Texas Homeless Education Office The University of Texas at Austin Charles A. Dana Center 2901 N IH 35, Room Austin, Texas 78722

Ethical considerations in working with homeless youth and families

Ethical Considerations for Working with Homeless Youth & Families AGENDA Identify the what and why of ethics Identify common ethical standards in working with homeless youth & families Identify common ethical issues when working with homeless youth & families Identify possible solutions

Runaway, pushed out, and unaccompanied youth are a growing proportion of children in homeless situations They often know what they are running from, but have no realistic idea of what they are running to. YOUTH ARE HOMELESS

Runaway, pushed out, and unaccompanied youth are a growing proportion of children in homeless situations They often know what they are running from, but have no realistic idea of what they are running to. YOUTH ARE HOMELESS

What are some of the ethical considerations when working with the youth in this video?

Common situations that have ethical implications when working with youth Meeting with youth in “non-traditional” settings Mistaking friendship for appropriate trust building Keeping Confidentiality – to whom to tell what? When the youth says “Don’t tell anyone.” Reporting abuse and neglect – concerns for youth safety Reporting runaway – concerns for youth safety Addressing risky behaviors – if you do, will they leave? Giving Money, taking kids home, leaving youth in unsafe setting Failing to report or to act on information shared Dealing with “I only trust you” with certain information

Common considerations that have ethical implications when working with youth Dissonance: when your values differ from those of your client, your agency, your professional licensure, society at large. Example: abortion, HIV services, GLBT, etc. Confidentiality: issues with confidentiality that can particularly occur within residential, street, and home-based settings - who should be present when a home visit is occurring? What happens when other residents overhear information about a particular client? How do different agencies safeguard against this? Who needs to know which information? Referral: how to access other services for a client, without sharing confidential information? How to know when to access a referral, and how much information to share? Boundaries: are frequent issues within residential, community, and home- based settings, and when working with unaccompanied youth.

Common considerations that have ethical implications when working with youth Agency or professional policies and/or practices that are particularly helpful in addressing ethics conflicts. Do no harm – Understanding competencies: What tells social workers that they are working beyond their competence? Dual Relationships – business, social, relative, friends, etc. Language – What workers see and what they say frames the work for possibilities or barriers; labels, or enables the client. Informed consent – self consent for unaccompanied youth? At what age? Crisis work – what happens when you are in crisis mode? Does “business as usual” go out the door and what does this mean for ethical When are practitioners crossing ethical lines? When are boundaries fluid and when are they rigid? What information is too much to share, and what is not enough? Who does the youth worker look to for guidance in making ethical decisions in his/her work? How do crisis situations challenge ethical standards? Reporting, trust loss if you do; when safety and rapport building seem to be at odds.

What Are Professional Ethics? While the law establishes a minimum standard proscribing policy and practice, ethics defines the ideal intellectual approach to moral issues

“Professional ethics is not synonymous with personal morality or governmental regulation; it is the organized and systematic articulation of child and youth care values and their application to the issues encountered in practice.” Martha A. Mattingly, University of Pittsburg What Are Professional Ethics?

Professional ethics include: Core values – those absorbed from our family and culture, and those developed from life experiences

What Are Professional Ethics? Professional ethics include: Core values - those absorbed from our family and culture, and those developed from life experiences Ideals towards which the profession strives – i.e. safety and well-being of children and youth

What Are Professional Ethics? Professional ethics include: Core values - those absorbed from our family and culture, and those developed from life experiences Ideals towards which the profession strives – for example safety and well-being of children and youth Standards of professional conduct – for example to never intentionally do harm

What Are the Benefits of Adherence to Professional Ethics? Protection of a vulnerable clientele Protection of the professional who no longer stands alone in the face of difficulty, but stands with the profession

Why should programs serving youth & families be interested in ethical considerations?

Why should programs serving youth be interested in ethical considerations? Professional ethics can be thought of as representing the values of child and youth care to which the field holds a common commitment. When working with youth this is a commitment to protect, nurture, and enhance the well-being of children and youth. Thus we must………

Why should programs be interested in ethical standards when working with youth? Professional ethics can be thought of as representing the values of child and youth care to which the field holds a common commitment. When working with youth this is a commitment to protect, nurture, and enhance the well-being of children and youth. Thus we must……… understand their vulnerability

Why should programs be interested in ethical standards when working with youth? Professional ethics can be thought of as representing the values of child and youth care to which the field holds a common commitment. When working with youth this is a commitment to protect, nurture, and enhance the well-being of children and youth. Thus we must……… understand their vulnerability understand whether current practices “do no harm”

