Discussion Board: Ethical Issues
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Introduction to
Human Services –
Chapter 3&4
Fall 2020 Instructor: Dr. Marisha Wright-Stewart
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Chapter 3 Ethics & Values
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Professional Ethical Standards
● Every profession has a professional board that sets professional standards to maintain the integrity of the profession.
● "Human Services is bound by both a set of professional standards set forth by the National Organization for Human Services (NOHS), as well as applicable state and federal laws pertaining to specific practice settings, such as mental health, health care, school, and child care settings."
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Kitchener’s Ethical Decision
Making
"Kitchener’s (1984) model is based on five assumptions: that all ethical behaviors are presumed to be based on: (1) autonomy, (2) beneficence, (3) nonmaleficence, (4) justice, (5) fidelity."
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Culture Diversity Influences
Being culturally sensitive is key to understanding one’s morals and values as it relates to one’s perception on ethics.
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Social Justice Movement
"Since the human service profession is rooted in social justice movements. Thus, all aspects of the helping relationship will include an evaluation not only of the client’s personal dynamics but also of societal dynamics that are potentially impacting the client and the client’s environment (e.g., Bronfenbrenner Ecological Model)
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What about your morals and
values?
How can they impede helping a client?
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Ethical Code of Conduct
● "all the helping professions have such ethical codes mandating how practitioners should conduct themselves professionally. There are significant similarities among the ethical standards of the various helping professional organizations, such as the NOHS (2015), the APA (2010), the ACA (2014), and the NASW (2008)."
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Self-Determination
● National Association of Social Workers (NASW) code of ethics places self-determination as a priority as a critical professional value.
● Self-Determination is a person’s right to determine his/her own life plan without interference.
● The value of self-determination is important in the human service profession.
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Self Determination
● It is challenging to follow in practice, especially working with involuntary clients.
● It can be violated by manipulation as well as overtly coercive methods. Manipulation should be avoided.
● Remember…no one is value free. Our values are shaped by many influences: families, friends, school, church, the workplace, our social class, ethnicity, and gender.
●
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Value Dilemmas
•Let’s think about different issues that may cause value dilemmas in a Human Service professional: –Abortion –Euthanasia –Spanking –Child Neglect –Methadone Clinics –Racism –Sex Education
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Chapter 4 Helping Skills &
Strategies
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Generalist Practice Model
Theoretical approach that uses basic skills and capacities that can be used with a broad range of clients and client systems.
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Human Service Professional Must
know:
● Informed Consent - "disclosing to clients the nature and risks of the counseling relationship prior to their engaging in these services."
● Confidentiality - "based on the premise that for trust to develop in the counseling relationship, clients must be assured that they have a safe place to discuss their most private thoughts, feelings, and experiences."
● Mandated Clients - "those clients who are required by some legal requirement to seek mental health treatment."
● Duty to Warn - "When clients pose a danger to themselves or others, a counselor has a duty-to-warn and a duty-to-protect"
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Tarasoff v. Regents of the
university of California (1976)
"Duty-to-warn laws have been greatly influenced by a tragic event that occurred on the University of California, Berkeley, campus when a student disclosed his intent to kill his girlfriend to a campus psychologist. Although the psychologist informed various individuals, including his supervisor and campus police, he did not inform the intended victim or her family. The client later killed the girlfriend, and the family of the victim sued the university based on the psychologist’s failure to warn the victim. The case, Tarasoff v. Regents of the University of California, resulted in two decisions by the California Supreme Court in 1974 and 1976 (Tarasoff I and II, respectively). Tarasoff I found that a therapist has a duty to use reasonable care to give threatened persons a warning to prevent foreseeable danger. Tarasoff II was more specific in referencing the therapist’s duty and obligation to warn intended victims, if necessary, to protect them from serious danger of violence. Virtually every state in the nation now uses the Tarasoff decisions as a foundation for duty-to-warn laws"
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Class Discussion
"Watch this video on the case involving James Holmes, the Colorado theater shooter. Do you think the psychologist could have done more? What actions would professional ethical and legal obligations deem appropriate?"
"www.youtube.com/watch?v=p6Bt0 KnGLuo"
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Human Service Professional Must
know (cont’):
● Mandating Reporting - "Human service professionals are mandated reporters, and as such they are required by federal and state statute to report all cases of suspected child abuse, maltreatment, and neglect to the appropriate authorities."
● HIPPA Laws - "According to federal legislation called the Health Insurance Portability and Accountability Act of 1996 or, more commonly, the HIPAA Privacy Rule, patients have the right to have their personally identifiable medical and mental health information remain confidential and protected."
