Transcript Ties we Find: Ethical Social Work in Rural Practice and in

Ties we Find: Ethical Social Work in
Rural Practice and in Communities
within Communities
Elaine Spencer MSW, RSW
March 2006
ACSW Conference
Insider Social Work
Insider Social Work: when you are a
member of the community you serve.
A safe, well-boundaried approach -
Insider Practice
 Codes have generally been written with urban,
clinical practice in mind.
 Insider social work, in the last 20 years, has not
been well documented, and has been
“underground” to a certain extent.
 Underground practices can lead to ethics
concerns, ethics complaints.
 Non-sexual multiple relationships (nsmr) are
“inevitable” and we must learn to be open and
supportive, reflective and proactive to define
best practices.
Boundaries
Give each person a sense of legitimate
control in a relationship and set limits that
establish a safe connection between
practitioner and person seeking service.
Boundary violations are distinct from
boundary crossings, though often
misunderstood.
Boundary Crossings
Non-sexual dual or multiple relationships
(nsmr) are considered boundary crossings
Interests of the client(s) is the primary test
Harmful, neutral, salutory
Few absolutes
Contextual (rural/urban, cultural)
Dual/Multiple Relationships
 Professional relationship plus any other
relationship(s). Examples include social,
financial, cultural, sexual.
 Growing recognition that rural or small
community within community practice cannot be
“black and white” on dual/multiple relationships.
 Insider practitioners may be expected to provide
professional services when they are personally
impacted by community events (ie suicide)
Professional Regulation
 CASW Code 1983 – no exploitation of clients,
supervisors, students, employees, or research
participants sexually or otherwise.
 CASW Code 2005 – not yet proclaimed.
 Standards of Practice (1999) – explicit reference
to dual relationships of all types, noting
exceptions to the obligation to terminate (special
skills, services, emergencies).
 Guidelines critiqued as vague and simplistic,
without guidance to make ethical decisions
about nsmr, and inevitability in insider practice.
Critiques and Calls for Change
 Helpful Dual Relationships
 Open recognition of multiple roles and support
for Insider practitioners (ie aboriginal practice
late at night, child welfare, called to auntie’s
house)
 Thoughtful, reflective, decision-making
 Client first, client need first
 Practitioner responsibility for maintaining safety
for clients
 ACSW – no rural nsmr complaints
Components of Ethical Practice*
*c BJ Antle (2005)
Sensitivity and Empathy Intersect all Spheres
Human Rights
Charter
UN conventions
Prov/Terr Codes
Client
Culture and values
Priorities/resources
Context
Relevant laws
Workplace culture/policies
Social Worker
Ethical orientation
Codes/standards
Risk tolerance
Framework for Managing Insider Practice
Issues
 Wide diversity on potential harm/benefit of nsmr.
 Have a plan, any plan, and voice the plan,
discuss the plan, change the plan if necessary,
consult if necessary, seek supervision if uneasy.
 More writing on non-clinical multiple, non-sexual
relationships, in rural settings, in insider groups
 research on the effects of nsmrs shows
argument for positive and negative, I suggest
assess on a situation by situation basis.
Managing Multiple Relationships:
A Framework for Decision-Making*
*Gripton and Valentich’s 10 Factor Model:
1. Vulnerability of the client
2. Power Differences
3. Risks for the Client
4. Risks for the Practitioner
5. Benefits for the Client
6. Benefits for the Practitioner
7. Clarity of Professional Role Boundaries
8. Specificity or Diffuseness of Professional Roles
9. Access to Alternative Sources of Professional Services
10. Community Values and Cultural Norms
Implementation
1. Assess (understanding codes, policies,
legislation). Collaborative approach if
possible.
2. Reconsideration (read Marilyn Peterson
[now Armour]) for clinical “red flags”.
3. Consultation.
4. Documentation. (including steps taken
and rationale).
Real Examples
 Jenny and Beulah, both family therapists at a small agency plan to
meet at Jenny’s house to attend a music festival in your community,
after a long and stressful week. When Beulah shows up, your
friend, Ryan and his partner, are present. Beulah recently worked
with this couple, and had some quite negative feelings about the
choices they made. You all attend the music festival for a bit, Jenny
goes off with another friend, and later meets you back at the house,
after Ryan and partner have gone home. Beulah shows up with
Naomi, whom Jenny has worked with at the agency, a couple of
years ago, while Beulah was on a leave of absence. Jenny feels
quite positively about the work Naomi and she did, though her recall
is fuzzy, as time has passed. Beulah makes comments that she
really didn’t want to “deal with clients” that day, so was glad your
friends had left. She is obviously unaware of the previous client
relationship with Naomi. Apply the model to decide if any action
could be taken in this situation.
Real Examples
 Kulah is organizing a protest over living
conditions in her tied to income housing. She
asks Zalim, a local social worker, to help her, as
he lives in the building. Zalim works as a
community organizer for the Town, which is the
technical landlord of the housing in question.
 Using the model, identify issues and actions.
Real Examples
 Belinda is in clinical private practice in a small town. She
sees a couple for counseling. At the first day of school,
she notes her daughter and their daughter are in the
same class. The client couple greet Belinda in front of
the teacher, and explain to the teacher how neat it would
be if their daughter could play with their social worker’s
daughter, as they feel that might help their daughter with
issues around socialization. A few weeks later, a
birthday invitation is sent home with Belinda’s daughter.
Belinda is aware of alcohol use issues and violence in
the home. Belinda’s daughter expresses she does not
want to attend this party, as the client couple’s daughter
has been physically aggressive to her at school.
 Using the model, decide what would be best to do.
Real Examples
 June has been seeing you for counseling, referred by a
colleague of yours. June asked that you receive some
vital history from that colleague and you have complied.
During counseling, you begin to believe that you are not
being effective, as June remains very depressed, and in
a lot of pain most sessions. She is let go from her job,
where she worked for your colleague. You believe the
firing is unfair, and due to her health issues. Also, you
see June in a parade the next day, riding a big float,
smiling and laughing, and she pelts you with a snowball
as she goes by.
 Assess and decide.
The End
References on ACSW website
Acknowledge sources when using model.
Questions.