1. SWK 511
Class Three
Copyright (c) 2012 Brooks/Cole, a division of Thomson Learning, Inc.

2. The Helping Process
Phase I: Exploration, engagement, assessment, and planning
Phase II: Implementation and goal attainment
Phase III: Termination

3. Phase I: Exploration, engagement, assessment, and planning
Exploration of the problem
Establishing rapport
Multidimensional assessment
Mutually negotiating goals
Making referrals
EPAS A, EPAS b

4. Interviewing Process Physical conditions Structure of interviews
Adequate ventilation and light
Comfortable room temperature
Ample space
Attractive furnishings and décor
Chairs that adequately support the back
Privacy appropriate to the cultural beliefs of the client
Freedom from distraction
Open space between participants
Structure of interviews
Maintain flexibility
EPAS a

5. Interviewing Process Establishing rapport The exploration process
Starting where the client is-motivational congruence
Awareness of cultural norms and biases
Use of verbal and non-verbal cues that convey attentiveness
Use of an interpreter
The exploration process
Furthering responses, paraphrasing, empathic responding
Exploring expectations
Eliciting explicit information
EPAS b , b , a

6. Interviewing Process Focusing in depth Employing outlines
Assessing emotional functioning
Exploring cognitive functioning
Exploring substance abuse, violence, and sexual violence
Negotiating goals and a contract
Ending interviews
Goal attainment
EPAS c, b

7. Phase II: Implementation and goal attainment
Enhancing self-efficacy
Monitoring progress
Barriers to goal accomplishment
Relational reactions
Enhancing clients’ self-awareness
Use of self
EPAS , b

8. Phase III: Termination
Assessing that goals have been satisfactorily attained
Helping client to develop strategies to maintain change past termination
Successfully terminating the helping relationship
Planning change maintenance strategies

9. Social Work Values & Ethics

10. NASW Core Values
Copyright (c) 2012 Brooks/Cole, a division of Thomson Learning, Inc.
All human beings deserve access to the resources they need to deal with life’s problems and to develop to their fullest potential
Commitment to help securing resources
Development and implementation of policies to help fulfill unmet needs
Self-examination of personal values and biases that may serve as obstacles
EPAS 2.1.1a & 2.1.1b

11. NASW Core Values
Social workers respect the inherent dignity and worth of the person. Social workers recognize the central importance of human relationships
Belief in the intrinsic importance of all people regardless of past or present behaviors, beliefs, way of life or social status
Respect, acceptance, and trust are paramount to establishing a helping relationship
Affirm the individuality of all people
Understand personal judgmental tendencies
EPAS 2.1.1b, 2.1.2a

12. NASW Core Values
The value of integrity means that social workers behave in a trustworthy manner
Social workers act honestly, encourage ethical practices, and take responsibility for their own ethical conduct
Accurately represent self and credentials
Treat fellow professionals with respect
EPAS 2.1.1f, 2.1.2a

13. NASW Core Values
The value of competence requires that social workers practice only within their scope of knowledge and ability
Take responsibility for knowing personal limits
Seek knowledge and experience needed to develop expertise
Utilize supervision
Be a lifelong learner and stay abreast of practice-related research
Be alert to personal events or problems that may impact professional competence
EPAS 2.1.1f, 2.1.1e, 2.1.1b

14. Challenges in Embracing the Profession’s Values
Worker’s inability to conform to profession’s values
Explore through supervision or therapy
Opt to transfer case
If transfer is not an option seek intensive assistance
Differences in cultural norms and values
Practice “moderate universalism”

15. Ethics The intersection of laws and ethics Key ethical principles
See Figure 4-1
Key ethical principles
Self-determination (case examples 21-25)
Providing informed consent
Preserving professional boundaries
Safeguarding confidentiality
EPAS 2.1.2b, 2.1.1c, 2.1.1d

16. Figure 4-1: The Relationship of Law and Ethics

17. Ethics What are the limits of confidentiality?
Copyright (c) 2012 Brooks/Cole, a division of Thomson Learning, Inc.
What are the limits of confidentiality?
Supervision and consultation
Client waivers
Danger to self or others
Suspicion of child or elder abuse
Subpoenas and privileged communication
Confidentiality in various types of recording
EPAS 2.1.1f

