Ethical assessment and moral reasoning in child therapy

Social workers find it hard to operationalize the profession's Code of Ethics, and few professionals even rely on the Code, as a point of reference in making judgments when faced with ethical dilemmas. Children and adolescents hold a special position in clinical practice. Issues requiring ethical judgments are more complex, because any intervention involves people other than the child. How the professional meets the interests of the parents and those of the child, is frequently a cause for conflict. This article presents philosophical models of moral reasoning, and ethical assessment, to assist clinicians in identifying and resolving frequently faced practice dilemmas, with the goal of improving the quality of patient care, in terms of both the process and the outcome. Emphasis is not only on the ethics of the actual decision but also on the ethics of the decision-making process itself.This article is based on the author's unpublished dissertation, seminars, and grand rounds presentations on applied ethics in clinical social work. Additionally, this author has had consultative and collaborative contact with the Hastings Center, Institute of Society, Ethics and Life Science.     

Professional Relationship Boundaries: A Social Work Teaching Module

Social workers are often challenged by the complex and ever‐changing dynamics within their relationships with clients, and struggle to find ethical responses within professional boundary grey zones where boundaries with clients can be difficult to identify, yet easy to cross. Social work educators attempt to prepare students for these complex situations, yet in the United States research reveals rates of social work boundary violations that lead one to question the efficacy of social work ethics education. This article describes the educational competencies and instructional strategies that comprise an adaptable course module which was developed in response to this challenge, and intended to increase students' self‐awareness, motivation and professional judgment‐making abilities related to their professional boundaries. The educational competencies for this course include the abilities to: identify boundary violations, apply critical thinking skills to complex professional relationship contexts, increase awareness of self and other, and initiate prevention strategies. In contrast to traditional approaches to education, this article describes instructional strategies that are based on adult‐learning principles, which have the purpose of effectively and creatively teaching topic areas in such a way as to produce behavioural change. These course topic areas include a ‘Professional Relationship Boundaries Continuum’ conceptual framework, boundary violation impacts, personal boundary vulnerabilities, blurring boundary indicators, and risk‐minimizing strategies.     

Teaching Note—Tweeting Macro Practice: Social Media in the Social Work Classroom

ABSTRACT

Despite its ubiquity, social work educators are just beginning to harness social media in teaching. In this teaching note, we discuss our use of Twitter in a bachelor’s-level macro Human Behavior in the Social Environment course. We present results from a survey of 45 students designed to assess their perceptions of Twitter use in the classroom and, in particular, as a macro social work learning tool. Students appreciated using social media in the course and reported that Twitter was a valuable professional social work tool. We explore how social work educators can provide an innovative classroom experience that incorporates ethical and professional use of social media and demonstrate how we used Twitter to apply macro practice competencies.     

Teaching Note—Closing the Health Gap and Social Work Education: A Grand Challenge

The American Academy of Social Work and Social Welfare has defined 12 challenges for the social work profession, one of which is Close the Health Gap, addressing health inequities in the United States. The Close the Health Gap challenge is appropriate for the profession from historical, theoretical, ethical, and professional perspectives. Therefore, it is incumbent on social work educators to incorporate content on this challenge into the classroom. This Teaching Note presents a suggested assignment that can be used to incorporate such content into already existing classes, mapping them onto social work competencies.     

Moving the Boundaries of Feminist Social Work Education with Disabled People in the Neoliberal Era

Until recently social work education in Australia has either marginalised or neglected disability by omission. Given the increasing number of disabled people in the community, the teaching of social work within a disability studies emancipatory paradigm as an essential part of the curriculum is long overdue. As many social work educators have suggested, we are at a critical moment in Australia, where the policy environment in which social work is embedded has largely been reframed in line with neoliberal trends. For disabled people, this has meant an ongoing state campaign to diminish disability entitlements, from decreasing disability social security regimes through to the rationalisation of adult disability support and care schemes. Social workers are negotiating the competing demands of these policy constraints alongside the needs of the disabled people they work with. New moral dilemmas have emerged where they are actively faced with the question of ‘who to serve?’.     

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.     

Are Codes of Ethics Promoting Religious Literacy for Social Work Practice?

ABSTRACT

As codes of ethics play at least a symbolic, if not educational, role in highlighting and informing professional priorities, 16 codes of ethics for social work practice were examined for references to religion and belief and analysed against the four domains of Dinham’s religious literacy framework. Although religion and belief are mentioned in all but two of the documents, approximately half the surveyed codes only mention religion and belief in respect of either knowledge or skills. Some recognise the need for social workers to be aware of their own biases, but few recognise the need to explain what is meant by religion and belief, despite these terms being in flux. While codes of ethics can contribute to the development of religious literacy among social workers, this requires social workers who already have some religious literacy to actively participate when codes of ethics are being revised.

