Ethics UpdateFor School CounselorsPresented by:Gary R. Schoener, M.Eq., LicensedPsychologistDirector of Consultation & TrainingSCHOOL DISTRICT 27926 APRIL 2013
• School or Agency rules & policies• Ethics codes• Codes of conduct (licensure board)• Laws & rules• Standard of care: what a reasonable &prudent practitioner would do in thesame or similar circumstances(failure = malpractice)Standards for Conduct
Roles & Responsibilities• The school & professional as fiduciaries –position of trust – explicit vs. implicitwarranties – we set the rules• Supervisory role – the supervisor isresponsible for actions of the superviseedone within scope of employment –vicarious liability (respondeat superiori)vs. negligent supervision• Consultation -- is there such a thing asnegligent consultation?
EthicalStandards [ASCACode,2010]• Responsibilities to students• Confidentiality• Dual Relationships• Appropriate Referrals• Standards related to group work• Danger to self or others• Student records• Evaluation, Assessment & Interpretation• Technology
Decision-makingrecommendedby ASCA•Define the problem emotionally &intellectually•Apply the ASCA standards & the law•Consider the student’s age &develop-mental level•Consider the setting, child’s rights,parent’s rights
Decision-making(continued)•Apply moral principles•Determine your potential course ofaction and their consequences•Evaluate the selected action•Consult•Implement the course of action
•Beneficence – doing good; helping•Non-maleficence – avoiding harm•Autonomy – client’s input and role•Fidelity – consistent with whatpromised•Justice -- welfare of client vs. others;fair use of resources – having a basisto proportion themEthical Framework
Ethical Decision-Making•Not what is ethical vs. unethical, butthe comparative ethicality of theoptions•Weigh which principles are bestdealt with through each option•Likely positive vs. negative outcomesof choosing a given course of action?
Positive Outcomes Negative OutcomesOption A ______________ _______________________________ _______________________________ _________________Option B ______________ _______________________________ _______________________________ _________________Decision table or chart
Professional boundaries•Confidentiality•Parent-child issues•School vs. individual•Dual relationships – limit risk, avoid• Potential exploitation• Conflict of interest• Sexual/romantic involvement
Dual relationships [ASCACode,2010]Avoid dual relationships that might impairtheir objectivity and increase the risk ofharm to students (e.g. counseling familymembers or children of close friends orassociates). If a dual relationship isunavoidable, the school counselor isresponsible for taking action to eliminateor reduce the potential for harm to thestudent through use of safeguards, whichmight include informed consent, consult-ation, supervision, & documentation.
Confidentiality• IEP Meeting & similar challenges – (a)group discussion of confidentiality; (b)private meetings with colleagues fromother fields to work out understandings.• Specific issues – who needs to know?:• Girl is pregnant• Boy involved in gang activity• Drug or alcohol abuse• Girl is sexually assaulted
Boundaries challenges•Contact w/ students not on caseload•Children/relatives of colleagues•Gifts from parents or students•Social encounters•Recovery groups•Attending funeral, graduation, etc. –issue of how visible to be
Ethical& Practice Challenges• Suicide intervention – related challenges:• Keeping up to date -- assessment• Having consultative resources• Safety plans• Intervening w/ dangerousness:• What do we know about assessment?• Talk, writings, posts & what they mean• Duty to warn or protect
Caution regarding internet posts• Some suicides and violent acts against othersfollow angry posts on websites or blogs;• The problem is that we have no good data onwhat constitutes a warning we should heed• In the wake of tragedies, over-reaction towritings & statements can bring about harshtreatment. A 17 year old high school studentwas suspended after she wrote a poem in herpersonal notebook including: “I understand thekillings in Connecticut; I understand why hepulled the trigger” (referring to Adam Lanza)
Challenges of private knowledge• CASE 1: You have a case with severeabuse. You visit your sister and notice thefamily lives next door, and her kids aregoing over to play in the abuse house.What actions do you take if any?• CASE 2: Your brother brags to you how hefooled child protection into closing a case,by threatening his wife and kids to denythe complaint. What action options arethere? What if any should you take?
Traditional Boundaries withregard to Information Access• Client has access to information aboutthe professional based on publishedbiography or revelations, news items• Professional only has access toinformation about client fromdisclosures or access granted throughsigned releases
Self-disclosure by professional• Are you obligated to answer all of thestudent or parent’s questions?• There are not clear rules on this, andthere is great variability in the field• What helpful or expected?• What is risky or ill-advised?• In general, problematic if too often, toomuch, too personal – Most complaintletters begin with list of alleged self-disclosures
Realities of a small community• You & client belong to same church, samesocial club, same athletic club• Client lives in same building as a friend ofyours – what are the issues?• Client interacts with member of yourfamily, with or without knowing theconnection;• Former client interacts with you or afriend or family
Traditional Communication• Communication by traditional mail (nowcalled “snail mail”);• Communication by phone during limitedbusiness hours;• Leave messages on answering machinesfor later response;• Phone calls private, although a messageleft might be saved;• Quick response not expected or promised
Communication in today’s world• Expectation of being able to connect at allhours, even when professional is awayfrom office, via cell phones, texting, etc.• Same is true for emails;• Emails and text messages create a record;• Emails can be misdirected or examined byothers – need to warn people aboutemployer access to work computers
Technology [SectionA.10.inASCACode]• Promote benefits of and clarifylimitations of technological applications• Advocate for equal access to technology• Take reasonable measures for maintain-ing confidentiality of student info.• Understand the intent of FERPA and itsimpact on sharing electronic records• Consider the extent to which cyberbully-ing is interfering with student’s educa-tional progress.