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Helping Skills
•Helping skills have traditionally been proven to be important in building a positive counseling relationship.
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Helping Skills
• Listening Skills – requires us to be able to hear our clients and understand their issues; good listening does involve talking.
– Hindrances can include our own baggage, i.e., prejudices, biases, and unfinished business can block us from hearing our clients.
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Helping Skills (Cont’)
• Techniques to help be a good listener: – Calm yourself down – Stop talking and don’t interrupt – Don’t jump to conclusions – Actively listen – Concentrate on feelings – Concentrate on content – Have an open body posture – Be sensitive to personal space – Don’t ask questions unless clarifying
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Helping Skills (Cont’)
• 2) Empathy – to perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the “as if” condition (Rogers, 1959). This is one of the most important counseling skills. Carkhuff (1969) states that empathy is expression of a deep understanding of the pain the client feels as well as recognizing the complexity of the situation.
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Helping Skills (Cont’)
• 3) Silence – is a counseling skill helpers use to allow the clients to reflect on what he or she has been saying and allows the helper to process the sessions and to formulate his/her next response.
• 4) Encouragement/Affirmation – helpers must be able to see beyond the hurts, the depression, the anger, and the attitude. HS professionals need to believe that their clients have the potential—that they can “do it.”
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Helping Skills (Cont’)
• 5) Questioning can be helping skill uncovering patterns, gathering information quickly, inducing self-exploration, challenging the client to change. There are types of questions: – Open vs. Closed – Tentative (ex. I’m wondering, I would guess) – Solution-Focused (future oriented) – Why (not recommended)
•
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Helping Skills (Cont’)
• 6) Self-Disclosure is when the helper reveals something about himself/herself “verbally, nonverbally, on purpose, by accident, wittingly, or unwittingly…” (Bloomgarden & Mennuti, 2009, p.8). “A general rule if it feels good to self-disclose don’t.”
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Professional vs. Social Helping Relationship - Setting Boundaries
Professional Roles Social Roles • Limited • Clear Focus • Specific role • Disciplined • Built on
Acceptance
• Varies • Multiple Purpose • Fluid • Relatively free • Not built on
acceptance
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Case Management
"Case management is defined as the coordination of services and advocacy for clients and involves human service professionals working with other professionals to coordinate an array of services for the client that diminishes fragmentation and service gaps (Barker, 2003)."
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•"The human services profession is grounded in the notion that people are a part of larger systems and that to truly understand the individual one must understand the broader system this individual is operating within (e.g., ecological systems theory, person-in-environment)."
Effecting Change at Macro Level
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Person-in-environment (PIE)
This approach is often used as a basic orientation in practice because it encourages practitioners to evaluate individuals within the context of their environment. Start at the micro level.
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"Before beginning any discussion on social advocacy efforts on a macro level it is important to identify populations that are often the target of marginalization, social injustice, oppression, and human rights violations. In essence, an at-risk population can include any group of individuals who are vulnerable to exploitation due to lifestyle, lack of political power, financial resources, and societal advocacy and support, and generally, lack of a powerful voice in society."
Marginalization Populations
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Knowledge
Skills
Attitudes/Values
Pyramid Model
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Pyramid Model • Professionals in every field require a
combination of attitudes and values, skills, and knowledge, a constellation that has been dubbed the “ASK” concept (Schulman, 2008, Sue).
• Why do you think the pyramid is designed with the attitudes/values at the base?
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• Stage I – Rapport and Trust Building • Stage II – Problem Identification • Stage III – Deepening Understanding & Goal Setting • Stage IV – Work • Stage V - Closure
Stages of Helping Relationship
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• Stage I – Rapport and Trust Building – Helping clients clarify the key issues calling for
change.
– Help clients tell their stories. – Help clients break through blind spots. – Help clients choose the right problems to work on. – Explain all the tools to use
Stages of Helping Relationship (cont’)
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Stages II & III - What Solutions Makes Sense for Client – Help clients explore and choose possibilities for a
better future.
– Imagining a better future – Choosing realistic and challenging goals – Finding incentives that will help with commitment – Help client explore different tools and apply
– figure out the answer within
Stages of Helping Relationship (cont’)
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Stages IV & V - What Do I Have to do to Get What I Need or Want:
– Help clients to: – Visualize that there are many ways to achieving
their goals.
– Different tools can be used
– Putting plan into action – Re-evaluate goals – Ending helping relationship
Stages of Helping Relationship (cont’)