IMPLICATIONS

• It is an ethical imperative that social workers are able to engage with religion and belief.

• Social workers require religious literacy, including skills and knowledge of different religions, recognition of the fluidity of the concepts, “religion” and “belief”, and understanding one’s own attitudes towards religion.

• Codes of ethics can contribute to the development of religious literacy among social workers, but this potential is often not realised as fully as it might be.

     

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.     

Teaching Note—Time for a Teach-In? Addressing Racist Incidents on College Campuses

ABSTRACT

This teaching note discusses a teach-in organized in response to a racist incident on a college campus. An examination of the history of teach-ins demonstrates that social work educators have been involved with them since the beginning of the profession, and the method is a natural fit for social work given its historic role. Social work educators have unique professional and ethical responsibilities to respond to hate crimes and other racist incidents on campus and to develop the competencies of social work students to do the same. Teach-ins are a model for doing so in ways that demonstrate the profession’s commitments to social justice advocacy, social justice education, and a robust implicit curriculum.     

Teaching Note—Ask the Audience: Using Student Response Systems in Social Work Education

Social work educators are uniquely tasked with balancing content while helping students evaluate personal biases and develop ethical conduct necessary for social work professionalism. Social work education may benefit from technology like Student Response Systems (SRS) that allow educators to pose questions on sensitive topics in real time while simultaneously eliciting students' anonymous responses and leading discussion. This article reviews literature on SRS, also known as “clickers,” and presents findings from a survey regarding the use of SRS in a BSW-level social policy class. A model is presented to guide educators in their decisions to incorporate SRS into the classroom, and implications for social work education are discussed.     

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.     

Social Work Sense and Sensibility: A Framework for Teaching an Integrated Perspective

The divisions between ‘micro practice’ and ‘macro practice’ are often traced to historical splits between the originating strands of the social work profession. These splits have been reified in social work education and in institutional settings that largely focus on particular aspects of practice. We argue that this split has been overly polarized and, more importantly, disregards the science and ethics of social work—what we call the sense and sensibility of the profession. Science requires that we recognize the complexity of human activity; ethics require that we alleviate individual suffering and work to attack its root causes. Social work sense and sensibility interweave expectations that practice, policy, theory and research understandings must all be informed by, and inform, ethical social work practice. This bridging framework can help educators respond to calls for connecting all levels and types of social work practice.     

Technical assistance,neo-colonialism or mutual trade? The experience of an Anglo/Ukrainian/Russian social work practice learning project

Since the collapse of the Soviet Union there has been a steady stream of Western consultants ready to work in Eastern Europe and Russia and share professional and academic expertise and experience. Social work, unknown as a discrete discipline or profession in the Soviet Union, has been a growth area with funding from a variety of sources to help promote East–West partnerships.

Social work theory and practice emphasises critical appraisal of policy and embraces issues of power, discrimination and oppression. Social work educators should therefore be especially alert to the complex ethical questions which these kinds of collaborations raise, and adept at finding practical solutions or workable compromises. This article explores these ethical and political issues with reference to a project to develop social work practice learning in a Russian oblast’ (region). The project was an ambitious partnership of British, Ukrainian and Russian educators, involving numerous Russian social work and related agencies, and four Russian universities and colleges in one oblast’. The authors use a series of vignettes to help the reader achieve insights into these East–West transactions. The article concludes with a discussion of different interpretations of these dealings, using three prisms: technical assistance, neo-colonialism and mutual trade.     

Evaluation as a social practice: Disenchantment,rationalities and ethics

We live in an age where evaluation is omnipresent. However, as a social practice, it has become hard to distinguish from auditing, inspection, quality assurance and other means of social control. As a result, the evaluation occupation is now widely viewed as intrusive and burdensome – a self-serving commercial enterprise. Yet, evaluation at its creation was conceived (or perhaps imagined) as a vocation devoted to the public good. This article probes the root causes of the spreading disenchantment; puts Weber’s logic of social action to work; and puts his rationalities concepts to work to explore the ethical and professional challenges currently faced by the evaluation community.     