Why should programs be interested in ethical standards when working with youth? Professional ethics can be thought of as representing the values of child and youth care to which the field holds a common commitment. When working with youth this is a commitment to protect, nurture, and enhance the well-being of children and youth. Thus we must……… understand their vulnerability understand whether current practices “do no harm” understand the impact of staff attitudes and behavior, agency policy and governmental policy and regulation

Why should programs be interested in ethical standards when working with youth? Professional ethics can be thought of as representing the values of child and youth care to which the field holds a common commitment. When working with youth this is a commitment to protect, nurture, and enhance the well-being of children and youth. Thus we must……… understand their vulnerability understand whether current practices “do no harm” understand the impact of staff attitudes and behavior, agency policy and governmental policy and regulation understand challenging conflicts in the core values and standards of care

Common Ethical Principles Beneficence: provide for the good of the client with at the least doing ‘no harm’, doing what is in the best interests of the client Appropriate Boundaries No dual relationships No personal gain Appropriate service

Common Ethical Principles Autonomy: Self Determination Justice: Fairness, impartiality, cultural competence Competence: provide only those services the professional is competent to provide

Common Ethical Issues with Youth Consent? Confidentiality? Who is the client?

Common Ethical Issues with Youth Record keeping & documentation Boundaries Trust building

Ethical Practices & Concerns Allowing youth self determination Addressing unsafe behavior Contacting parent or guardian

Ethical Practices & Concerns Sharing information with schools, CPS, other service providers Maintaining boundaries and trust building Non-traditional settings

Know Pertinent Federal and State Laws and Regulations Texas Family Code Texas Health and Safety Code Family Educational Rights and Privacy Act (FERPA) Health Insurance Portability and Accountability Act (HIPAA)

Know Professional Ethical Codes Social Work Licensed Professional Counselor Licensed Marriage and Family Therapist Licensed Psychologist Licensed Chemical Dependency Counselor

When are laws and regulations in conflict with professional ethics and/or agency policy and procedures?

When are all three in conflict with personal values and morals?

Choosing an Ethical Decision Making Model Law and Minimum Standards under the Law Professional Code of Ethics And Standards Agency Policy and Procedures What are the legal considerations ? Are professional ethics and agency policy in conflict? Ethical Decision Making Model Does the model used take all these factors into consideration? Do my own personal values conflict with legal, agency or professional standards?

Using a Model  Without a model:  A model:  No uniformity – each decision stands on it’s own and is less defensible  Is uniformly applied to all situations  May or may not be a logical and articulated decision making process  Provides for a logical and articulated decision- making process  May feel on your own in making a decision  Provides guidance in the process  Documentation may be haphazard  Provides a structure for documentation Using structure is important

Example of an Ethical Decision-Making Model Essential Steps for Ethical Problem – Solving 1. Determine – whether there is an ethical issue and/or dilemma. Is there a conflict of values or rights or professional responsibilities? For instance there may be an issue of self-determination of an adolescent vs the well being of the family. 2. Identify – the key values and principles involved. What meanings and limitations are typically attached to these competing values? For example, rarely is confidential information held in absolute secrecy, however, typically decisions about access by third parties to sensitive content should be contracted with clients.

Essential Steps for Ethical Problem – Solving 3. Rank – the values or ethical principles, which – in your professional judgment – are most relevant to the issue or dilemma. What reasons can you provide for prioritizing one competing value/principle over another? For example, your client’s right to choose a beneficial course of action could bring hardship or harm to others who would be affected. 4. Develop – an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. Confer with colleagues and supervisors about potential risks and consequences of alternative courses of action. Can you support or justify your action plan with values/principles on which the plan is based?

Essential Steps for Ethical Problem – Solving 5. Implement – your plan, utilizing the most appropriate practice skills and competencies. How will you use core skills such as sensitive communication, skillful negotiation, and cultural competence? For example, skillful colleague or supervisory communication and negotiation may enable an impaired colleague to see her/his impact on clients and to take appropriate action. 6. Reflect – on the outcome of this ethical decision making process. How would you evaluate the consequences of this process for those involved: Clients, professionals, agencies? Increasingly, professionals have begun to seek support, further professional training and consultation through the development of Ethics Review Committees or Ethics Consultation processes.

Ranking ethical principles* – a higher level principle is more compelling than one based on a lower ranked principle: 1.The principle of protection of life 2.The principle of equality and inequality 3.The principle of autonomy and freedom 4.The principle of least harm 5.The principle of quality of life 6.The principle of privacy and confidentiality 7.The principle of truthfulness and full disclosure *Lowenberg, F.M. & Dolgoff, R. (1992) Ethical Decisions for Social Work Practice, 4 th ed., Itasca, Ill: F.E. Peacock Publishers, Inc.

Situations/Dilemmas Work as a group Use the model and worksheet Work the steps Identify the: ethical principles ethical issues ethical practices and concerns

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