Week 3 Discussion

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Professional Standards: Embracing Preventive Ethics in Human Services

Chaniece Winfield, Narketta Sparkman-Key, Anthony Vajda

Abstract

Recent updates to the National Organization for Human Services Code of Ethics create an

opportunity for further recognition within the field. The next logical step to recognition is the

adoption of the concept of preventive ethics, in which ethical codes set the tone for the

development of grievance procedures and agency level policies. Fostering an environment of

preventive ethics within the human services profession will further establish awareness and

recognition within the field. This discussion provides support for the development of a grievance

process through the conceptual lens of preventive ethics and suggests a framework for the

development of a grievance process to be considered by the members of the National Organization

of Human Services.

Introduction

The National Organization of Human Services (NOHS) has been at the forefront of

increasing recognition and growth of human services. One result of this has been the adoption of

the 1996 NOHS ethical code and the more recent, 2015 revision (NOHS, n.d.; Wark, 2010).

Ethics are a critical aspect of the human services field as practitioners are often faced with

challenging ethical dilemmas. It is important in practice that practitioners have the ability to

make thoughtful and informed ethical decisions resulting in the greatest good for the field

(Milliken & Neukrug, 2009). Consequently, the NOHS ethical code serves as the standard of

ethical practice in the human services profession, and human services professionals agree to

uphold the ethical standards of the profession as a result of their membership in NOHS (NOHS,

n.d.).

Ethical codes serve three purposes: (1) educating professionals and the general public

about responsibilities; (2) providing a framework for professional accountability through the

enforcement of ethical codes and (3) serving as a basis for self-monitoring and improving

practice (Cory, Schneider, Corey & Haynes, 2015). Though the NOHS ethical code serves these

purposes and sets the standard for the field of human services, there is an absence of grievance

procedures as well as recognition of the use of the code within professional agencies. In fact,

many professionals note the ethical codes of other professions as leading their decision making

processes (Sparkman & Neukrug, 2014). As a result, there is a need for further recognition and

advancement of the NOHS ethical code that extends beyond creating standards.

NOHS Ethical Code The revised ethical code provides the opportunity for practitioners to be informed in

ethical decision-making (NOHS, n.d.) while addressing responsibilities of human services

professionals that were missing in previous versions of the code (Milliken & Neukrug, 2009).

The preamble of the ethical code notes the importance of ethical decision-making processes and

consideration of standards when making choices (NOHS, n.d.). Additionally, it addresses the

foundational values of the human services profession and discusses the overarching purpose of

the ethical code. Emphasized in the revision are five areas of responsibility for the human

Chaniece Winfield, Narketta Sparkman-Key, and Anthony Vajda, Department of Counseling and

Human Services, Old Dominion University. Correspondence regarding this article should be addressed to [email protected].

Journal of Human Services Fall/2017

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services practitioner: (1) responsibility to clients, (2) responsibility to the public and society, (3)

responsibility to colleagues, (4) responsibility to self, and (5) responsibility to students (NOHS,

n.d.). As part of their responsibility to the profession, NOHS members are expected to consider

these standards when making ethical decisions. Wark (2010) contends that “following the code

of ethics protects practitioners in malpractice suits and provides professional organizations self-

control instead of potential regulation by government” (p. 18).

Despite the recent revisions, the ethical code does not outline a process for addressing

grievances (Wark, 2010). Higgs-Kleyn and Kapelianis (1999) argue that the first step in

promoting ethical behavior of professionals is to “ensure that leaders of the professional

community advance the importance of ethical conduct and the power to ensure this rests in the

hands of the professional governing bodies” (p. 365). The responsibilities of governing bodies

extend beyond the development of an ethical code, and include the need to foster adherence to

the code. The absence of a grievance process suggests that NOHS ethical codes are aspirational

with little implication toward enforcement of violations (Sparkman & Neukrug, 2014; Wark,

2010). In fact, developing a grievance process allows the human services field to join other

helping professions such as social work, counseling, and psychology in holding members

accountable for their actions. By increasing and enforcing accountability, the expectation of

responsibility to clients, public/society, colleagues, and students as noted in the NOHS ethical

code (NOHS, n. d.) increases in credibility (Mabry, 1999). Addressing the call for a grievance

process sets the foundation for advancement of the ethical code. However, this is only the initial

step in supporting a profession that relies on the standards of ethical decision-making and seeks

to utilize those standards in practice.

