Evolving Ethical Standards in the Digital Age

ABSTRACT

Ethical standards in social work have matured significantly since the formal inauguration of the profession in the late 19th century. This article traces the global evolution of ethical standards in social work, focusing especially on current challenges in the digital age. The author discusses changes over time in social workers’ understanding of ethical issues and development of conceptual frameworks and protocols for managing them. Social workers’ increasing use of digital technology poses novel and unprecedented ethical challenges pertaining to privacy, confidentiality, informed consent, professional boundaries, conflicts of interest, documentation, client abandonment, and professionalism, among others. The article outlines emerging ethical standards designed to help social workers manage ethical challenges in the digital age.     

Boundary Issues in Gay and Lesbian Psychotherapy Relationships

Abstract

Gay and lesbian psychotherapists face unique challenges when working with clients who also identify as gay or lesbian. Of particular importance are the roles professional boundaries play in working with sexual minorities. For example, clinicians must decide whether it is in the client's best interests to know the therapist is gay. Issues of contact outside of the therapy hour also become important, particularly when the therapist lives in a small community, or otherwise risks the possibility of seeing the client in the community. This chapter addresses some of these issues, and poses options for therapists on how to minimize professional boundary or ethical violations.     

Confidentiality

Abstract

Confidentiality was the ethical dilemma most frequently encountered by Israeli social workers in a 1998 national survey (Linzer, Conboy and Ain, 2002). A reanalysis of survey responses found the social workers cared about preventing violations of client privacy, promoting client self-determination, and respecting client dignity, especially when challenged by: (1) public institutions' right to know, (2) limitations of protection of client communications and information, including duty to warn, (3) child and family dilemmas, (4) informed consent ambiguities, and (5) computers and technology utilization. Social workers looked to their own counsel, colleagues, and supervisor's advice and their professional code of ethics for guidance.     

Beyond “Dry Drunkenness”: Facilitating Second Stage Recovery Using Wilber's “Spectrum of Consciousness” Developmental Model

ABSTRACT

The usefulness of Wilber's “Spectrum of Consciousness” developmental model in the treatment of substance abuse is demonstrated by a case study that illustrates how underlying emotional pain and intimacy issues can be worked through in the counselling process with a client during the second stage of recovery from addiction. Wilber's model allows for narcissistic, critical self, social, identity, intimacy, existential, and psycho-spiritual issues to be integrated into the counselling process for long-term recovery. This model provides social workers and addictions counselors with a useful map in embracing client recovery.     

Counselors as Social Advocates

ABSTRACT

The authors discuss the importance of social advocacy and empowerment models in working with lesbian clients. They also explore the multiple contexts that impact lesbian clients and their families. A case illustration involving a lesbian client facing issues of internalized homophobia, heterosexism, sexism, and legal issues is presented. Suggestions for applying a feminist and social advocacy approach are offered.     

Eye Movement Desensitization and Reprocessing in the Treatment of Traumatized Gay Men

Summary

Gay men suffering from traumatic experiences can benefit from Eye Movement Desensitization and Reprocessing treatment (EMDR). In the past decade the theory and practice of EMDR has expanded to address acute and chronic childhood and adult traumas, substance misuse or abuse, identity issues including shame and self-esteem, and health issues. Through a process of accelerated information processing, traumatic memories are desensitized and reprocessed, resulting in less distress for the client in the present and future. EMDR can also be useful for developing internal resources and for exploration of relevant themes for the client. Further attention is needed in exploring the use of EMDR for gay men traumatized by hate crimes, sexual issues resulting from traumatic experiences, and internalized homophobia.     

Privacy and confidentiality in social work

Abstract

In the human services confidentiality is a central principle defining the relationship between the worker and the client. In this paper the authors argue that the human services have privileged the notion of confidentiality over the more fundamental right of privacy. They argue there is a persistent confusion between these two concepts and that privacy is an important but neglected ethical concept within human services. The authors discuss the relationship between privacy and confidentiality and identii some of the implications of the privacy concept for practice.     

