SOCW 6520 Assignment: Week 3 Blog

Safety in Social Work Settings THE SCOPE OF PERSONAL SAFETY RISKS IN SOCIAL WORK

Have you wondered about your physical safety at your practicum site? Does the thought of home visits create feelings of anxiety? Have family members worried about your choice of profession because of safety issues? Have you heard other students and faculty discuss agency safety issues? Has the absence of any discussion of safety worried you? Many students, especially beginning students, have concerns about safety and security and struggle with the decision to voice their concerns to their professors, other students, and their field instructors. Students may be reluctant to discuss safety fears and concerns with others for fear of being viewed as uncommitted to the profession or to clients. Other students may assume that the role of the social worker is viewed strictly as one of helper and enabler and cannot fathom it being viewed as a threat. However, the practice of social work typically does involve some degree of risk. If not addressed, concerns about personal safety can significantly affect learning opportunities in the field placement. This chapter will address safety concerns associated with social work and provide guidelines that can assist you in minimizing the risk of harm.

Corina Wonders about Her Safety On her first day of practicum,

Corina was given a tour of the detention facility, introduced to all of the staff, oriented to the various systems, and provided with agency manuals and policy guidelines. She began shadowing other social workers and sat in on their group therapy sessions. On the third day, she remembered to ask about the unusual name of the unit in which she would be completing her practicum. She was told it was named after a staff member who had been shot to death by a client in the office a year ago. She was shocked. She had no idea that this practicum could pose a threat to her well-being. Are her fears real? What would you do on learning this information?

Faced with this kind of information, most students would be concerned about working at the agency. Some might even contemplate requesting a transfer to another agency. Other students might consider the likelihood of this kind of incident occurring twice to be very small and so disregard safety as a serious matter. Should safety be a concern for students in practicum? While most social work employers adequately address safety issues (Whitaker, Weismiller, & Clark, 2006), research findings suggest that concern over personal safety issues in social work is warranted. Estimates of the proportion of social workers who report experience with work-related violence range from 42% to over 80% (Criss, 2010; Ringstad, 2009; Winstanley & Hales, 2014). The National Institute for Occupational Safety and Health (2002) defines workplace violence as “violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.” Almost half of all nonfatal injuries in the United States from work-related assaults and violent acts occurred in health care and social services (U.S. Bureau of Labor Statistics, 2006). Of the injuries and illnesses occur-ring in health care and social services, 13% were the result of violence, a proportion that has been increasing over the past few years (U.S. Bureau of Labor Statistics, 2014). Studies have found that 15%–75% of survey respondents reported verbal aggression and 2%–29% reported physical aggression in medical practice settings (Hills & Joyce, 2013). Approximately half of all mental health professionals, including social workers, will be physically or psychologically assaulted at least once in their professional careers (Arthur, Brende, & Quiroz, 2003; Bride, Choi, Olin, & Roman, 2015), with social workers being nearly six times more likely than other workers to experience workplace violence (Respass & Payne, 2008). Social workers are the target of violence for a wide variety of reasons, including the following (Anderson & West, 2011; Newhill, 2013; Weinger, 2001): • Social problems (e.g., unemployment, poverty, and racism) that create an environment conducive to violence • Budget cuts that cause rising caseloads, resulting in less time with clients to assess for violence • The paradox of the professional role as both a helper and an agent of social control • Inadequate mental health services for the potentially violent client