Preventive Ethics “Preventive ethics” is a term coined within the health field which describes the

phenomenon that occurs when agencies create policies and procedures to embrace the ethical

codes of their respective professions (Levine-Ariff, 1990). The ideology of preventive ethics

extends beyond the notion of creating standards of ethical practice and includes the goal of

minimizing and/or preventing ethical conflict (Levine-Ariff, 1990). Embracing preventive ethics

ideology ensures that ethical decision-making is thoughtful and beneficial to the populations

served by NOHS members as a move toward preventive ethics includes clear ethical standards

developed by the organization.

Preventive Ethics in Action While preventive ethics aims to meet the goal of preventing conflict, it is not without its

limitations as individual agencies or professionals may conclude differing outcomes for the same

violation if there are no established guidelines within that professional organization (Levine-

Ariff, 1990). Despite this limitation, the focus of preventive ethics is the utilization of

professional organizations’ codes of ethics within agencies to develop comprehensive policies

which inform and address ethical decision making at the agency level. The policies developed

serve to help professionals plan for situations that require prompt intervention, provide guidance

on how specific situations should be handled, promote dialogue and collaboration among

colleagues, and affirm commitment to institutional standards (Levine-Ariff, 1990). They also

help to clarify the organizational mission, promote accurate and timely communication with

clients, and clarify what conduct is ethically prohibited, ethically required, and ethically

permissible. The notion of preventive ethics assumes the responsibility of developing policies on

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ethical issues that reflect the most up-to-date thinking on ethical decision making within the field

(Levine-Ariff, 1990). Policies promote practices that confirm ethical standards within the

profession as well as adhere to laws and regulations within the field.

The process of implementing policies based on ethical standards of professional

organizations at agency level includes discussing their development within the context of an

institution. The policy itself must demonstrate a specific process and incorporate certain concepts

specific to the institution implementing the policy (Levine-Ariff, 1990). In order to be effective

in the development of such policies, a multidisciplinary committee of professionals impacted by

the policy should outline the content. Also involved in the process should be an ethics committee

of the institution or outside consultation from ethicists well-versed in ethical decision-making.

Research suggests that during drafting of policies, informational sessions should be held for

those who will be impacted by new policies. The push toward agencies adopting professional

ethical standards in the human services field is a process that requires education within the field.

Therefore, professional organizations must educate the field on the importance of ethical

standards in policy development and disseminate this information to stakeholders in charge of

policy development (Levine-Ariff, 1990). Professional organizations are at the forefront of the

move towards preventive ethics within the field. The overarching goal is to create an

organizational structure that has a direct focus on fostering ethical behavior.

Professional Organizations and Preventive Ethics: Implications for NOHS Embracing the concept of preventive ethics within human services agencies suggests the

need for NOHS to provide concrete guidelines for violations within the ethical standards. In

order to avoid erroneous outcomes for violations of the NOHS ethical codes, the development of

a grievance process is the next logical step in influencing practice within human services. After

its development and implementation, increasing awareness of its existence for current and future

membership holders is vital to increasing adherence.

Professional organizations of other helping professions can serve as examples of

successful implementation of ethical codes and grievance procedures. The disciplines of

counseling, social work, and psychology have been identified as helping professions that are

governed by professional organizations (Castro-Atwater, 2015). Each of the aforementioned

disciplines has identifiable professional organizations with established ethical guidelines (Kaplan

& Gladding, 2011; McDonald, Boddy, O’Callaghan, & Chester, 2015). Similar to NOHS, each

professional organization provides membership to professionals who meet specific criteria for

their discipline with corresponding guiding principles and expectations (American Counseling

Association [ACA], 2014; American Mental Health Counseling Association [AMHCA], 2010;

American Psychological Association [APA], 2010; National Association for Social Work

[NASW], 2015).

Overview of Professional Organizations Within the ethical guidelines for professional membership affiliation, each organization

has consistent goals of protecting their respective profession as well as maintaining the best

interest of the public in terms of health, welfare, and safety (ACA, 2014; AMHCA, 2010; APA,

2010; NASW, 2015). While the goals of these organizations parallel those set forth by NOHS, a

major difference was found when comparing the grievance processes for ethical violations within

these professional organizations. Specifically, the previously mentioned disciplines addressed

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their grievance processes for violations while this information was lacking in the ethical codes

adopted by NOHS.

The grievance processes of the professions of social work, counseling, and psychology

have gained recognition within the helping field and could serve as a model for human services.

