – “sometimes” to “very often”
      • 41.7% responded from “sometimes” to “very often”
      • 19.1% responded “rarely”
      • 58.1% responded from “sometimes” to “very often”
      • 35.7% responded “rarely”
      • 23.9% responded “rarely”
      • 15.4% responded “rarely” or “sometimes”
    • Self Reported rates of Boundary-Related Behaviors
      • Description
      • Disclosed details of current personal stresses to a client
      • Went out to eat with a client after a session
      • Accepted a client’s invitation to a special occasion
      • Reported Rate
      • 38.9% did this with a few other clients
      • 11.6% did this with a few other clients
      • 35.1% did this with a few other clients
      • What does Power Differential mean?
    • Exploitation of Relationship Power Differential
      • Exploitation occurs when the professional uses the power of his/her position for personal gain from the client in some way
      • Although the counseling relationship will end, the power differential remains indefinitely and affects any future non-therapeutic relationships
    • POWER DIFFERENTIAL
      • 1 . The ideal - The professional is close enough to be emotionally involved. Clients feel protected and supported in their vulnerability. Te professional is also distant enough to allow clients the autonomy they need to heal.
      • 2. Shrinking the boundary space - If we are uncomfortable with our power, we may reposition ourselves a buddies or peers. We come in too close. Clients may feel confused, angry, or unsafe; they know that we have more power, though we are acting as if we don’t.
      • 3. Expanding the boundary space - If we’ve been too close, we might react by moving too far away. We forget client’s vulnerability and abandon them. We remove ourselves from the complex emotional relationship and thus act outside it. We may begin to think of clients as walking diagnoses – objects to be acted upon. Clients may feel alone, unheard, confused, unsafe.
      • POWER DIFFERENTIAL SCENARIO THE APPOINTMENT
    • POWER DIFFERENTIAL
      • 1. How is “The appointment” similar to or different from what your clients experience?
      • 2. Will your clients speak up directly if they don’t like something you say or do?
      • 3. Will your clients directly refuse to follow a recommendation?
      • 4. What are examples of ways you have power over your clients?
    • Dual Relationships in the Workplace
      • “… when professionals assume two roles simultaneously or sequentially with a person seeking help” (Herlihy & Corey)
      • May occur beginning, during, or after a counseling relationship
      • Not always problematic or unethical
      • Greatest potential for harm may result from the power held, or perceived as being held, by the counselor or other professional
      Dual Relationships
      • They can be difficult to recognize
      • They can be very harmful, but they are not always harmful
      • They are the subject of conflicting views
      • They are not always avoidable
      What Makes Dual Relationships Problematic?
    • Maintaining Neutrality
      • Avoid dual relationships that could impair
      • the professional’s judgement or objectivity
      • in the manner of treatment of the case.
    • Sexual Relationships
      • Most professional associations agree that concurrent sexual and professional relationships are unethical (sexual relationships comprise 20% of complaints and other kinds dual relationship complaints 7%.)
      • Even after termination, some professionals believe “once a client, always a client”
      • 1. Most ethical codes draw strong distinctions between sexual and nonsexual dual relationships.
      • Although the codes considered here prohibit the counselor from having a sexual relationship with a current client, variation occurs in the prohibition of such a relationship with former clients and the length of time that must pass for such a relationship to be permissible.
      • 2. Other relationships cited in the ethical standards include those of friendship, business association and supervision.
      • These interactions also lie on a time line encompassing outside relationships that existed before counseling, those that develop during
      • the course of counseling and those that arise following termination.
      • 3. One variable in determining the ethical ramifications of a potential dual relationship is its avoid ability.
      Ethical Issues regarding Dual Relationships
    • Ethical Guidelines regarding Dual Relationships
      • Former Clients
      • Sexual dual relationships with clients are among the most serious of all ethical violations
      • Some codes say that counselors should not engage in sexual relationships with former clients within a minimum of two years after ending the counseling relationship (per some licenses, two years recommended in other situations, some feel it is never appropriate) .
      • THOUGHTS??????
      • 1. Counselors make every effort to avoid dual relationships with clients that could impact professional judgement or increase the risk of harm to clients.
      • 2. When a dual relationship cannot be avoided, counselors should take appropriate professional precautions such as informed consent, consultation, supervision and documentation to ensure that judgement is not impaired and no exploitation occurs.
      Ethical Guidelines Regarding Dual Relationships
    • Recovering Counselor
      • Self disclosure of personal recovery, should be used judiciously.
    • Social Relationships Role Conflicts
      • The roles of friend and counselor are not compatible
      • A counselor’s objectivity is compromised when the client is also a friend
      • Clients may hesitate to reveal sensitive issues for fear that the counselor/friend will lose respect for them
    • Social Relationships Role Conflicts for Deaf Counselors
      • Clients may be former schoolmates of the counselor, and this can lead to conflicts in role.