Text Messaging• A growing number of people do textinginstead of (or in addition to) emailing;• This is an abbreviated type of messagewith less information;• This the only way to quickly reach people;• Unlike a phone call, it is silent, so peoplecan receive and view a text without thering of a phone
Text Messaging (continued)• Veterans Crisis Line (800) 273-8255 or textto 838255 http://veteranscrisisline.net• Crisis Connection has a program fortexting in 7 counties in northeast Minn. –they are receiving more texts from youngpeople in a day than they previouslyreceived as phone calls in a month.• Some use for follow-up or crisis contacts
Smartphones & Tablets & Apps• The Therapist May See You Anytime,Anywhere (NY Times, 2/13/12)• Cognitive bias modification (CBM) usingan app for social anxiety which directsattention away from hostile faces• Nader Amir at San Diego State –30”/week for anxiety disorder• Daniel Pine at NIMH – 40 children withchronic anxiety
More apps• Hazelden’s Field Guide to Life• iMedicalApps -- examines new apps• Mobilyze – “a therapist in your pocket”• Can be a source of reference informationor assist the practitioner• Can enable a client to log in personal dataand keep focused on goals• In future may use sensors
More apps• Mood 24/7 https://www.mood247.comget to know yourself• PTSD Coach Mobile App downloaded45,000 times in 58 countrieswww.americantelemed.org/i4a/pges/index.cfm?pageid=3969• Defense Dept: T-2 Mood Tracker identify& track stress; Breathe2Relax releasestress; Tactical Breather manage stress
Social Networking Sites•Facebook -- >845 million users•50% log in on any given day;•Linkedin – 175 million members;•200 million are on Twitter•Posts can be from you, friend,relative, including children
Networking for support• Pro-Ana blogs: social support, ways tocope, self-expression – but risk ofexposure & question about whether itencourages (“pro-ana” on Wikipedia)• Bipolar: www.dbsalliance.org• Victims of abuse: rape and sexual assaultvictim bulletin boards• Do an internet search about anycondition or problem to see what is there
Limiting access to sites• On Jan. 23, 2013, US Court of Appeals for7th Circuit ruled in Doe v. Marion CountyProsecutor, striking down Indiana lawthat imposed broad social mediarestrictions on sex offenders,• The law prevented most registered sexoffenders from using social networkingwebsites, instant messaging services, &chat rooms.
More visibility issues• If you use a family photograph onFacebook, even with the highest privacysettings people see that photo;• Even if you don’t show your family to theworld, friends or family may show yourphoto or a family activity;• 90% of US physicians are on Facebook orLinked in or some social media.
Twitter – constantly being in touch• Twitter involves sending “tweets” – shortmessages sent rapidly all over• People end up engaging in somethingakin to a conversation• For anyone impulsive, this is dangerous• A French court [1/24/13] told Twitter toidentify people who posted anti-Semitic& racist entries [lawsuit claims peoplebroke French law against racist speech]
Hazards Never Imagined (for staffor even clients)• Happy slapping – assaulting someone whileothers film it (usually on cell phone)• Sexting – sending racy photos of yourself orsomeone else• Filming and/or broadcasting a party, orother event• Live broadcast using cell phone or camera(privacy invasion case – Tyler Clementisuicide at Rutgers – Dharun Ravi, age 19,convicted in Feb. 2012.)
Hazards Never Imagined (cont.)• Fake profiles• Internet harassment – which can lead togreat distress the same as any type ofbullying (1/3 to 1/2 of adolescents?);• Fake emails & chat screen names – so onecan harass secretly;• Massive Defriending – being shut-out bygroups of friends or classmates on a socialnetworking site such as Facebook
Undressing your Friends (orenemies)• FalseFlesh.com, billedas “adult image editingsoftware” allows you topaste someone’s faceonto a nude body• “Easily make anypicture a nude picturein minutes”
Cases to lose sleep over• Draker v. Schreiber (2006, 2008) twostudents created My Space site with fakephotos trashing Asst. Principal – AnnaDraker sued them and their parentswithout success;• Megan Meier, driven to suicide by “Josh,”created by the mother of a girl she washaving a dispute with;
Cases (cont.)• Ryan Hallingan, middle school studentwith a learning disorder was the focus ofbullying & suggestions he was gay. Hehanged himself after a girl who claimedto be his friend told him publicly he was a“loser” and that she had been pretendingto be just like him so she could post theirconversations on line and humiliate him.