Using these processes as a guide, consideration should be given to the following concepts that

have been identified in other helping professions and/or within the ethical decision making

process: (1) identification of how complaints would be accepted (ACA, 2014; AMHCA, 2010;

NASW, n.d; Luke, Goodrich & Gilbride, 2013); (2) defining what constitutes a complaint (ACA,

2014; AMHCA, 2010; NASW, n.d; Luke et al., 2013); (3) selection and description of ethical

committee (ACA, 2014; AMHCA, 2010); (4) identifying the jurisdiction of the overseeing

committee (ACA, 2014; AMHCA, 2010); and (5) identification of what actions could be taken if

a complaint was found to be valid (ACA, 2014; AMHCA, 2010; NASW, n.d.; Luke et al., 2013).

Helping professions with established processes for addressing ethical violations provide

NOHS with a framework to develop a successful grievance process. Common practices among

those professional organizations have included a letter sanctioning the individual, or suspension

and/or revocation of one’s membership (ACA, 2014; APA, 1996). Sanctions identified by other

helping professions included placing limitations on membership, suspension of membership, and

the possibility of communicating severe complaints to licensing boards, credentialing bodies, and

employers (ACA, 2014; AMHCA, 2010; NASW, n.d.). Additionally, many of these

organizations have established review boards who oversee the appropriateness of membership

renewal or ethical committees to review grievances and complaints (APA, 1996; ACA, 2014;

AMHCA, n.d.).

Ethical committees serve as a benefit to professionals who often view the mediating role

of these committees as a practical means to avoid more legal conflict whenever ethical issues

arise in their professional practice (Marcus, Shank, Carlson, & Venkat, 2015). The American

Psychological Association (APA, 1996) and the American Counseling Association (ACA, 2014)

have established ethics committees which receive and adjudicate allegations of unethical conduct

that may impact a professional's ability to obtain or renew membership within that respective

organization. While AMHCA (2010) also has an established ethics committee, this committee

does not take responsibility for investigating and adjudicating ethics-related issues. However, the

committee will revoke membership in the event a member has his/her license suspended or

revoked by an appropriate state licensure board (AMHCA, 2010). Within each of the

aforementioned professional organizations, professionals are expected to cooperate with the

requirements and investigations of the ethics committee or review board (ACA, 2014; AMHCA,

2010; APA, 2010; NASW, 2015).

The establishment of guidelines is only useful if there are processes that address

sanctions or disciplinary actions for those who violate them, as ethical codes are “meaningless

without vigorous intention toward ethical behavior” (Mabry, 1999, p. 210). The ethical codes of

the aforementioned professional organizations present consistent evidence of established

guidelines in response to issues of ethical misconduct that may impact the membership status of

professionals (ACA, 2014; AMHCA, 2010; APA, 2010; NASW, 2015). Establishing a grievance

process for ethical dilemmas within NOHS is important to encourage the adoption and use of the

code within human services agencies. This would require agencies to not only provide

knowledge on the ethical standards and grievance processes outlined by NOHS, but also to

develop policies and procedures that adhere to the guidelines.

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Interorganizational Collaboration of Ethical Violations Literature did not support the identification of processes or collaborations utilized by

other helping professions in the development of their respective ethical guidelines and grievance

processes. However, it was noted that several of the organizations consider communicating

violations of ethical codes to other stakeholders such as licensing boards, membership and

credentialing bodies (ACA, 2014; AMHCA, 2010; NASW n.d.). Considering this, NOHS should

consider developing its own protocol for the inclusion of human services stakeholders that have

advanced the discipline and can play an active role in the support and development of sanctions.

One suggestion is that NOHS consider collaborating with the Center for Credentialing in

Education (CCE), which established and currently provides oversight for the Human Services—

Board Certified Practitioner (HS-BCP) credential (Hinkle & O’Brien, 2010). This collaboration

could benefit NOHS as CCE recently developed its own ethical code for those who become

credentialed as HS-BCP (CCE, 2009), many of whom are also NOHS membership holders.

Collaborating with the CCE could be mutually beneficial in the enforcement of both

organizations’ ethical codes as well as in supporting the development of a grievance plan that

supports the field overall.

Implications for Human Services The National Organization for Human Services has been leading the field in establishing

ethical guidelines within the field of human services (Sparkman & Neukrug, 2014). Despite this,

researchers have called for more focus on ethics within helping professions to prevent harm to

clients, agencies, and society as a whole (Milliken & Neukrug, 2009). NOHS’ consideration of

adopting an established process for addressing grievance processes will further establish the field

of human services among other helping professions and distinguish it as a distinct field. It will

also address the call for more focus on ethics within the profession (Milliken & Neukrug, 2009).

