1. Shhh, Don’t tell! Ethics and confidentiality in school social work
Presented by: Rachel S. Lahasky, LCSW
adapted from laura Richard, phd, lcsw
University of Southern Mississippi

2. Part 1: Schedule What are values? What are ethics? Personal values
Professional values
What are ethics?
Personal Ethics
Professional ethics
Value, principles, and purposes of nasw code of ethics
Ethical standards in code of ethics (brief overview)
Timely topics regarding values and ethics-from published sources

3. What are values?
A value is an idea or way of being that you believe in strongly--- something you hold dear and that is visible in your actions (sweitzer & king, 2009)

5. So, what are your values?

6. Is there a difference between personal values and professional values?

7. The difficulty of dealing with values
Values are such a central part of our thought processes that we often are not consciously aware of them and therefore we are unable to identify their influence on our decisions.

8. The difficulty of dealing with values
A person may be forced to choose among values that are in conflict with one another. This is known as a value conflict.

9. The difficulty of dealing with values
Addressing values in the abstract may be quite difference from applying them in a real-life situation.

10. The difficulty of dealing with values
Values are problematic because they change over time.

11. The place of values in social work
Values clarification is an important aspect of social work practice
Social workers must be concerned with his or her own values, and control for inappropriate intrusion into practice situations. This is known as value suspension.

12. Values held by social workers
Commitment to the primary importance of the individual in society.
Commitment to social justice and the economic, physical, and mental well-being of all in society.
Commitment to social change to meet socially recognized needs.

13. Values held by social workers
Respect and appreciation for individual and group differences.
Commitment to developing clients’ ability to help themselves.
Willingness to transmit knowledge and skills to others.
Reflect for confidentiality of relationship with clients.

14. Values held by social workers
Willingness to keep personal feelings and needs separate from professional relationships.
Willingness to persist in efforts on behalf of clients despite frustration.
Commitment to a high standard of personal and professional conduct.

15. Values according to nasw
Look under your seats…6 lucky people!!

16. Values according to nasw
Service
Social justice
Dignity and worth of a person
Importance of human relationships
Integrity
Competence

17. Values and ethics…are they different?
Values are concerned with what is good and desirable, while ethics deal with what is right and correct.

18. ethics
Ethics- moral principles (rules, guides); beliefs held about what constitutes moral judgment and right conduct.

19. History of ethics and social work
Ethics have been central to social work since its formal inception.
Grounded in concepts of justice and fairness
Evolution of social work values and ethics had several key stages.

20. Ethical values and principles
Value: Service
Ethical principle: social workers’ primary goal is to help people in need and to address social problems.

22. Ethical values and principles
Value: social justice
Ethical principle: social workers challenge social injustice
Ethical values and principles

23. http://www. someecards

24. Ethical values and principles
Value: dignity and worth of the person
Ethical principle: social workers respect the inherent dignity and worth of the person.

26. Ethical values and principles
Value: importance of human relationships
Ethical principle: social workers recognize the central importance of human relationship

27. http://www. sureslim. com

28. Ethical values and principles
Value: integrity
Ethical principle: social workers behave in a trustworthy manner.
Ethical values and principles

30. Ethical values and principles
Value: competence
Ethical principle: social workers practice within their area of competence and develop and enhance their professional expertise

31. http://www. google. com/url

32. Code of ethics
Code of ethics: explicit statement of the values, principles and rules of a profession, which acts as a guide for its members and their practice.

33. Code of ethics preamble
The primary mission of the social work profession is to enhance well being and help the basic human needs of all people, with particular attention to the empowerment of people who are vulnerable, oppressed, and living in poverty. A historic and defining feature of social work is the profession’s focus on individual wellbeing of society…the mission of…profession is rooted in a set of core values…(which include) service, social justice, dignity and worth of the person, importance of the human relationships, integrity, and competence. (Nasw, 2008, code of ethics preamble p.1)

34. Ethical standards
Relevant to the professional activities of all social workers.
6 standards outlined in the code of ethics:
Responsibilities to clients
Responsibilities to colleagues
Responsibilities in practice settings
Responsibilities as a professionals
Responsibilities to the social work profession
Responsibilities to the broader society