      • How the Deaf professional’s social relationships are perceived by others is a potential problem area
      • The social relationships that partners of Deaf counselors have can cause a conflict with the counselor’s professional relationships.
    • Social Relationships Role Conflicts for Hearing Counselors
      • In order to gain respect and credibility, the hearing person must be visible in the Deaf community
      • Some professionals prefer not to socialize within the Deaf community due to confidentiality and trust issues.
      • Professionals may feel an obligation to interpret when no interpreter is available and the need is crucial.
    • Social Relationships Role Conflicts for Deaf & Hearing Counselors
      • It can be awkward for a professional who attends a friend’s party and finds clients there
      • Consumers who discuss confidential issues at a social gathering are encouraged to save it for the office
      • Some professionals indicate that they would accept an invitation from former clients for events such as weddings, graduations, etc.
    • Survey Results: Dual Relationships
      • An obligation to interpret for consumers or Deaf friends when no interpreter available;
      • A struggle to clearly define their role and limitations;
      • Attempts at respecting the Deaf community may be misinterpreted as being aloof, or trying to meet their own financial or professional needs;
    • Survey Results: Dual Relationships
      • Jobs have multiple roles and difficult to define or clarify positions such as administrator, counselor, interpreter, friend, colleague;
      • Difficulties if seen at a social gathering when working in certain kinds of confidential positions;
      • Dilemmas related to determining when socializing within the Deaf community is appropriate in case they run into clients.
    • Unavoidable Relationships
      • In rural areas, professionals may play several roles and may find it more difficult to maintain clear boundaries than professionals who practice in more suburban or urban areas.
    • Unavoidable Relationships
      • Professionals who are asked to provide individual services to clients with close associations,(for example, husband and wife; close friends or enemies) will likely feel role conflicts.
    • Unavoidable Relationships
      • There are situations in which refusing to provide counseling to individuals with whom one has another relationship, would prevent people in need from receiving assistance.
    • Unavoidable Relationships Internet, E-mail & Instant Messaging
      • Set clear and consistent boundaries re: internet communication, anticipating how it could be abused.
      • ******What are you agency policies around E-mail and confidentiality issues ?
    • Private Therapist’s E-mail Policies
      • If you have already read my email policies (see below) and consent to the use of email as a form of communication, please click here .  If you are uncomfortable with email as a form of communication, please contact my office directly at _________.
      • Thank you
    • E-mail Informed Consent
      • I understand that by initiating email correspondence and/or providing you with my email address, I am agreeing to use email as an acceptable form of communication for confidential information.
    • Exploitation of Relationships Bartering
      • Bartering is not generally encouraged
      • It may be a standard practice in certain cultures and communities
      • It can lead to conflicts when the services being exchanged are not viewed by one of the parties as being equitable
    • Potential Role Conflicts Interpreting
      • May be difficult to explain why the professional would not interpret for them
      • May be a struggle to define their role and limitations for those involved
    • Jobs with Multiple Roles
      • May be difficult at times to clarify the various roles (i.e. positions such as administrator, counselor, interpreter, friend/colleague
      • Deaf counselors who have other positions in the Deaf Community (e.g. NAD, AAAD) may feel conflicted when clients join.
    • Dual relationships Among Co-workers
      • There are many kinds of relationships at any worksite. Overlapping roles with co-workers make boundary setting even harder.
      • It can be difficult to approach a co-worker with a boundary concern. This becomes even more difficult when layers of relationships exist among the staff.
      • We benefit by making dual relationships explicit.
    • Dual relationships Among Co-workers
      • We can decide if such relationships energize or deplete the staff by positively or negatively affecting the team and thus clients.
      • Example: You and a colleague play on a softball team after work.
      • 1. How would this relationship be viewed by the rest of the staff?
      • 2. Would your colleagues know about the boundary you’ve set? Will they trust that the boundary is upheld?
      • 3. Even if the dual relationship is explicit, would colleagues feel that the relationship is affecting work?
      • 4. Can colleagues raise their concerns?
      • *****ARE THERE ANY EXAMPLES OF DUAL RELATIONSHIPS THAT OCCUR IN YOUR OFFICE?
    • Dual relationships Among Co-workers
      • In order to keep a system focused on client care, we need to monitor and maintain our boundaries with co-workers.
      • When you’re angry or upset with a colleague or distrust a co-worker, where is your energy going?
      • The amount of energy we expend in self protection, anger, and disagreements with co-workers takes away from what we can give to our clients immediately and in the long term.
      • Caring for ourselves is important so we can care for others. When we take care of ourselves, we can better take care of clients.
    • Confidentiality
      • Is information obtained about clients, outside of the agency still confidential?
      When questions are asked about clients without releases signed, it is important to be clear about roles, so that silence is not misinterpreted.
