1. ETHICAL CHALLENGES AND MANAGING RISK IN SOCIAL WORK PRACTICE
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ETHICAL CHALLENGES AND MANAGING RISK IN SOCIAL WORK PRACTICE
2019 Chicago Social Work Conference
September 13, 2019
Oak Brook, Illinois

2. Joseph T. Monahan, M.S.W., A.C.S.W., J.D.
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Joseph T. Monahan, M.S.W., A.C.S.W., J.D.
Monahan Law Group, LLC, Chicago

3. Introduction Joseph T. Monahan, MSW, ACSW, JD
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Introduction
Joseph T. Monahan, MSW, ACSW, JD
Numerous laws affect social workers:
Confidentiality
Civil commitment/outpatient treatment
Child abuse and neglect reporting
Juvenile court
School student records
FERPA
Domestic violence acts
Americans with Disabilities Act
NASW Code of ethics
Professional licensing acts
Employment laws
Criminal statutes
Social Security Act
HIPAA
Individuals with Disabilities Education Act
Worker’s Compensation Act

4. Involvement in Legal Proceedings
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Involvement in Legal Proceedings
Why do social worker’s get sued?
Malpractice
Civil Actions
Theories of liability
Substantive risk areas
Elements
Duty
Breach
Proximate/legal cause
Injury
Know the law, embrace the law!
Risk management tips:
Records management
Consultation
Identify difficult cases early
Listen to client complaints
Qualifications/credentials
Malpractice insurance
Confidentiality
Understand expectation of privacy
Avoid inappropriate boundaries

5. What to do if You are Sued
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What to do if You are Sued
Do not ignore court papers
Contact supervisor/attorney
Relationship with attorney
Knowledgeable in practice area
Do not speak with opposing parties
Or opposing counsel
Maintain “normal course” of practice
E.g. do not change record-keeping practices
In the courtroom:
Know the actors
Know your role
Direct examination
Cross examination
Tips for trial participants
Answer the question that is asked
Do not go farther than what you know as a witness
Add case law

6. Client Suicide – Big Picture
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Client Suicide – Big Picture
Statistics
Major public health concern
2nd leading cause of death among individuals 10-34
Risk Management
Policy
Training
Crisis response protocol
Documentation
Risk factors
Behavioral health issues
Personal characteristics
Adverse life circumstances
Risky behaviors
Family characteristics
Environmental factors
Warning signs

7. Client Suicide – Professional Liability Concerns
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Client Suicide – Professional Liability Concerns
Survivors are searching for answers
Protecting yourself
Professional liability insurance
Potentially multiple defendants
Records and confidentiality
Just say “no!”
Secure the record
Requests for records
Speaking with family members
Self-care
Tips for talking about suicide:
Give accurate information
Address blaming and scapegoating
Do not focus on the method
Address anger
Address feelings of responsibility
Promote help-seeking

8. Confidentiality Reasons for and importance: Confidentiality is complex
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Confidentiality
Reasons for and importance:
Privacy
Foundation of the therapist-client relationship
Confidentiality is complex
Involves legal and ethical knowledge and judgment
General rule:
All records and communications are confidential and shall not be disclosed except as provided by law
What records must be maintained?
With consent
Without consent
Subpoenas:
Do not be intimidated
Just say “no!”
Who is asking, on what authority?
Consultation, notification, documentation
Always retain control of the original file

9. Boundary Issues & Dual Relationships
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Boundary Issues & Dual Relationships
Boundary violations vs. boundary crossings
Identification
Assessment
Risk management
Conceptual framework
Intimate relationships
Personal benefit
Emotional and dependency needs
Altruistic gestures
Unanticipated circumstances
NASW Code of Ethics
1.05 Cultural Competence and Social Diversity
1.06 Conflicts of Interest
1.09 Sexual Relationships
1.10 Physical Contact
1.11 Sexual Harassment
1.13 Payment for Services
Risk management strategy to avoid boundary violations

10. Clinical Supervision & Consultation
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Clinical Supervision & Consultation
Professional supervision
“The relationship between supervisor and supervisee in which the responsibility and accountability for the development of competence, demeanor, and ethical practice take place.”
Common liabilities in the supervision context:
Inadequate and improper supervision or social work guidance
Sexual improprieties
Outside supervision v. supervision in the workplace
Formal supervision agreement or memorandum of understanding

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