While grievance processes and ethical guidelines are significant to practice since they provide

accountability within the field, research suggests that grievance processes have limited influence

on a professional’s behavior if there are no consequences for violations (Healy & Iles, 2002). An

established grievance process with clear consequences for ethical violations will hold NOHS

members accountable for their actions and will also hold NOHS accountable for enforcing the

code established for members of the organization. This accountability extends beyond

identifying ethical dilemmas and emphasizes the importance of remaining ethical in the

responsibility to the field of human services as a whole.

Research notes the tendency for professionals to disregard ethical codes as oftentimes the

ethical codes and grievance processes are produced and subsequently published with little to no

enforcement (Healy & Iles, 2002). The lack of a grievance process for the revised ethical codes

adopted by NOHS (2015) leaves the membership holder without guidance as to how ethical

violations will be addressed thus significantly reducing accountability. This has negative

implications for the discipline as the lack of enforcement creates opportunities for professional

organizations to be represented by membership holders who engage in unethical behavior (Beets

& Killough, 1990). Unethical behavior of membership holders negatively impacts the credibility

of the professional organization as it contradicts NOHS’ stated responsibility to the client, public

and society, colleagues, and to students (NOHS, n.d.). This contradiction creates scrutiny for the

human services field that in turn impedes the growth of the human services profession as a

whole.

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Developing a grievance process that addresses potential ethical violations, validates the

ethical code, and provides accountability within the profession which is essential in protecting

membership holders’ professional identity and supporting the mission and purpose of NOHS.

Luke et al. (2013) state that the core components of ethical decision making processes include

problem identification, reference to the organization’s ethical code of conduct, establishing the

scope of the ethical dilemma, creating strategies to address the dilemma, consideration of the

consequences for each course of action, and assessment and selection of an action plan. The

ethical decision making process could serve as the foundation for creating a grievance process

that meets the needs of the human services profession and supports the revised version of the

already established ethical code.

Professional governing bodies serve as custodians of professional tradition by keeping

moral commitments of the profession relevant (Frankel, 1989; Higgs-Kleyn Kaplianis, 1999).

Due to their role in leading the field, professional organizations have the obligation of addressing

ethical dilemmas as they arise as affected agencies rely on the professional organization and code

of ethics to promote ethical practice and ethical behavior in the delivery of services (Lonne,

McDonald & Fox, 2015). Professional obligations of these organizations extend beyond creating

and publishing an ethical code, but also include an obligation to enforce the codes as a

requirement of the profession. Dissemination of the requirements among members of the

profession is important in order to ensure that the community is aware of the ethical code.

Having an established grievance process to assist in examining and adjudicating those concerns

provides professionals with guidelines of what to expect from the professional organization

which governs the field when ethical violations arise.

Conclusion With the adoption and implementation of its revised ethical codes, the National

Organization of Human Services continues to advance the field of human services and define

ethical practice. While development and revision of the codes are important to the discipline and

provide a guideline for ethical practice for membership holders, lack of enforcement of these

codes contradicts the overarching goal of the codes. Enforcement of the codes increases

accountability of the professional while also serving as a vehicle to meet the goal of protecting

clients, society, and other areas identified by NOHS (NOHS, n.d.). A grievance process for

ethical violations should be one that is consistent with expectations of other applicable

credentialing boards in order to ensure uniformity throughout the human services discipline.

In addition to developing a grievance process for ethical violations, NOHS should

consider developing a communication protocol for professional organizations, licensing boards,

and other respected entities to provide transparency within the helping professions. As many

human services professionals hold membership in NOHS as well as the HS-BCP credential,

NOHS should consider communicating ethical violations with CCE. When communicating, both

entities would have to consider the differences in authority over their members in the

development of a grievance process. Collaboration during the development phase may be needed

to address this issue. NOHS is encouraged to consider sanctions similar to NASW and AMHCA

which include adopting the sanction of public notification and notifying appropriate state

licensing boards who may impose fines, probationary periods, or other appropriate actions

related to licenses or certifications held by violators (Chauvin & Remley Jr., 1996). In

conclusion, developing a process for responding to ethical violations within its membership that

is structured, rooted in the ethical decision-making model, and addresses the field in a holistic

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manner by utilizing what has been done within other helping professions as a guide would

benefit NOHS and further advance the human services profession.

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