Cases (cont.)• Ghyslain Raza, the “Star Wars Kid,” aCanadian adolescent made a video in 2002pretending to fight with a light saber as aschool project. Another student posted it,adding music, and 900 million saw it on theweb. Raza was taunted repeatedly anddropped out of school. After treatment fordepression he got support, some from theinternet, graduated law school, and heads afoundation for preservation.
Cases (cont.)• Jesse Logan, Ohio teenager, sent nudepictures of herself to her boyfriend. Afterthey broke up he sent them to other girlswho circulated them on line. She wascalled a slut & ridiculed and startedskipping school. Jesse went public withher story via a TV interview in May 2008,but two months later hanged herself. Aclassic example of the dangers of sexting.
Cases (cont.)• 4/21/11 Buffalo, NY. Police invade homewith assault rifles; throw man on floor;call him a “pervert” and “pedophile” andconfiscate all computers and cell phonesin the house including those of his wifeand daughter. He did not have a passcodeon his wireless router and it was utilizedby someone nearby to downloadpornography. This can be done byneighbor, or from a car.
Other networking issues• Caring Bridge – sites related to illness:counselor’s illness?; posting on client’sbridge?;• Blogs -- posting responses;• Sites focused on special interests:• Client alerts you to site• You encounter client on a site• Former client alerts you to site
Google & Net Research• Should you “Google” a client?• Emergency Situation – identity issue;• Client denies suicide history but hasprior attempts;• Reality check on claims by client;• Checking on criminal justice history;• Screening for sex offenders
Google & Net Research (cont.)•What if the client googles you?• Intern entering therapy googles hertherapist and then wonders if she’s“blown it” by doing this.• What if they tell you? What if yoususpect?• Sites that evaluate professionals –YELP has >25 million hits a month
Some thoughts• The internet creates a “small town” orethnic subgroup for all of us;• With some areas of work such as criminaljustice, there may be greater challenges –clientele, role of security;• Health care rating sites are likely to growand include more therapists –healthgrades.com, vitals.com
Self protection• Be aware of your web-presence• “Google” yourself• If there is false information, contact siteadministrator to get things changed• Should you control on-line presence byexpanding it? Should you post your ownwww.google/com/profile?• Collegial discussion – develop standards
On line reviews• It’s hard to know what they mean – theyare not systematic;• The data about your work or practice maybe in error or outdates;• Many times there are only a few who doa review so there can be a heavyinfluence of just a few ratings• Consumers focus on manner – civility,perceived warmth, etc.
Consent and Disclosure• What ground rules will you have for agiven school or program for googling?• If you do “Google” someone, will youdisclose this to them?• What rules if any will you ask clients tofollow as regards the internet?• Will you ask them to maintain anyprivacy or respect any boundaries?
Communications & Social MediaPolicy (examples)• Email: Email only to arrange or modifyappointments. Do not email content orimportant things we should discuss faceto face…..• Rating or review sites: Info. on them isquestionable; I cannot respond to themand do not need positive ratings; ask meabout any concerns you have about myservices.
Communications & SocialMedia Policy (continued)• Text messaging: please do not use to contactme – leave phone message for time changes,etc.; email not as good but at ….• Internet interaction: do not use wallpostings or other means of communicationon the internet – none are private• Blog or Twitter: I do not follow you on either– if there are things you want to share, bringthem to a session
Communications & SocialMedia Policy (continued)• Friending: It is my practice to not acceptcontact or “friend” requests from clientson social networking sites such asFacebook or Linkedin. They cancompromise privacy and also complicateour helping relationship.• Website or Facebook Page: If you havequestions, bring them in a session. Pleasedon’t interact on the internet.
Communications & SocialMedia Policy (continued)• Search Engines: I do not research myclients on Google or other search engines.There may be occasions where you willdirect me to look up something related toyour life or experience, and if so we candiscuss it at a future meeting. If youchoose to check me out on the web Iwould note that not all information isaccurate, and would suggest that wediscuss anything which you find troubling.
Communications & SocialMedia Policy (continued)• Recording: Unless we have specificallydiscussed it, there will be no recording ofour meetings or any phone conversation. Allof our discussions are private.• Records: I will maintain the records of ourwork together as confidential although somebilling-related information may becommunicated securely. Please rememberthat any notes you make can compromiseyour privacy if not carefully protected.
Gary R. Schoener, Licensed Psychologist, M.Eq.Director of Consultation and Training2421 Chicago Avenue SouthMinneapolis, MN 55404(612) 870-0565 Ext. firstname.lastname@example.org.WalkIn.orgCONSULTATION &TRAINING INSTITUTE