      • The greater the incompatibility of expectations in a dual role, the greater the risk of harm
      • The responsibilities associated with dual roles diverge, the potential for divided loyalties and loss of objectivity increases
      • Clients by virtue of their need for help, are in a dependent, less powerful, and more vulnerable position
      Measuring Potential for Harm
      • Set healthy boundaries from the onset
      • Involve the client in setting the boundaries of the professional relationship
      • Informed consent needs to occur at the beginning and throughout the relationship
      • Discussion and clarification needs to be an ongoing process
      Safeguards to Minimize Risks
      • Consultation with other professionals can be useful in getting an objective perspective and identifying unanticipated difficulties
      • Practitioners should work under supervision
      • Documentation is an important ethical precaution
      Safeguards to Minimize Risks (continued)
      • Recognize the complexity of therapeutic relationships
      • Attend to self-care
      • Engage in peer consultation
      • Engage in ongoing self-evaluation
      • Acknowledge potential for multiple relationships and possible harm to clients
      • Use sound clinical judgment
      Dual Relationship Considerations
      • You’re a program supervisor and develop a close friendship with one of the program staff. It’s obvious to everyone in the office that you’re friends. However, after a somewhat negative performance review, one of your other staff members complains that you don’t treat everyone fairly. What would you do?
        • Rationale:
      Dual Relationship Scenario
      • You and Keisha, a deaf woman, have been close friends for a long time. Keisha has recently moved and will become a client in your office. You are the only counselor in the office who knows sign language. Would you always, sometimes, or never agree to work with this client?
        • Rationale:
      Dual Relationship Scenario
      • You are a VR counselor, and a client with whom you’re working is newly in recovery from alcohol and other drug problems. You see this client is sometimes struggling with recovery, and often is not able to get much support. You consider sharing with the client that you are in recovery yourself.
        • Rationale:
      Dual Relationship Scenario
    • Dual Relationship Scenario
      • Your community has a very limited number of interpreters, most of whom are children of deaf adults. Several of the interpreters who are available to work in your program are siblings or cousins. Is this a problem? Would you always, sometimes, or never agree to hire family members?
      • You are a rehabilitation counselor in a small town and, while at a social function, you see a client with whom you have been unsuccessful contacting for an appointment. You take the client into another room, and proceed to discuss her vocational plans.
        • What do you see as the ethical issue(s)?
        • How would you handle this situation?
      Ethical Dilemma
      • Competent professionals have the
      • knowledge, skills, and abilities necessary to perform the tasks relevant to that
      • profession as well as
      • understanding when
      • it is appropriate to
      • provide services or to
      • refer a student.
      Competent Professionals
      • Level of skill
      • Objectivity
      • Recognition of existing problems
      • Asking for assistance
        • Referrals
        • Peer consultation
      • Ongoing professional development
      Competence
      • Are you working regular overtime?
      • Are your personal relationships “fifty-fifty” That is, do you get as much from these relationships as you give?
      • Do you take all of your vacation days?
      • Do you have friends who are not related to your work?
      • Do you have friends who are not in the helping fields?
      Personal Conduct Self Care Skills
      • Do you play as hard as you work?
      • Do you really leave work at work? Are you having fun in your life?
      • Who are your mentors? What characteristics of theirs do you admire?
      • How do you keep your work and life separate?
      Personal Conduct Self Care Skills
      • 1. Review your code of ethics and legal mandates.
      • 2. Seek input from a second party.
      • 3. Determine the values (motives) involved.
      • 4. Evaluate the long-term effects of your choices on the individual.
      Making Ethical Decisions
      • 1. Identify the Problem
      • *Gather information in a comprehensive
      • manner
      • *No clear right or wrong..one has to deal with ambiguity
      • 2. Identify potential issues that might be involved
      • *Collect critical issues and discard irrelevant ones
      Steps in Making Ethical Decisions
      • 3. Review relevant ethical guidelines
      • *Do the guidelines, standards or principles of your organization or profession offer a possible solution?
      • *Consider whether your own values and ethics are considered or in conflict with relevant guidelines
      • *If in conflict, do you have a rationale
      Steps in Making Ethical Decisions
      • 4. Obtain Consultation
      • *Objectivity can be difficult when on your own
      • *Consulting can help you think about possible ramifications that might otherwise be overlooked
      • *Allows for feedback regarding your justifications
      Steps in Making Ethical Decisions
      • 5. Consider possible and probably courses of action
      • *Brainstorming can be useful
      • *Enumerate the consequences of various decisions
      • *Ponder the implications (pros and cons)
      • 6. Decide best course of action
      • *Avoid second guessing
      Steps in Making Ethical Decisions
      • Respect autonomy
      • Do no harm
      • Benefit others
      • Be just
      • Be faithful
      Considering Ethical Principles (Kitchener)