18. The Ethics of Practice With Minors
Minors’ rights are limited by laws and policies, differences in maturity and decision-making capacity
Parents may retain the right to review a child’s treatment record and be informed of issues child raises in therapy
Rights are dependent on the particular service setting and presenting problem (i.e. substance abuse services, treatment for sexually transmitted diseases)
EPAS 2.1.2c

19. Understanding and Resolving Ethical Dilemmas
Rights to life, health, well-being, and necessities of life take precedence over confidentiality
One’s individual rights to well-being takes precedent over another’s right to privacy, freedom, or self-determination
Right to self-determination takes precedence over own right to basic well-being
Right to well-being may override laws and policies
EPAS 2.1.2c

20. Steps for Ethical Decision Making
Identify the dilemma; gather information
Determine core principles and competing issues
Review the relevant codes of ethics
Review applicable laws, policies, and regulations
Consult with supervisors, colleagues, and legal experts
Consider possible courses of action and examine consequences
Decide on a course of action
Develop strategy for implementing
Evaluate process and results
EPAS 2.1.2d, 2.1.1f

21. Ethical “Hierarchy” No rule applies OR
Examine Code for applicable rules;
these rules take precedence
over the worker’s values
No rule applies OR
rules provide conflicting guidance
One or more rules applies
Follow Code rule
Principles Screen
Dolgoff, Lowenberg & Harrington, 2005

22. Ethical “Hierarchy” Truthfulness/ Full disclosure Principles Screen
Privacy/
confidentiality
Quality of life
Least harm
Self-determination
Equality/inequality: Those without power
Protection of life: Duty to warn/protect
Principles Screen
Dolgoff, Lowenberg & Harrington, 2005

23. Ethical “Hierarchy” Protection of life: Duty to warn and protect
Principles Screen
Protection of life: Duty to warn and protect
Equality/inequality: Those without power
Autonomy and freedom: Self determination
Least harm
Quality of life
Privacy and confidentiality
Truthfulness and full disclosure
Dolgoff, Lowenberg & Harrington, 2005

24. Liability Faulty assessment, diagnosis or treatment Fraud
Lack of referrals to medical evaluations
Over-assumption that the problem is psychological or socially based
Fraud
Reducing diagnoses to “protect” clients
Specifying an illness when one is not present
Boundary violations (dual relationships)
Sexual relationships (most prevalent, 1/5 of all complaints)
Financial relationships (accepting gifts)

25. Liability (Contd)
Malpractice – Professional negligence (act of commission or omission that harms the client) or misconduct. Points to prove are:
The social worker had a professional duty
The social worker was remiss in the performance of that duty
Harm occurred that can be measured
A link between what the social worker did (or didn’t) and the harm that client suffered
Liabilities
Direct liability: Harm has resulted in a supervisor’s acts of commission or omission (i.e. assigned duties without adequate training or experience)
Vicarious liability (respondeat superior): Harm has resulted in a supervisor’s responsibility for a supervisee’s actions during the course of employment, training or field instruction

26. Privacy, Confidentiality & Privilege
Privacy: Basic rights of individuals to decide how information will be shared
Confidentiality: Obligation of social worker to not divulge information obtained during the course of a professional relationship without permission; exceptions:
Consent
Information in lectures and writings if identity is disguised
Circumstances as defined by law (duty to protect, duty to warn)
Privilege: Legal right that prevents confidential information from being disclosed
Client is “holder of privilege”
Exception if minor or incompetent, then parent/guardian is holder
Limits defined by state law

27. Confidentiality (contd)
Court Decisions
Tarasoff v. Regents (1976) – Ruled by Supreme Court of CA stated that, under certain circumstances, psychotherapists whose clients tell them that they intend to harm someone are obliged to warn the intended victim (Duty To Warn)
Jaffe v. Redmond (1996) – United States Supreme Court ruled that conversations between clinical social worker and their clients are protected from disclosure in Federal trials; the Court extended privilege to all levels of social work

28. Internet Resources Ethical decision making and field work
NASW Code of Ethics
IFSW Code of Ethics
Various Codes of Ethics
HIPAA