Week 2 Ethical Issues in Social Work ResearchWhether social

Week 2: Ethical Issues in Social Work Research
Whether social workers are counseling clients or conducting
research, an adherence to standards for ethical practice is
mandated. Persuading a client to participate in sexual activities
during sessions is clearly unethical. Conducting research that
puts clients in either physical or emotional danger is clearly
unethical. However, there are myriad situations in which the
answer of right or wrong is not so clear. This week, you
consider the mandates and standards for ethical practice in
social work. You also review guidelines in Walden University's
Institutional Review Board (IRB) document.
Learning Resources
Note:
To access this week’s required library resources, please click on
the link to the Course Readings List, found in the
Course Materials
section of your Syllabus.
Required Readings
The Parker Family
S

ara is a 72-year-old widowed Caucasian female who lives in a
two-bedroom apartment with her 48-year-old daughter,
Stephanie, and six cats. Sara and her daughter have lived
together for the past 10 years, since Stephanie returned home
after a failed relationship and was unable to live independently.
Stephanie has a diagnosis of bipolar disorder, and her overall
physical health is good. Stephanie has no history of treatment
for alcohol or substance abuse; during her teens she drank and
smoked marijuana but no longer uses these substances. When
she was 16 years old, Stephanie was hospitalized after her first
bipolar episode. She had attempted suicide by swallowing a
handful of Tylenol® and drinking half a bottle of vodka after
her first boyfriend broke up with her. She has been hospitalized
three times in the past 4 years when she stopped taking her
medications and experienced suicidal ideation. Stephanie’s
current medications are Lithium, Paxil®, Abilify®, and
Klonopin®.
Stephanie recently had a brief hospitalization as a result of
depressive symptoms. She attends a mental health drop-in
center twice a week to socialize with friends and receives
outpatient psychiatric treatment at a local mental health clinic
for medication management and weekly therapy. She is
maintaining a part-time job at a local supermarket where she
bags groceries and is currently being trained to become a
cashier. Stephanie currently has active Medicare and receives
Social Security Disability (SSD).
Sara has recently been hospitalized for depression and has some
physical issues. She has documented high blood pressure and
hyperthyroidism, she is slightly underweight, and she is
displaying signs of dementia. Sara has no history of alcohol or
substance abuse. Her current medications are Lexapro® and
Zyprexa®. Sara has Medicare and receives Social Security
benefits and a small pension. She attends a day treatment
program for seniors that is affiliated with a local hospital in her

neighborhood. Sara attends the program 3 days a week from
9:00 a.m. to 2:00 p.m., and van service is provided free of
charge.
A telephone call was made to Adult Protective Services (APS)
by the senior day treatment social worker when Sara presented
with increased confusion, poor attention to daily living skills,
and statements made about Stephanie’s behavior. Sara told the
social worker at the senior day treatment program that, “My
daughter is very argumentative and is throwing all of my things
out.” She reported, “We are fighting like cats and dogs; I’m
afraid of her and of losing all my stuff.”
During the home visit, the APS worker observed that the living
room was very cluttered, but that the kitchen was fairly clean,
with food in the refrigerator and cabinets. Despite the clutter,
all of the doorways, including the front door, had clear egress.
The family lives on the first floor of the apartment building and
could exit the building without difficulty in case of emergency.
The litter boxes were also fairly clean, and there was no sign of
vermin in the home.
Upon questioning by the APS worker, Sara denied that she was
afraid of her daughter or that her daughter had been physically
abusive. In fact, the worker observed that Stephanie had a
noticeable bruise on her forearm, which appeared defensive in
nature. When asked about the bruise, Stephanie reported that
she had gotten it when her mother tried to grab some items out
of her arms that she was about to throw out. Stephanie admitted
to throwing things out to clean up the apartment, telling the
APS worker, “I’m tired of my mother’s hoarding.” Sara agreed
with the description of the incident. Both Sara and Stephanie
admitted to an increase in arguing, but denied physical violence.
Sara stated, “I didn’t mean to hurt Stephanie. I was just trying
to get my things back.”