Safety in the Practicum Setting

Social work practitioners and students are increasingly subject to threats in the workplace, the most common place where violence occurs, with approximately 50% reporting the experience of client physical or verbal violence (Sousa, Silva, Veloso, Tzafrir, & Enosh, 2014). Students are well advised to consider safety and liability issues when considering practicum sites and learning activities. The anxiety felt by many students regarding safety is justified by the experience of previous students. Although most students never experience any personal risk in practicum, approximately 42% of MSW and BSW practicum students experience some form of violence in the field placement (Criss, 2009). Violence mostly occurs in the form of verbal abuse, followed by threat of physical harm (Criss, 2009), with physical assaults rarely happening (Robson, Cossar, & Quayle, 2014). In one study, the majority of students experienced or were exposed to at least one incident in practicum that was emotionally or physically distressing (Didham, Dromgole, Csiernik, Karley, & Hurley, 2011). The most common form of threat to a practicum student is a verbal threat from a client, paraprofessional, or other professional (Robson et al., 2014). The 2015 Council on Social Work Education (CSWE) Educational Policy and Accreditation Standards do not address physical safety, assessment of potentially dangerous clients, or strategies for ensuring safety in the workplace. Thus, social work pro-grams vary widely in their knowledge of and approach to safety concerns (Criss, 2009). Although the National Association of Social Workers (NASW) offers safety standards for social work practice and guidelines about student safety (National Association of Social Workers [NASW], 2013), school policy that addresses safety issues is sparse: Only 12% of social work schools have a formal written policy on student safety (Reeser & Wertkin, 2001), and approximately 50% of practicum sites do not have agency safety policies regarding client violence (Barlow & Hall, 2007; Criss, 2009).

Reasonable Concerns and Caution

Social workers often work in neighborhoods and communities and with groups and clients that others may deem unsafe. In fact, many social workers will work in challenging situations and with challenging people as a routine part of their jobs or as part of being a social work professional. For example, in some states, social workers may be trained to be a “mental health first responder,” who actively assists people experiencing a mental health or substance abuse crisis by, for example, de-escalating the situation safety (Crisanti, Pasko, Pyeatt, Silverblatt, & Anastasoff, 2015; National Council for Behavioral Health, 2015). Social workers in mental health or clinical roles often work with clients who have difficulty regulating their emotions, reacting appropriately to situations, or tolerating dis-tress, which can lead to violence. Developing some level of acceptance and tolerance for challenging behavior and learning how to react professionally in a manner that is helpful to the client and that promotes safety will prove useful in practicum (Hyde, 2014). Although being careful is important, strive to separate stereotypes and myths from reality by having a realistic perception of risks so you can be an effective practitioner. If not addressed, the beginning anxiety you may feel can impede your willingness to draft ambitious and valuable learning plans. Talking with other students in practicum at your site, other current and former practicum students at the agency, and your field instructor can help you to determine the level of risk involved in conducting specific tasks and your comfort level in completing those tasks. You must ensure your safety and avoid allowing unfounded fears or inexperience to become impediments to the delivery of effective services. Situations posing physical threats to social workers can occur in any setting, and students should exercise due caution regardless of the perceived risk. The agency setting can significantly influence the level of perceived risk to the staff. Toward that goal, NASW safety standards suggest that agencies create and maintain an “organizational culture that promotes safety and security for their staff” (NASW, 2013). If your practicum agency is a residential setting (e.g., a children’s residential facility, hospital, substance abuse treatment facility, domestic violence facility, or correctional facility) that seeks to create this type of culture, you will likely encounter a highly structured setting with specific policies and procedures regarding some or all of the following (NASW, 2013): • Locks, both keyed and keyless • Metal detectors • Panic buttons • The need to receive permission from security guards for movement within the site • Confidentiality regarding location • Client restraints • Movement to and from your car in the agency parking lot • Situations in which staff must work in teams to ensure safety • Standard precautions (e.g., universal precautions) for avoiding exposure to illnesses such as HIV/AIDS, hepatitis, and tuberculosis • The completion of safety and violence response workshops in which you are trained to respond to violent aggression by clients and are expected to intervene physically with clients • The posting by staff of personal information on the Internet (possibly through social media networking sites), since these sites are highly accessible Administratively, you may also find that agency leadership has committed in writing to staff safety, actively manages workplace behaviors and collects data on incidents that involve safety risks, and has created safety committees to monitor agency safety policies (NASW, 2013). If you are working in a community-based agency, you may find fewer (if any) protocols and safety guidelines. Your field instructor may discuss safety matters with you during your interview to provide a realistic view of risk prior to your commitment to the agency. He or she will likely discuss policies and procedures regarding safety as you begin your practicum as well as the agency process for reporting safety policy and procedure violations. Completing the following practice applications can help you to gain a realistic perception of the safety risks in your setting and implement agency safety policies.