Enhancing Critical Thinking and Professionalism Through Use of the Discussion Forum in Social Work Practice Courses

SUMMARY

Development of critical thinking skills, application of theory, ethical decision-making, and achieving a professional identity are among the goals of social work education. This paper describes a three-year experience integrating discussion forums into graduate and undergraduate practice courses. Forums were designed to promote students' ability to use theory, analyze controversial issues, analyze and address ethical issues, professionally critique the work of peers, and conceptualize practice problems and issues for discussion in the forum. Evaluations indicated that discussion forums enhanced the depth of thinking about practice and practice issues and increased the sense of collegiality among students.     

Social Media and Social Work: The Challenges of a New Ethical Space

ABSTRACT

Social media and other online technologies have transformed communication between social workers and service users, with many practitioners engaging and working with clients through social networking sites. While there are numerous ethical issues associated with online practice related to con?dentiality, dual relationships, and boundary crossing, there is lack of clarity about how to deal with such issues. This article uses a case example to develop a nuanced understanding of ethical issues and ethical behaviour in online spaces. We argue that social workers need to link their knowledge of the complex interplay between discourses that underpin daily practice like those related to power, permanency, authorship, audience, embodiment, and professionalism to social media created spaces. In doing this, social workers must retain their commitment to ethical values and critical reflective practice. We conclude with recommendations for education, research, and practice.     

Ethical Dilemmas of Practicing Social Workers Around Psychiatric Medication

Abstract

It is acknowledged that social workers in mental health and other settings routinely experience client-related ethical dilemmas. Further, there is wide recognition of the potential impact of ethical dilemmas on social work practice with clients who use psychotropic medication. Little is know empirically, however, about the experiences of practitioners with these dilemmas. This article describes the results of a national survey of practicing social workers regarding the nature of ethical dilemmas they face related to their work with clients on medication issues. The results make it clear that social workers regularly confront a variety of ethical dilemmas in this type of practice. Many of these dilemmas are related to ambiguities around the knowledge base of practice, appropriate roles of providers, and basic personal and professional values. The authors present implications of these findings for social work practice and further research.     

A Review of Automated Assessment

Summary

The following briefly overviews current computer tools available for clinical testing, diagnostic, and interviewing purposes. The impact of these computer-based assessment tools is then assessed in terms of empirical evidence regarding their performance and client response. The paper concludes with a discussion of training needs ana issues.     

Conducting research using web-based questionnaires: Practical,methodological, and ethical considerations

The use of the internet for social science research is becoming increasingly common. This paper outlines practical, methodological and ethical issues for researchers to consider when using web-based questionnaires. This is illustrated by consideration of the authors' own experience of conducting a study into the phenomenon of self-harm.     

Ethical Issues in the Provision of Online Mental Health Services (Etherapy)

ABSTRACT

A number of ethical issues involved in face-to-face therapy are examined in relation to online therapy (etherapy). Etherapy is defined and its strengths and weaknesses discussed. Specific ethical issues addressed include boundaries of competence, basis in science, avoidance of harm, confidentiality, avoidance of false or deceptive statements, forums, testimonials, solicitation of clients, fees, and informed consent. A concluding section briefly addresses legal issues, particularly interstate etherapy. It is recommended that federal licensing legislation be enacted, informed by the NASW, the APA, and similar groups.     

Working with Women Associated with Bikie Gangs: Practice Dilemmas

Abstract

Much has been written about bikie gangs, but there is little about the women and children who are part of gang life. The present paper describes domestic violence agency social workers’ ethical practice dilemmas when assisting women who have left bikie gangs to search for a new, safer lifestyle away from the gang culture of drug use and violence, in particular sexual violence. The paper concludes with a discussion of the ethical processes and issues in resolving such practice dilemmas.     

Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents

SUMMARY

This paper will focus on ethical dilemmas that arise in the treatment of adolescents with gender dysphoria. We will begin with a discussion of ethical and legal issues pertinent to the treatment of any adolescent, and then proceed to the gender dysphoric adolescent, since there is a great deal of overlap between the two areas. The authors re-view legal decisions, the existing data on adolescent decision-making, and ethical principles that may help the clinician in resolving some very complex situations. Utilizing case vignettes of three gender dysphoric adolescents, the authors provide a pragmatic illustration of the ethical dilemmas involved in evaluation and treatment of these youth. It is the authors' belief that treatment interventions should be based on respect for the adolescent's autonomy and confidentiality where he or she is deemed competent to make decisions.     

Faith and Religious Delusions in First-Episode Schizophrenia

ABSTRACT

Empirical research has not adequately examined whether social workers and clients discuss sociocultural issues when addressing mental health problems, nor the quality of the interaction when such discussion occurs. This exploratory mixed-method study examined the interactional process associated with discussion of sociocultural issues in the first three counseling sessions with four white social worker/client of color dyads. Findings showed that productive cross-cultural interactions were associated neither with specific sociocultural content nor client-worker composition, but rather with the social worker's perception and skill. Analysis differentiated one worker/client dialogue from the others, highlighting the importance of training practitioners to apply social work knowledge and skills in a synthesized manner.     

An Alternative Database Table Design

ABSTRACT

Social workers oftentimes experience a disconnect between the work they do and how that work is captured by agency databases. The database design described in this article attempts to remedy some of those issues–specifically, having to enter identical client information more than one time, not having a way to capture complex family relationships, and not having a way to capture evolving client relationships over time–while being mindful of ideal database design principles, particularly the concept of database normalization. This alternative design grew out of an ongoing research project and is discussed with in the context of one of the involved agencies.     

Phenomenology and intersubjectivity: considerations for webcam-facilitated psychotherapy

ABSTRACT

The clearest distinction between webcam-facilitated versus face-to-face psychotherapy is the available sensorial information. The following questions guide this discussion: 1. How do our senses inform the psychotherapeutic process? 2. What are the implications for the therapeutic process when sensory information is different than during face-to-face therapy? This examination of the role of the senses in the creation of knowledge is grounded in phenomenology. Individual unity of consciousness and reciprocal understanding are applied to literature on webcam-facilitated therapy. An amalgam clinical example illustrates these phenomenological concepts and role of intersubjectivity. The core issues are involvement of sensory processes in the process of psychotherapy and co-construction of knowledge. By accepting the limitations of therapist knowledge, the client is encouraged to articulate and develop their own knowledge, and make conscious their unconscious. It is not necessary for therapist and client to share a physical space for co-creation of knowledge necessary for client transformation.     

Virtues,Values and Victims: Toward a Theory of Social Problems

Abstract

The area of social problems has suffered from inadequate definitions, largely because there is no serious application of theory to the problem. An examination of epistemological issues reveals three distinct approaches: the virtues approach, based on objectivity, the values approach, based on subjectivity, and the victims approach, based on a dialectical relationship of object and subject. The implications of these epistemologies for social problems are assessed, and the necessity of an ethical position is demonstrated. Finally three social problem issues are defined: issues of human survival, of human community, of human dignity.     

Morals,Ethics and practice — in search of social justice

Abstract

This paper reports a study of sources of influence on moral and ethical decision-making in social work practice. Practitioners from ten government and five non government agencies kept journals about the main moral issues they faced over a one-month period and were then interviewed about the nature of those issues, their resolution and the influences that shaped those resolutions. Practitioners' personal moral perspectives were found to be the main sources of influence on resolutions to a wide range of dilemmas and most of those resolutions did not conform to accepted social wok ethical practice principles. Even though the results of this study are drawn from a small sample, some implications are suggested for practitioner development, professional ethics and social work education.