The APS worker observed that Sara’s appearance was unkempt
and disheveled, but her overall hygiene was adequate (i.e., clean
hair and clothes). Stephanie was neatly groomed with good
hygiene. The APS worker determined that no one was in
immediate danger to warrant removal from the home but that the
family was in need of a referral for Intensive Case Management
(ICM) services. It was clear there was some conflict in the
home that had led to physical confrontations. Further, the house
had hygiene issues, including trash and items stacked in the
living room and Sara’s room, which needed to be addressed.
The APS worker indicated in her report that if not adequately
addressed, the hoarding might continue to escalate and create an
unsafe and unhygienic environment, thus leading to a possible
eviction or recommendation for separation and relocation for
both women.
As the ICM worker, I visited the family to assess the situation
and the needs of the clients. Stephanie said she was very angry
with her mother and sick of her compulsive shopping and
hoarding. Stephanie complained that they did not have any
visitors and she was ashamed to invite friends to the home due
to the condition of the apartment. When I asked Sara if she saw
a problem with so many items littering the apartment, Sara
replied, “I need all of these things.” Stephanie complained that
when she tried to clean up and throw things out, her mother
went outside and brought it all back in again. We discussed the
need to clean up the apartment and make it habitable for them to
remain in their home, based on the recommendations of the APS
worker. I also discussed possible housing alternatives, such as
senior housing for Sara and a supportive apartment complex for
Stephanie. Sara and Stephanie both stated they wanted to remain
in their apartment together, although Stephanie questioned
whether her mother would cooperate with cleaning up the
apartment. Sara was adamant that she did not want to be
removed from their apartment and would try to accept what
needed to be done so they would not be forced to move.

The Parker Family
Sara Parker: mother, 72
Stephanie Parker: daughter, 48
Jane Rodgers: daughter, 45
Stephanie reported her mother is estranged from her younger
sister, Jane, because of the hoarding. Stephanie also mentioned
she was dissatisfied with her mother’s psychiatric treatment and
felt she was not getting the help she needed. She reported that
her mother was very anxious and was having difficulty sleeping,
staying up until all hours of the night, and buying items from a
televised shopping network. Sara’s psychiatrist had recently
increased her Zyprexa prescription dosage to help reduce her
agitation and possible bipolar disorder (as evidenced by the
compulsive shopping), but Stephanie did not feel this had been
helpful and actually wondered if it was contributing to her
mother’s confusion. I asked for permission to contact Jane and
both of their outpatient treatment teams, and both requests were
granted.
I immediately contacted Jane, who initially was uncooperative
and stated she was unwilling to assist. Jane is married, with
three children, and lives 3 hours away. At the beginning of our
phone call, Jane said, “I’ve been through this before and I’m not
helping this time.” When I asked if I could at least keep in
touch with her to keep her informed of the situation and any
decisions that might need to be made, Jane agreed. After a few
more minutes of discussion around my role and responsibilities,
I was able to establish a bit of rapport with Jane. She then
started to ask me questions and share some insight into what
was going on in her mother and sister’s home.

Jane informed me that she was very angry with her mother and
had not brought her children to the apartment in years because
of its condition. She said that her mother started compulsively
shopping and hoarding when she and Stephanie were in high
school, and while her father had tried to contain it as best he
could, the apartment was always cluttered. She said this had
been a source of conflict and embarrassment for her and
Stephanie all of their lives. She said that after her father died of
a heart attack, the hoarding got worse, and neither she nor
Stephanie could control it. Jane also told me she felt her mother
was responsible for Stephanie’s relapses. Jane reported that
Stephanie had been compliant with her medication and
treatment in the past, and that up until a few years ago, had not
been hospitalized for several years. Jane had told Stephanie in
the past to move out.
Jane also told me that she “is angry with the mental health
system.” Sara had been recently hospitalized for depression, and
Jane took pictures of the apartment to show the inpatient
treatment team what her mother was going home to. Jane felt
they did not treat the situation seriously because they
discharged her mother back to the apartment. Stephanie had
been hospitalized at the same time as her mother, but in a
different hospital, and Jane had shown the pictures to her
sister’s treatment team as well. Initially the social worker
recommended that Stephanie not return to the apartment because
of the state of the home, but when that social worker was
replaced with someone new, Stephanie was also sent back home.
When I inquired if there were any friends or family members
who might be available and willing to assist in clearing out the
apartment, Jane said her mother had few friends and was not
affiliated with a church group or congregation. However, she
acknowledged that there were two cousins who might help, and
she offered to contact them and possibly help herself. She said
that she would ask her husband to help as well, but she wanted