35. Responsibilities to clients
Clients’ interests/well-being are primary
Client has right to self-determination
Informed consent
Competence
Cultural competence and social diversity
Conflicts of interest
Privacy and confidentiality
Access to records
Sexual relationships
Clients interests- Unless the social worker is required by law to report harm to self or others.
Self- Determination- Self-discrimination can be limited when a client’s actions or potential actions pose a serious risk to themselves or others.
Informed consent- Social workers should inform clients of the purpose of services, risks related to services, limits to services due to a 3rd party payer, costs, alternatives, right to refuse or withdraw consent and time frame covered by the consent. If client has difficulty understanding, social worker should take steps to ensure that they are informed. If client cannot provide informed consent, permission should be gotten from a 3rd party. Involuntary services should be explained with the extent of right to refuse. Risks of services via electronic devices should be given to clients. Informed consent should be obtained before audio or video taping a client or permitting a 3rd party to observe.
Competence- Provide services only in the boundaries of your education, training, license, etc. Only use new techniques or information after studying or training in them. In emerging areas of practice, use your best judgment a and protect your clients from harm.
Cultural competence and diversity- Social workers should understand culture and its function on human behavior, be sensitive to clients’ culture and obtain education about social diversity and oppression.
Conflicts of interest- Avoid conflicts of interest that interfere with professional discretion and impartial judgment; do not take unfair advantage of any professional relationship; no dual or multiple relationships with clients or former clients- relating to clients in more than one relationship whether it be professional, social, or business; when social workers provides services to 2 or more people who have a relationship, the social worker should clarify with all parties who is the client; if the social worker has to perform in conflicting role (going to court for a custody or divorce hearing) they should clarify their role with the parties involved.
Privacy and confidentiality- Respect clients’ right to privacy; disclose only with valid consent from client or legal representative; information obtained in the course of professional services should be protected unless used to prevent serious, imminent harm to a client or another person; inform clients of disclosed information and potential consequences; should discuss the nature of confidentiality and limitations to confidentiality; when seeing more than one person (families, couples, or groups) all should agree to preserve confidentiality; inform clients of policy of sharing information with parties involved; do not disclose confidential information to 3rd party payers without authorization from client; social workers should not discuss confidential information in public or semi-public areas; protect confidentiality in legal proceedings to the extent permitted by law- if court orders social workers to disclose and it could hurt the client, social workers should request that the order be withdrawn; protect clients when responding to the media; protect clients’ written and electronic records; maintain confidentiality in , fax, telephone messages, etc.; dispose of client records according to state statues (LA says shredding after 6 years is ok); should not disclose identifying information about clients when teaching/training or working with consultants; protect confidentiality of deceased clients.
Access to records- Provide reasonable access to records for clients when those records concern them; protect the confidentiality of other individuals identified in client records.
Sexual relationships- No sex with clients whether consensual or forced; no sex with client’s relatives or anyone else client has close relationship with- social workers assume the full burden for setting clear, appropriate and culturally sensitive boundaries; no sex with former clients; do not provide clinical services to individuals with whom they have had a prior sexual relationship.

36. Responsibilities to clients
Physical contact
Sexual harassment
Derogatory language
Payment for services
Clients who lack decision-making capacity
Interruption of services
Termination of services
Physical contact- no physical contact when there is the possibility of psychological harm; social workers must set boundaries.
Sexual harassment- no sexual advances, sexual solicitation, requests for sexual favors and other verbal or physical conduct of a sexual nature.
Derogatory language- Use accurate and respectful language in all communications about clients.
Payment for services- ensure fees are fair and reasonable; avoid accepting goods or services from clients as payment; should not solicit private payment from clients when those services are available through the social workers’ employer or agency.
Clients who lack decision making- Take reasonable steps to safeguard the interest and rights of clients when acting on their behalf.
Interruption of services- Make efforts to ensure continuity of services.
Termination- Terminate services when services are no longer needed or required; avoid abandoning clients who still need services and assist in making appropriate arrangements for continuation of services when necessary; services may be terminated to clients who are not paying if the financial arrangement was made clear to the client, if the client is not in danger to self or others and if the non-payment and consequences have been discussed with the client; should not terminate services to pursue a social, financial, or sexual relationship with the client; notify clients when you anticipate the terminiation or interruption of services and seek the transfer, referral or continuation of services that are necessary and appropriate.