At Your Practicum Site •

Inquire about the number of recent incidents of physical or verbal abuse, harassment, and other violence that staff have experienced inside or outside the agency. • If the information was not included in the orientation, inquire about agency safety protocols (e.g., telephone number for emergency assistance, location of the first aid kit, emergency exit procedures for the building, and locations of fire extinguishers) as well as the process for reporting protocol violations. • Request a tour of the surrounding neighborhood, particularly if you will be conducting home visits. • Ask whether certain neighborhoods or areas should be avoided or approached with more caution than usual by staff members for safety reasons, and be prepared to follow suit when working independently.

Within Your Social Work Program •

Ask how many students have experienced problems related to safety in practicum in recent years. • Research the safety protocols of your social work program. • Take advantage of safety resources available from your social work program, or ask the faculty for assistance in obtaining resources such as safety training, seminars, videos, handouts, and discussions. After you have gathered all the information noted, demonstrate the knowledge you have gained through a discussion with your field instructor, a reflection paper for your integrative practice field seminar, or a journal entry

Ask to be observed by a staff member as you are making the transition to independent work with clients, and ask for feedback regarding safety risks and the implementation of safety guidelines. Journal about these early experiences related to safety issues as well as the safety precautions utilized and not utilized by you or by staff. Discuss and critique the following with a member of your practicum team: • Information gathered regarding safety issues in the practicum site • Skills you are developing related to the implementation of safety guidelines • The safety training and/or protocols of both the agency and your social work program (Were the protocols sufficient? Was the training helpful?) • Your apprehensions or fears concerning your safety while conducting practicum activities (Are your apprehensions based on reality and experience? How much of a factor could myths, stereotypes, inexperience, or bias be playing in your fears?). History is often the best predictor of risk. Increased caution should be exercised when working with clients who have these characteristics (Newhill, 2008; Ringstad, 2009; Weinger, 2001): 1. Severely violent behavior 2. History of remorseless parental brutality 3. History of fighting and school problems 4. Difficulty getting along with others and authority figures 5. History of overt parental seductiveness 6. Familiarity with and access to weapons 7. Currently under the influence of drugs or alcohol 8. Currently under severe stress and feeling over-whelmed or hopeless 9. Currently verbalizes being upset and angry or will not communicate with you 10. Currently threatens you either verbally or physically 11. Currently involved in illegal activities 12. Erupted verbally or physically in the last 30 to 40 minutes 13. Unable to sit still or is pacing 14. Currently suicidal 15. Was the victim of verbal or physical assault by a social worker

Assessment of Potentially Violent Clients

Due to the increased safety risks faced by social workers in many settings, it is critical that you be able to assess potential risk accurately. While human behavior is unpredictable and you will not be able to determine risk accurately in advance of an actual threat to your safety, be aware that certain factors may increase the risk of harm (see Box 3.1). Caution should be exercised when working with certain client groups under the following circumstances (Anderson & West, 2011; Criss, 2009; NASW, 2013; Ringstad, 2009; Scalera, 1995; Weinger, 2001): • Young male clients with criminal records or histories of substance abuse, weapons possession, or violence • Clients with a mental illness with specific risk factors and acute symptoms (i.e., paranoid delusions, command hallucinations, and syndromes such as mania, paranoid schizophrenia, and panic) • Clients with a history of weapons possession or training • Clients with a history of child or adult violence, substance abuse, or ritualistic or cult practices • Clients with lower intelligence or history of head trauma • When you are engaging in a high-risk activity during the visit (e.g., preparing for or actually removing a family member, such as a child; notifying a client about a reduction in benefits; terminating parental rights; carrying out a civil commitment procedure; or helping a partner attempting to leave a relationship) • When you are working in a geographic location that may pose danger (e.g., a rural, isolated, or high-crime area) • When you are working during evening or nighttime hours • When animals that may pose a threat are present