assurance that her mother would cooperate. I explained that
while I could not promise that her mother would cooperate
completely, her mother had stated that she was willing to do
whatever it took to keep living in her home. Jane seemed
satisfied with this response and pleased with the plan.
I then arranged to meet with Sara and her psychiatrist to discuss
her increased anxiety and confusion and the compulsive
shopping. I requested a referral for neuropsychiatric testing to
assess possible cognitive changes or decline in functioning. A
test was scheduled, and it indicated some cognitive deficits, but
at the end of testing, Sara told the psychologist who
administered the tests she had stopped taking her medications
for depression. It was determined Sara’s depression and
discontinuation of medication could have affected her test
performance and it was recommended she be retested in 6
months. I suggested a referral to a geriatric psychiatrist for
Sara, as she appeared to need more specialized treatment. Sara’s
psychologist was in agreement.
Because they had both stated that they did not want to be
removed from their home, I worked with Sara and Stephanie as
a team to address cleaning the apartment. All agreed that they
would begin working together to clean the house for 1 hour a
day until arrangements were made for additional help from
family members. In an attempt to alleviate Sara’s anxiety
around throwing out the items, I suggested using three bags for
the initial cleanup: one bag was for items she could throw out,
the second bag was for “maybes,” and the third was for “not
ready yet.” I scheduled home visits at the designated cleanup
time to provide support and encouragement and to intervene in
disputes. I also contacted Sara’s treatment team to inform them
of the cleanup plans and suggested that Sara might need
additional support and observation as it progressed. Jane
notified me that her two cousins were willing to assist with the
cleanup, make minor repairs, and paint the apartment. Jane

offered to schedule a date that would be convenient for her and
her cousins to come and help out.
Key to Acronyms
APS: Adult Protective Services
ICM: Intensive Case Management services
SSD: Social Security Disability
We then discussed placement for at least some of the cats,
because six seemed too many for a small apartment. Sara and
Stephanie were at first adamant that they could not give up their
cats, but with further discussion admitted it had become
extremely difficult to manage caring for them all. They both
eventually agreed to each keep their favorite cat and find homes
for the other four. Sara and Stephanie made fliers and brought
them to their respective treatment programs to hand out.
Stephanie also brought fliers about the cats to her place of
employment. Three of the four cats were adopted within a week.
During one home visit, Stephanie pulled me aside and said she
had changed her mind—she did not want to continue to live
with her mother. She requested that I complete a housing
application for supportive housing stating, “I want to get on
with my life.” Stephanie had successfully completed cashier
training, and the manager of the supermarket was pleased with
her performance and was prepared to hire her as a part-time
cashier soon. She expressed concern about how her mother
would react to this decision and asked me for assistance telling
her.
We all met together to discuss Stephanie’s decision to apply for
an apartment. Sara was initially upset and had some difficulty
accepting this decision. Sara said she had fears about living