37. Responsibilities to colleagues
Respect
Confidentiality
Interdisciplinary collaboration
Disputes involving colleagues
Consultation
Referral for services
Sexual relationships
Sexual harassment
Impairment of colleagues
Incompetence of colleagues
Unethical conduct of colleagues
What are our responsibilities to each other? What about whistle blowers?
Respect- treat colleagues with respect and avoid negative criticism of colleagues in communication with other professionals; cooperate with colleagues for the well-being of clients.
Confidentiality- respect confidential information shared by colleagues
Interdisciplinary-members of an IDT should participate and contribute in decisions; if a decision raises ethical concerns they should attempt to resolve the disagreement through appropriate channels.
Disputes- Don’t take advantage of a dispute between a colleague and an employer to further yourself; don’t exploit clients in disputes with colleagues.
Consultation- Seek advice and counsel of colleagues; keep informed about colleagues’ areas of expertise; disclose as little as possible about clients when consulting with colleagues.
Referral- Refer to other professionals when their knowledge or expertise is needed to serve the clients fully; facilitate transfer to colleague; no giving or receiving payment for a referral.
Sexual- No sex with supervisees, students, trainees or other colleagues over whom they exercise professional authority; avoid sex when there is potential for conflict of interest.
Sexual harassment- Don’t do it
Impairment of colleagues- If you have direct knowledge, consult with that colleague and assist them in taking remedial action; if their impairment interferes with practice and no steps to correct it have been taken, take action.
Incompetence- Colleagues’ incompetence- consult with that person; if adequate steps are not taken, act.
Unethical- Discourage, prevent, expose, and correct the unethical conduct of colleagues; know policies and procedures for handling concerns about colleagues’ unethical behavior; discuss concerns with colleague; defend and assist colleagues who are unjustly charged with unethical conduct.

38. Responsibilities in practice settings
Supervision and consultation
Education and training
Performance evaluation
Client records
Billing
Client transfer
Administration
Continuing education and staff development
Commitments to employers
Labor-management disputes
Supervision- have the knowledge and skills to supervise or consult; set clear appropriate and culturally sensitive boundaries; no dual or multiple relationships with supervisees in which exploitation or harm could come to the supervisee; evaluate performance fairly.
Education- provide instruction only in your area of knowledge; evaluate students fairly; inform clients when services are being performed by a student; no dual relationships with students
Performance evaluation- evaluate fairly.
Client records- ensure documentation in records is accurate and reflects the services provided, ensure continuity of services, protect privacy and store records for the number of years required after termination of service.
Billing- Establish and maintain billing practices that reflect the services provided.
Client transfer- consider client needs before consenting to provide services; discuss with the client whether you should consult with the previous provider and obtain consent to do so.
Administration- Administrators should advocate within and outside the agency for adequate resources to meet clients’ needs; make sure enough resources are available to meet clients’ needs and to provide adequate supervision to staff; ensure work environment meets NASW code of ethics standards.
CEU’s- SW Administrators should provide or arrange for cont. ed and staff development
Commitments to employers- Adhere to commitments made to employers; work to improve employing agencies; ensure that employers are aware of social workers’ ethical obligations and not to allow policies, etc to interfere with their ethical practice of social work; act to prevent and eliminate discrimination in agency; only accept employment or field placements in organizations that exercise fair personnel practices; be diligent stewards of resources of their organizations.
Labor Management- May engage in organized actions to improve services to clients and working conditions, but must do so guided by the professionals values, ethical principles and ethical standards.

39. Responsibilities as professionals
Competence
Discrimination
Private conduct
Dishonesty, fraud, and deception
Impairment
Misrepresentation
Solicitations
Acknowledging credit
Competence- accept responsibility or employment only on the basis of existing competence or plans to get it; remain proficient; keep current with emerging knowledge, continuing education; should base practice on knowledge relevant to social work and social work ethics.
Discrimination- should not practice, condone, etc with any form of discrimination.
Private conduct- This should not interfere with the ability to fulfill professional responsibilities.
Dishonesty- should not participate in, condone or be associated with dishonest, fraud, or deception.
Impairment- Should not allow personal problems, psychosocial distress, legal problems, substance abuse or mental health difficulties to interfere with professional judgment and performance or jeopardize clients; if impaired, social worker should seek consultation and take remedial action.
Misrepresentation- be careful wheat you say or do as a private individual and as a rep of your organization/agency.
Solicitations- Should not solicit potential clients who are vulnerable due to their circumstances; should not use client testimonial endorsements.
Ackowledging- take responsibility and credit only for work you have actually performed; acknowledge work and contributions of others.