Specific Guidelines for Safety within the Office

Many students will meet with their clients in an office setting and encounter few problems. However, even the most structured setting cannot guarantee complete safety. The following suggestions can reduce the chances of experiencing physical harm in the office (Hyde, 2014; NASW, 2013; Newhill, 2013; Weinger, 2001): • Follow agency safety policies to the letter. Take advantage of any agency safety training opportunities, and read agency policy about staff and client safety. • Study the files of all clients before interacting with them to ascertain the risk involved in working with them. • Learn how to do a risk assessment, to include consideration of a client’s history of violence, involvement with correctional systems, appearance, demeanor, intent to harm self or others, and psychiatric or medical risk factors, including substance abuse, and the degree to which the client is compliant with requests. • Ask a staff member to accompany you when working with a client who has a his-tory of violence or who exhibits behaviors that may pose a threat. • Remove all objects from your desk (pens, staplers, and paperweights) that could be used as weapons. • Leave a client who is becoming belligerent or threatening, and seek help from a colleague. • If there is no system in place, develop one whereby you can discreetly signal another staff member that you need assistance (e.g., call another staff member, state the client name, and say that you need “the progress folder”). • Leave office doors open, and arrange the furniture so that both you and the client could make a quick exit. • When possible, develop relationships with those who are charged with ensuring your safety. Let them know when you will be working late, and ask the guards/ safety patrol officers to escort you to your car when needed. • When at the agency, keep your valuables in a confidential, locked location. • If clients have access to the office in which you are working, lock it whenever you leave • Have a working knowledge of the technology available from the agency to ensure your safety, such as panic buttons within offices and internal alert systems that can be activated from a mobile device, and the location of the security cameras. While all violence cannot be prevented, these steps represent the efforts that you can make to help ensure your safety in the office setting. If safety is an issue within the practicum office and some of the aforementioned suggestions are not being utilized, consider recommending them. It is important to take safety issues seriously within an office setting.

Interacting with Clients within the Home and the Community

Ben Has a Frightening Client Encounter Ben was unsure about the contents of the long case in the client’s hand. The client walked quickly, put the case in the backseat, and joined Ben in the front seat. As Ben greeted him and reiterated the need for the trip to the office, the client began to ramble incoherently. However, Ben was able to understand that the client wished to go first to a different location to pick up a check. When Ben objected, the client referred to the shotgun he had placed in the backseat. The client made disparaging remarks about Ben’s Asian heritage. Frightened and unclear about what he should do, Ben drove to the location the client requested and then drove him home. As Ben debriefed later with his field instructor, he found himself shaking and short of breath. Did he do the right thing in this situation? How did diversity issues impact the interaction?