alone, but when we discussed senior living alternatives, Sara
was adamant she wanted to remain in her apartment. Sara said
she had lived alone for a number of years after her husband died
and felt she could adjust again. I offered to help her stay in her
apartment and explore home care services and programs
available that will meet her current needs to remain at home.
Yegidis, B. L., Weinbach, R. W., & Myers, L. L. (2018).
Research methods for social workers
(8th ed.). New York, NY: Pearson.
Chapter 2, “Ethical Issues in Research” (pp. 24-51)
Labott, S. M., & Johnson, T. P. (2004).
Psychological and social risks of behavioral research. IRB:
Ethics & Human Research
,
26
(3), 11–15.
Retrieved from Walden Library databases.
Nicotera, N., & Walls, N. E. (2010). Challenging perceptions of
academic research as bias free: Promoting a social justice
framework in social work research methods courses.
Journal of Teaching in Social Work
,
30
(3), 334–350.
Walden University (n.d.). Academic Guides: Research Ethics &
Compliance: Welcome from the IRB. Retrieved September 12,
2016, from
http://academicguides.waldenu.edu/researchcenter/orec

Research Ethics FAQs for Doctoral Students in the
Clinical/Intervention Fields: Practical Tips for Avoiding Delays
and Problems in the Research Approval Process
Ries, N. M. (2007). Growing up as a research subject: Ethical
and legal issues in birth cohort studies involving genetic
research.
Health Law Journal
,
15
, 1–41.
National Institutes of Health Office of Human Subjects
Research Regulations and Ethical Guidelines (n.d.). Ethical
principles for human subjects research. Retrieved June 8, 2016,
from https://humansubjects.nih.gov/ethical-guidelines-
regulations
Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014).
Sessions: Case histories
. Retrieved from Baltimore, MD: Laureate International
Universities Publishing. [Vital Source e-reader].
The Parker Family
Discussion 1: Sara Parker and Ethics
One of the reasons there can be so much debate about ethical
issues is because ethics are opinions informed by people's
values and people have different values. People can disagree
about whether or not something is unethical, and, oftentimes,

there is no right answer. In order to make decisions about what
may be ethical or unethical, Yegidis (2018, p. 25) suggests
focusing on these three questions:
"Who should benefit or suffer from the actions of the
researcher?"
"Whose rights should take priority over those of others?"
"Does the end (increased knowledge) justify the means (the
methods used to acquire it and their potential for harm)?"
For this Discussion, view the Sessions episode on the Parker
family. As you do so, consider which, if any, ethical mandates
or standards were violated.
By Day 3
Post
a response explaining your reaction to the Parker episode. Be
sure to address whether or not the social worker violated any
ethical mandates or standards. Also explain which strategies
could have been used to guide ethical practice. Finally, describe
the responsibility of the social workers in the Parker case.
Please use the resources to support your answers.
By Day 5
Respond
with a reaction to a colleague's views on the Sara Parker case
study. Use these questions to guide your thinking:
Do you think that research participants should be compensated?

How would compensation impact voluntary participation?
Do research regulations do enough to protect special
populations?
Are there any changes you would like to make to our current
research protections?
Please use the resources to support your post.
Discussion 2: The Research Approval Process
The early years of the 20th century were host to a number of
unethical research studies. Research involving the way that a
young child reacts to and generalizes fear responses, medical
experiments conducted in concentration camps, and observing
the way people respond to authority were just a few of the most
famous experiments whose byproduct was placing clients in
physical pain and/or mental anguish. Since then, it has been
recognized that research subjects need to be protected from the
flagrant disregard of researchers. This week, you consider the
guidelines in Walden University's Institutional Review Board
(IRB) document, "Research Ethics FAQs for Doctoral Students
in the Clinical/Intervention Fields: Practical Tips for Avoiding
Delays and Problems in the Research Approval Process."
By Day 5
Post
a description of two ways the guidelines in Walden University's
IRB document may impact the selection of a research
population, research setting, and/or research design. Please use