40. Responsibilities to the social work profession
Integrity of the profession
Evaluation and research
Contribute to the development of knowledge
Keep current with emerging knowledge
Protect research participants
Obtain written, informed consent
Inform of right to withdraw from research at any time
Access to appropriate supportive services
Ensure anonymity/confidentiality
Avoid conflicts of interest/dual relationships with research participants
Be educated about responsible research practices
Integrity of the profession- promote high standards of practice; uphold and advance values, ethics, knowledge and mission of the profession; contribute time and their knowledge to the profession; work to prevent the unauthorized and unqualified practice of social work.

41. FAQs about the code of ethics
Are there limits to how far a social worker is committed to a client?
Are there directions that we may use to decide if a client’s self-determination should be restricted?
What if I am not sure a client is capable of understanding “informed consent?”

42. Faqs about the code of ethics
Is therapy over the telephone or by a computer allowable?
What infraction of the code has resulted in the most negative actions against social workers?
How much should I know about diversity and culture to be competent?

43. Faqs about the code of ethics
What if my religious or other basic values conflict with the code of ethics in a particular instance?
I live and work in an area where I see my clients frequently at social settings such as restaurants, church, while shopping, and so forth, sometimes we serve on voluntary committees together. Am I in an dual relationship?

44. Faqs about the code of ethics
How do I know if I am violating a client’s privacy when asking about things related to his or her treatment?
What if I am called to court to testify for a client? Should I release all information?
I am concerned that my members in my group therapy sessions, couples, and family therapy may break confidentiality. Will I be at fault for this?

45. Faqs about the code of ethics
Am I required to allow a client to see his or her file?
What should I do if a client appears to want more intimate contact with me?
Are there casual factors that we may foresee to help us avoid becoming intimately involved with clients?

46. Faqs about the code of ethics
When should I begin to prepare clients for termination?
I know social workers who gossip frequently about each other. others do not believe in the work of particular professions recognized by the state and refuse to cooperate with them. Are these actions allowable behavior?

47. Faqs about the code of ethics
A social worker at my job purposely is acting unethically. What should I do?
I would like to volunteer to be a supervisor toward licensing for msw’s. does nasw have requirements I should meet?
Are social workers allowed the freedom to bill for services as they wish?

48. Faqs about the code of ethics
Once I become an administrator, am I still responsible to the nasw code?
What if I have a chance for employment in an agency that acts against nasw code guidelines?
Part of the code involves acting well as a professional. What does this mean?

49. Faqs about the code of ethics
How can I make social work a better profession?
What if I am presenting on behalf of an organization and its policy is congruent with the code but I have doubts. Should I state my opinion or the agency’s?
Do we have any more responsibilities?

50. Questions & comments

51. References
Duncan-Daston, R., Hunger-Sloan, M., & Fuller, E. (2013). Considering the ethical implications of social media in social work education. Ethics and Information Technology, 15(1),
Franklin, C.; Harris, M.B, & Allen-Meares, P. (2006). The school services sourcebook: A guide for school based professionals. NY: Oxford University Press.
Lipschutz, R. (2010, Nov. 1). Ethics corner: To text or not to text. Retrieved from
Mattison, M. (2006). Professional ethical codes: Applications to common ethical dilemmas. In Franklin et al., pp
NASW & ASWB. (2005). Technology and Social Work Practice. Washington D.C.:NASW Press
NASW(2006). Code of Ethics of National Association of Social Workers. Washington, DC: NASW Press
Overcamp-Martini, M. A. (2006). The law, ethical guidelines, records, assessments, and reports for school-based practice. In Franklin et al. pp
Reamer, F. G. (2013). The digital and electronic revolution in social work: Rethinking the meaning of ethical practice. Ethics and Social Welfare, 7, 2-19.
School Social Work Site (2010, February18). Technology and the School Social Worker. Retriieved from socialworksite.com/2010/02/technology-and-school-social worker.html.
Smiar, N.P.(2012,August). Technology, social media, and social work ethics. Presented at ABSW Training. Chicago, IL.