As Ben discovered, stepping into the community to serve clients entails leaving the structured environment of the office setting. Working with clients outside an office setting can also, as in Ben’s case, leave a practitioner wondering which course of action is best as an interaction with a client unfolds in the real world. Making home visits and encountering clients in the community can offer the opportunity to gather a rich array of infor-mation about them that is not available from a meeting in the office. The home visit enhances the delivery of services to clients in their natural setting. While interacting with clients outside of the agency can be intimidating for a new professional, the delivery of professional services on the “home turf” of the client can be essential to the success of the intervention. Although not every home visit poses a safety risk, consider the follow-ing suggestions to decrease the potential for harm (NASW, 2013). Preparation Preparing for work with clients outside of the agency can minimize your risk of physical harm and liability. Transportation If you will be transporting clients in a vehicle, • Determine the ages of any children you may be transporting. Make arrange-ments for carseats and child safety locks for young children. • Check the number and condition of seatbelts. • Review the travel location resources available in your car. Have access to a current street map (either hard copy or electronic) or a GPS device, and practice using the map/device prior to independent home/community visits • Ensure that your car is equipped for emergencies, including a spare tire (and the necessary changing equipment), ample fuel, and battery cables. If your work will involve extensive travel, consider obtaining emergency roadside assistance coverage. • Verify that there is insurance coverage for clients transported in your personal vehicle. Before using an agency vehicle, confirm that students and volunteers are covered by the agency policy. • Keep only necessary keys on your key ring. Consider obtaining a two-part key ring that allows you to detach a portion that contains your car keys. Home Visits As a practicum student, you may conduct a home visit on your own or shadow another worker or your field instructor. The following precautions may mini-mize your risk in the community. If you shadow another worker, consider discussing this list and taking responsibility for some of these preparations (Burry, 2003; Hyde, 2014; NASW, 2013; Respass & Payne, 2008; Spencer & Munch, 2003; Weinger, 2001): • Before leaving for a home visit, gather information from colleagues, administra-tors, and the case file at the agency so you can assess any known risks, including acute symptomatology, noticeable behavior changes, alteration or discontinuance of medication, known or suspected use of drugs or alcohol, mandated treatment, previous threats, and known history of violence. • Determine whether the visit can occur in a public location and/or with another worker, supervisor, or law enforcement personnel. • Inform agency staff of the addresses you plan to visit and your expected route and return time. If you suspect a potential for danger, arrange for someone to call you during your visit, or take another staff member. Take only materials necessary for the home visit, and leave valuables (e.g., extra cash, unneeded credit cards, and jewelry) at the agency or at home. • Schedule home visits in the morning when possible. Neighborhoods and homes tend to be calmer during the morning hours than at any other time of day. • When calling to establish the visit, attempt to determine the client’s level of cooperation. Be clear about the expectations for your visit. • If cell phones or beepers are standard for other staff in the field, consider asking for a loan of this equipment during your practicum or taking your own phone, and have a charger in the car. Leave your number with agency staff, and have emergency contacts on speed dial. A cell phone can be tempting for thieves, so plan to keep it concealed, but keep it turned on during your visits (possibly with the vibration function activated) so that you can use it at a moment’s notice. If a phone is needed during an encounter with a client, use the phone discreetly to avoid becoming a target for robbery and escalating a volatile situation. It may be helpful to use a smartphone app that allows someone to locate you through the smartphone’s GPS and/or the audio/video recording capabilities of a smart-phone when meeting with a client deemed potentially dangerous. • Prominently display forms of identification to the client (e.g., agency name badge, business card, or logo on the agency vehicle). • Pattern your dress after that of the other field staff. Some agencies prefer a profes-sional look in the field, while others promote a casual dress style. Limit jewelry. Have clear written directions to the home location. Allow extra time if you are unfamiliar with the area. If you get lost, retrace your route. If you must ask for directions, do so at a public place. Do not ask directions from persons on the street, and never allow anyone to get into your car to show you the way to your destination. • Listen to and trust your instincts. If the situation seems uncomfortable and you sense the possibility for trouble, reschedule the appointment or make alternative arrangements. During the Visit Adhering to the following suggestions can ensure safety during home visits. If you are shadowing another social worker, consider asking a few questions prior to the visit. First, you could ask whether the social worker has a safety plan and if so, whether she or he will share it with you. Second, you could ask whether the social worker has ever had a conversation about personal safety with the client or created any sort of safety contract with the client. Last, consider discussing the specific recommendations below prior to your visit to ensure the safety of both of you (Burry, 2003; NASW, 2013; Weinger, 2001): • Use confident (but not arrogant) nonverbal behavior, and avoid acting timid. • Park your car as close to the client’s home as possible and in a location that allows for a quick departure, and store unnecessary belongings (e.g., large bags, back-packs, coats, purses) in the trunk. • Lock all car doors, and keep your keys in a place in which you have quick, easy access to them (e.g., in a pocket, on your clipboard). • Note the presence of any animals on the property, and ask the client for assis-tance with any unleashed animals. • Avoid walking through a group of unknown individuals when attempting to enter the house. (You may wish to leave and call to reschedule.) • Avoid entering any elevators or stairwells with anyone who appears threatening. • Take note of individuals present in the home, and ask the client about strangers. If you are uncomfortable in the presence of others in the home, ask if you can meet with the client alone or somewhere quiet. Encourage the client to keep confiden-tial the information you will be discussing by asking others to leave the home. • If possible, sit on a hard chair near a door with your back to a wall so that you can leave quickly if necessary. • Take note of all exits as you enter the house. • Avoid talking with a client in the bedroom or the kitchen, as weapons are fre-quently stored in these rooms. • Leave the home immediately if weapons or drugs are visible or if anyone appears to be under the influence or actively engaging in risky illegal activity. • After the visit, move your car to another location to complete the paperwork. Avoid sitting in a car in front of a client’s home after a home visit. Document any risks associated with your visit.