the resources to support your answer.
By Day 7
Respond
to a colleague's post in one of the following ways:
Expand upon your colleague's post regarding ways that the
IRB's ethical guidelines may impact his or her study.
Explain an insight you gained from this week's Resources that
addresses a topic in your colleague's post.
Please use the resources to support your post.
Rhondas Response
The Parker case is a case where a mother, Sara, and daughter,
Stephanie, are living in home together. Sara has recently lost
her husband and Stephanie suffers from multiple mental health
diagnosis. Stephanie feels as though Sara is a hoarder and
attempts to clean the home by throwing somethings away. This
cause conflict between Sara and Stephanie. The social worker
became very pushy towards the end of the video. I seemed as
though she was putting her client on the spot to decide on
something that she was very leery of.
Ethics violation
The social worker in this video did in fact violate a few ethics

principles. One of a social worker’s ethical responsibilities
include privacy and confidentiality (NASW,2018). In this video,
the social worker pushed the client to be okay with the social
worker giving the client’s phone number to a colleague for her
to participate in a study (Plummer, Makris & Brocksen, 2014).
Not only did Sara indicate verbally that she was not interested
in participating in this study, but she also changed her posture
and facial expressions to allow the social worker now that this
is not something that she was comfortable doing (Plummer,
Makris & Brocksen, 2014). Instead of backing away from the
idea, the social worker continued to force the client to
participate in the study.
Another ethical violation that the social worker exhibited was
solicitations (NASW,2018). She continuous solicited her client
to participate in a study that she obviously did not was to
participate in. One of the ethical responsibilities states that a
social worker is not to solicit unwarranted clients. The social
worker was very adamant about allowing the client to
participate in this study.
Additionally, the social worker violated the ethical principles
by referring a client for services when it was not necessary for
her treatment (NASW,2018). The client’s participation in this
study is not something that is mandatory, and therefore should
not have been pushed onto the client. The social worker also
avoided answering the client’s questions. Instead of provided
answers to the questions, she continued to remind her client that
she would receive compensation for her participation.
Strategies that Could have been used
A strategy that could have been used in the scenario
is to explain to the client what the study consists of in as much
detail as possible and using layman terms when possible. Also,
the social worker could explain how participating in this study

may benefit the client. Often, people do not want to participate
in something if they feel that they will not get anything from it.
There could be other benefits that would benefit the client other
than money. This way the client may have been able to make an
informed decision instead feeling forced to participate.
Responsibilities
In the Parker episode for this week, Sara is speaking with a
social worker to create a sense of peace within the home, by
reaching a common ground that will satisfy both parties. Other
responsibilities of the social worker include referring or
providing other resources that she tells her clients may benefit
from.
Angelica Wiggins
RE: Discussion 1 - Week 2
COLLAPSE
Individuals living with serious mental illness are often difficult
to engage in ongoing treatment, with high dropout rates. Poor
engagement may lead to worse clinical outcomes, with symptom
relapse and rehospitalization (Dixon, Holoshitz & Nossel,
2016). A specific challenge in the mental health care system for
the care of individuals with chronic illnesses is the treatment
gap. The treatment gap represents the absolute difference
between the true prevalence of a disorder and the treated
proportion of individuals affected by the disorder (Kohn et al.,
2004).
In the Parker case, mental illness is apparent. Both the mother,
Sara, and daughter, Stephanie, suffer from depression. It has
been said that the mental health system has not done enough to
care for Sara and Stephanie’s illness. This results back to the

treatment gap. The depression is there but the treatment has
been ineffective.
With the intensity of this case, the social worker did well
however, she did violate ethical mandates or standards. In a
sense the social work became a little pushy and forced what she
thought was best for the client onto the client, which was
participating in the study.
The treatment gap needs to be addressed and will guide ethical
practice. The treatment gap must be bridged in order to
effectively identify a client’s disconnection. As social workers
we may want things for our clients so bad however, they
ultimately have to make the decision. Stressors and
uncomfortableness can aggravate mental illness and the
treatment gap and make treatment more challenging.
It is the social worker’s role to reduce any stressors and present
the clients with treatment and resolutions that will best fit their
situation and lifestyle while allowing them a say-so in the
process.

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