The international field placement: a reconciliation of identity

The international field placement is a site of both identity confusion and identity development for the social work student. Aiming to develop their professional identity they are faced with a challenge: the presence of two dominant identities, the tourist identity and the student identity. Whilst the embodiment of the tourist identity has often facilitated the student’s motivation to undertake the placement experience, the student identity is what both university staff and agency field educators perceive as integral to student engagement in this remote educational setting. Social work educators perceive this identity challenge as an impediment to learning. In contrast, students report feeling that their tourist traits strengthened their personal and professional capacity, natural curiosity and ability to engage with the local community. By analysing the roles of university staff as liaison support, and field educators as agency supervisors, it is possible to explore a teaching and learning relationship that is student-centred, grounded in the immersive international experience. Through privileging the student’s voice social work educators involved with organising, supporting and supervising international field placements are able to understand the placement as a continuum of learning. On this continuum identity reconciliation is viewed as a crucial element in the development of a professional identity.     

The Resilient Survivor—A Student Social Worker's Journey on Placement

This paper represents the continuation of my ‘personal and professional journey’ from social work student to social work practitioner focusing on my first Practice Learning Opportunity (PLO). Recognising the potential impact of childhood sexual abuse (CSA) in a classroom environment is as important as the potential impact on actual practice learning and practice. This is salient in the real world of social work practice as the potential misuse of a painful childhood experience has greater ramifications. Utilising the ideas and assumptions of social constructionism (including context and multivocality) the significance of silence from social work educators shall be examined in relation to self-disclosure as a means of aiding PLO learning and practice. This paper will also focus on the concept of critical reflection and its significance in exploring the transferability of a childhood experience such as CSA and personal and professional dilemmas regarding self-disclosure. This paper concludes by highlighting areas for consideration for both students and social work educators and conveys an important message regarding the importance of communication between students and social work educators.     

Books Received

In addition to acting as teachers, social work educators can play many other roles in relation to their students—including sexual partner, friend, therapist, or employer. Combining the role of instructor with one of these other roles may lead to ethical violations and dilemmas. This article urges educators to consider their power differential and the potential for harm to their students before entering a dual relationship. It reviews the NASW Code of Ethics and relevant literature about dual relationships in practice and in academia; discusses examples of dual relationships in social work education; and formulates questions for educators to use in assessing ethical practice.     

A Bioethics Approach to Social Work Practice With Transgender Clients

Increased advocacy for the informed consent model of transgender health care specifies that patients should be in control of access to receiving medical interventions such as hormone therapy or surgery. However, in practice, mental health clinicians, including clinical social workers, are increasingly called upon by medical providers to serve as gatekeepers for these processes. It is frequently the role of social workers to assess transgender clients’ baseline mental health and their understanding of the consequences of treatment, and to forward recommendations to medical providers regarding the readiness of patients to transition. Therefore, social workers assisting transgender clients must be aware of the ethical standards that are particularly pertinent to their work with this marginalized and oppressed population. They must also be prepared to address unique ethical dilemmas that may be especially challenging to resolve. In this article we apply the most commonly utilized bioethical framework known as Principlism to describe the ethical standards and values that are particularly important to consider when working with transgender clients, namely autonomy; beneficence; nonmaleficence; and social justice. Because clinical social workers are frequently in the position of balancing client self-determination with their role as gatekeepers, a framework for resolving resulting ethical dilemmas is described (I CARE) and applied to three case examples.     

An Interdisciplinary Ethics Module for MSW and Nursing Students

The teaching of ethics in social work can be incorporated in the curriculum in multiple ways. This article outlines an interdisciplinary module with nursing and social work students at a small United States Midwestern university as a means of developing awareness of multiple perspectives surrounding ethical dilemmas in healthcare. Background information related to teaching interdisciplinary ethics and use of case studies is presented. Discussion of the interdisciplinary ethics exercise includes a summary of observations relative to the exercise and challenges in its implementation are outlined.     

A Strengths Perspective on Caregiving at the End-of-life

Abstract

The most recent version of the Australian Association of Social Workers Code of Ethics includes substantial reference to social workers’ professional responsibilities for environmental awareness and advocacy. This article reports on a qualitative study of 20 Australian environmentally-conscious social workers from a variety of fields of practice. The study found that while there was a high level of awareness of the relevance of environmental issues for social work practice, participants reported professional and organisational constraints, which prevented them from aligning their environmental concerns with their professional practice. The findings from this study suggest that proenvironmental views and actions may not yet be accepted as a legitimate aspect of social work practice, despite strong recognition of the links between social justice, human rights, social work, and the environment in the Australian Association of Social Workers Code of Ethics.