Working with Angry, Resistant, or Aggressive Clients

Despite the best planning, preparation, and adherence to protocol, you may find yourself in a situation with an angry, resistant, or aggressive client. Ideally, you should be able to leave a situation or attempt to get help. If this is not an option, consider the following strategies (Burry, 2003; Hyde, 2014; Respass & Payne, 2008; Weinger, 2001): • Maintain a quiet, calm, and firm demeanor. Avoid exhibiting any alarm, hostility, distress, or defensiveness. • Talk to the client in simple, direct sentences. Facilitate the expression of feelings and thoughts through empathy, summarizing, and paraphrasing, and encourage problem solving. Validate the client’s point of view to the extent possible, and avoid arguing. • Offer positive choices to the client (e.g., “Would you like to move over to my desk so that we can sit and discuss this?”). • Use assertive language to calm the client when appropriate (e.g., “I feel threat-ened when you shout at me like that. Can you tell me what you want in a lower voice? Otherwise, I am scared of you.”). • Use language to give the client control over the situation (e.g., “If you don’t want to talk right now, that’s fine. We can talk later.” or “Is it OK if I ask you about this?”). • Attempt to redirect the conversation away from the topic presented by the client. • Attempt to slow down the pace of the interaction so that the client has time to ventilate, calm down, and think (e.g., “OK, why don’t you take a deep breath?” or “Let’s get a cup of coffee.” or “Why don’t we just take a break and pick this up later?”). • Avoid any physical contact with the client. Attempt to engage verbally with a client at the first outward signs of agitation to allow for ventilation at the earliest possible point. • Allow ample room between the two of you (more than one arm’s length) to give the client plenty of personal space. Approach the client at an angle rather than from the back or directly from the front. • Make every effort to seat the client. If it is not feasible to sit, allow ample room between the two of you, and stand off center to the client to give yourself plenty of room to maneuver. • Invite another staff member into the interaction. Invite the client to share her or his point of view with the staff member. • If the situation appears immediately unsafe, leave the room. Working with agitated clients requires a calm, professional demeanor, preparation, and personnel resources. If you are presented with a risky situation in the office or in the field, these suggestions can serve to defuse a potentially dangerous interaction. Follow-Up to Crises Even with the best preparation, planning, and use of defusing techniques, crises still occur. For example, if available, using a panic alarm to call other staff or security may be the best option. If no panic alarm is present, you may be able to use a cell phone to call security or the police. If attacked, use the minimum force needed to restrain the person or to free yourself and move to another location for assistance. If you need medical assis-tance, seek it right away (Hyde, 2014). After moving to a safe place and attending to your physical needs (if necessary), if you are involved in an incident, report the incident to your field instructor in a manner that is in accordance with the agency policy. Your field instructor should communicate with agency administration and provide you with the support and guidance you need. With the sup-port of your field instructor, you will likely complete an incident report that documents what occurred in the situation, including the type of incident (e.g., verbal threat/abuse, intimidation, attempted or successful physical assault, property damage) and its severity (in terms of physical or mental health or financial cost). The incident report may also ask about any witnesses or breaches in protocol or policy that led to the incident (NASW, 2013). This incident report is an important document, and you should review it carefully with your field instructor, as it may be used for a variety of purposes, including inform-ing management. It is important that the facts be carefully recalled and documented so the response to the client is appropriate to the situation. Agencies should thoroughly review every incident and support those who are involved in and affected by serious incidents. Such efforts might include filing a police report, pressing charges against the client, obtaining a restraining order, arranging mediation with the staff and the client, referring the client to another staff member or a different agency, holding debriefing sessions, making changes to staff schedules and suggested routes, and identifying resources and protocols to ensure staff safety in the future (Hyde, 2014; Spencer & Munch, 2003; Weinger, 2001). Regardless of the response of your field instructor and agency, take advantage of the peer-support networks available at your agency and within your social work program as well as your personal support system. If the incident involved a high degree of risk or you are finding that you have been deeply affected by the situation, you may wish to consider taking time off from the practicum and/or developing an individualized safety plan for completing the practicum. Contacting a mental health practitioner to process and work through the incident, learning to monitor self-talk, and learning stress reduction tech-niques may also be helpful (Hyde, 2014).

Ethical Dilemmas Involving Safety Issues

• What should I do if my agency physically restrains clients and I hold a personal belief against this? • How do I decide whether to carry out activities in my practicum that my family or friends have asked me not to do? • What should I do if I observe another staff member not following agency safety procedures? • What should I do if I am required to conduct a home visit even after I discuss my uneasiness about the arrangements with my field instructor? • What should I do if I am required to work at night even though I feel uncomfort-able doing so? These questions are evidence that even under the best circumstances with clear guide-lines, students sometimes encounter situations that demand difficult decisions. At times, difficult situations emerge that involve conflict among your personal beliefs, agency protocols, and client interests. At the practicum site, you may be asked to carry out activities to which you are personally opposed or about which you feel uneasy. Although the NASW Code of Ethics (2008) is silent on the matter of safety, the primacy of client interests is clear (Section 1.01: “In general, clients’ interests are primary.”). The Code discusses the obligation social workers have to carry out the work of their employers in good faith (Section 3.09: “Social workers generally should adhere to commitments made to employers and employing organizations.”); however, it does not explicitly require social workers to follow agency policies and procedures. You may be left in a quandary when determining the best course of action in a situa-tion that involves conflict among your beliefs and comfort level, agency procedures, and client interests. Ideally, you were informed of the need for the activities in question prior to your commitment to the agency, and you either made a decision to allow the interests of the agency and the clients to supersede your feelings or negotiated different arrangements prior to your commitment. If expectations or arrangements related to safety emerge after your commitment, you may decide to do one of the following: 1. Negotiate your involvement with activities about which you feel strongly with your field instructor/agency after you begin the practicum. 2. Make a decision to engage in the activities in question regardless of your feelings. 3. Process and explore your feelings with your field instructor to determine whether your fears are founded. 4. Discuss your experiences and feelings in integrative seminar in order to deter-mine a course of action. 5. Discuss the situation with your faculty liaison. 6. Attempt to switch to another practicum site if you are unable to resolve the conflict. Although the guidelines outlined in this chapter are suggestions, situations are rarely clear-cut, and students are often left to their own best judgments to discern a course of action. Indeed, students often struggle with the same dilemmas faced by seasoned social workers. As social workers strive to deliver quality services under increasingly volatile circumstances, the struggle to integrate personal feelings with professional demands and to resolve safety dilemmas becomes more difficult and more common.

Helping to Ensure Client Safety

As a practicum student, you have a responsibility to implement agency policies designed to ensure clients’ safety. For example, as a student, you must follow agency policies and procedures to avoid falls and other injuries. The NASW Code of Ethics (2008) requires social workers (and you as a practicum student) to provide appropriate professional ser-vices during “public emergencies”—for example, during public disasters and during and after terrorist activities, when clients may need immediate medical attention (e.g., CPR). Depending on your setting, you may also need to use universal precautions to protect your-self and your clients, such as the use of materials that serve as protective barriers (e.g., gloves, masks, and protective eyewear).

HARASSMENT

Lauren Experiences Harassment

An openly homosexual female staff member has asked Lauren out several times for drinks after work. Despite Lauren’s repeated refusals, she continues to ask. She seems to create rea-sons for contact with Lauren and brings her small gifts of food. Lauren surmises that the staff member perceives that she is also lesbian. The field instructor and staff member are good friends. In discussions with her family about the situation, Lauren has been pressured to end the problem by involving administrators or outside agencies. Is she being harassed? What should she do?

Situations such as this call for careful thought, tact, and a judgment call. It may be very difficult to distinguish between friendliness and harassment. It is important to note that harassment—defined as “any unwelcomed, unsolicited, and offensive con-duct that is severe or pervasive and tends to injure, degrade, disgrace, or show hos-tility toward a person because of sex, race, color, religion, national origin, ancestry, disability, age, sexual orientation, marital status, gender expression/identity, genetic information, pregnancy, or any other characteristic protected by law” (Saint Louis University, 2013)—is a safety issue. Armed with good intentions, the NASW Code of Ethics (2008), and professional work experience, many students conclude that harass-ment will not be an issue. Given the value base and humanist orientation of the profession, you might think that the social work workplace would be free of harassment. However, social workers encounter harassment in their workplaces, with one of the most common forms being sexual harassment. In fact, sexual harassment is the third most common type of abuse encountered by social workers in practice (Macdonald & Sirotich, 2005). Social work practicum students can expect to encounter sexual harassment as frequently as do social work practitioners, and sexual harassment is experienced by female and male workers (Alink, Euser, Bakermans-Kranenbury, & Van IJzendoorn, 2014). Most sexual harass-ment crosses gender lines, but same-sex sexual harassment is also a problem (U.S. Equal Employment Opportunity Commission [EEOC], n.d.a.).

Defining Features of Harassment

Harassment occurs in many forms, ranging from jokes to sexual intercourse. Sexual harassment is currently defined as verbal (pressure for sexual activity, comments about the female or male body, sexual boasting, and sexist and homophobic comments); nonverbal (looking up dresses or down shirts, obscene gestures, and suggestive sounds); physical contact (touching, patting, pinching, and kissing); or environmental (sexually offensive literature, pictures, or music). Harassment can also include offensive remarks about a person’s sex. Agencies are compelled by law to address the issue of sexual harassment in the workplace according to Title VII of the 1964 Civil Rights Act and under guidelines issued in 1980 by the Equal Employment Opportunity Commission (EEOC) regarding policy statements and grievance procedures (U.S. Equal Employment Opportunity Com-mission [EEOC], n.d.b). The NASW Code of Ethics (2008) requires social workers to reject sexual activities with clients under all circumstances, renounce all forms of discrimina-tion, avoid relationships that pose a conflict of interest, maintain a clear interest in social justice, and preserve human dignity. Both your field instructor and your agency have a clear interest in maintaining an atmosphere that is free of harassment.

Intervention

What should you do if you encounter harassment of any type at the practicum? The cir-cumstances of the harassment will determine the response. Consider the following steps (EEOC, n.d.b): • Document the circumstances of the harassment, including dates, times, quota-tions, other details of the interaction/situation, and verification from any witnesses. • Document your work accomplishments and maintain copies of evaluations. This documentation may be critical if your work performance becomes an issue when you take action against the harassment. • Seek other victims of harassment and consider taking action as a group. • Confront the harasser in person or in written form. Include the facts, your feel-ings, and a clear directive to stop the harassment. • If appropriate, report the experience(s) to your field instructor and your faculty liaison. • Explore the complaint process available at the agency as well as within your social work program and affiliated institution, and consider filing a formal complaint. • Consult with other social work students. Take advantage of field seminars or other mechanisms to consult with and receive support from other students. • If an agency complaint process does not exist, consider advocating for one. • Consider contacting outside resources. You may wish to contact an attorney; a local, state, or federal agency charged with addressing complaints of harass-ment (e.g., the EEOC); a nonprofit organization (e.g., the NAACP); or another resource.

Reference

Birkenmaier, J., & Berg-Weger, M. (2018). The practicum companion for social work: Integrating class and fieldwork (4th ed.). New York, NY: Pearson.

Chapter 3, “Safety in Social Work Settings” (pp. 63-77)