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Sense and Sensibility: Ethical Considerations in the Workplace

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Title: Sense and Sensibility: Ethical Considerations in the Workplace


1
Sense and Sensibility Ethical
Considerations in the Workplace
  • Debra Guthmann, Ed.D.

2
Developed by
  • Debra S. Guthmann, Ed.D.
  • Director of Pupil Personnel Services
  • California School for the Deaf
  • Fremont, CA
  • Project Director, Minnesota
  • Chemical Dependency Program for
  • Deaf and Hard of Hearing Individuals

3
What are Ethics??????
4
Ethics are …
  • Doing the right thing because it is the right
    thing to do. (Aristotle)
  • Theories or systems of moral principles that
    provide a code of conduct.
  • The beliefs, standards, and values that are
    adhered to by an individual, a group, or a
    society, and which reflect a system of moral
    principles.

5
Ethics are …
  • What ought to be in a world of what is.
  • Not static they change and evolve in response to
    the changes in individuals and their societies.

6
Myths about Ethics
  • One must have ethical perfection to raise ethical
    issues
  • Everyone knows when theyve made mistakes

7
Law Versus Ethics
  • Law
  • Reflects the minimum standards that society will
    tolerate
  • Ethics
  • Represents the ideal standards set by
    professionals
  • The basic purpose is to further the welfare of
    the client

8
Law Versus Ethics
  • WHAT HAPPENS WHEN ETHICS AND THE LAW ARE IN
    CONFLICT?????
  • EXAMPLE OF SOMETHING UNETHICAL AND LEGAL
  • EXAMPLE OF SOMETHING ETHICAL AND ILLEGAL

9
What is a Code of Conduct?
  • A formal statement of the values and business
    practices of an agency/corporation.
  • A code may be a short mission statement, or it
    may be a sophisticated document that requires
    compliance with specific standards and a
    complicated enforcement mechanism.

10
Code of Ethics?
  • Does your Agency have a Code of Ethics??????
  • What are some examples of groups of
    people/organizations that have Codes of Ethics?
  • Why have a Code of Ethics?

11
Self-Inventory Boundary Exercise
  • On a piece of paper, write down 1-10 and the
    word by each
  • statement which is most accurate for you. (None,
    Little, Average,
  • Much, Always)
  • 1. How much are you threatened by others whose
    moral views are different than yours? (None,
    Little, Average, Much, Always)
  • 2. How much are you threatened by others whose
    political views are different from yours? (None,
    Little, Average, Much, Always)
  • 3. How much are you threatened by others whose
    religious views are different from yours? (None,
    Little, Average, Much, Always)
  • 4. How much do you allow others to determine your
    values for you?
  • 5. How much do you allow others to set your
    priorities for you? (None, Little, Average, Much,
    Always)

12
Self-Inventory Boundary Exercise
  • 6. How often do you tell things about yourself to
    the wrong people? (None, Little, Average, Much,
    Always)
  • 7. How much are you thrown off base by people who
    say and do inappropriate things around you?
    (None, Little, Average, Much, Always)
  • 8. How much do you throw up a wall to protect
    yourself from others abuses? (None, Little,
    Average, Much, Always)
  • 9. How often do you store up feelings until they
    explode and then feel you must apologize for the
    way you expressed them? (None, Little, Average,
    Much, Always)
  • 10. How much do you allow yourself to become lost
    in the other persons with whom you choose to
    connect? (None, Little, Average, Much, Always)

13
Self-Inventory Boundary Exercise
  • An answer of none indicates a strong healthy
  • boundary.
  • An answer of always indicates a
  • weak, unhealthy boundary or no
  • boundary at all.
  • Based on your answers,would you say that you
  • have boundaries that are mostly excellent, good,
  • fair, poor, or non-existent?

14
Boundaries Quiz
  • Choose the correct answer
  • A. The word boundary, as used today refers to
  • 1. Physical and sexual limits
  • 2. Emotional and spiritual limits
  • 3. Relational limits
  • 4. All of the above
  • B. The phrase boundary violation indicates
  • 1. That ones limits have been breached
  • 2. That one has expanded his or her frontiers
  • 3. A minor infringement of ones defenses
  • 4. A problem only to the victim of the
    violation.

15
Boundaries Quiz
  • Choose the correct answer
  • C. A boundary violation causes
  • 1. No particular consequence
  • 2. An emotional shock wave
  • 3. No harm to a really strong relationship
  • D. Boundaries are
  • 1. Usually flexible
  • 2. Usually rigid
  • 3. Impossible to change
  • 4. Different for different people

16
Boundaries Quiz
  • Mark the incidents that are boundary violations
  • 1. Grandpa takes little Jim fishing.
  • 2. Esther tells Betty a secret Mary told her.
  • 3. You are a counselor and invite a client to go
    for coffee
  • 4. Your boss wants to know information about your
    personal life
  • 5. Your boss cries on your shoulder about his/her
    problem.
  • 6. Your counselor accepts an invitation from you
    to go to coffee
  • 7. Your boss asks if youd like a hug
  • 8. Your colleague makes a comment about your
    weight

17
Healthy Versus Unhealthy Boundaries
  • What characteristics indicate to you that a
    person may have healthy boundaries? Examples?
  • What characteristics indicate to you that a
    person may have unhealthy boundaries? Examples?

18
Professional Boundaries
  • The line that separates where I end and where the
    client begins
  • Emotional and physical space that gives our
    clients room to focus on their own development
    and not on us
  • Limits that control the professionals power so
    that clients arent hurt

19
Professional Boundaries
  • Dictate our interactions with clients
  • Fluid limits that change depending on the
    clients vulnerability and our role
  • Parameters that keep the professional as
    objective as possible
  • Put a limit on professionals power so clients
    arent hurt

20
Signs of Unhealthy Boundaries
  • Telling all
  • Not noticing when someone invades your boundaries
  • Touching a person without asking
  • Taking as much as you can get for the sake of
    getting
  • Letting others direct your life

21
Issues Related to Boundaries
  • Gift giving
  • Touching/hugging
  • Confidentiality
  • Self-disclosure
  • Power differential
  • Boundaries between colleagues

22
Boundary Scenario
  • A client of your agency comes with a request to
    borrow money. She goes into details of why she
    needs the money and when you would be repaid.
    Would you always, sometimes, or never lend a
    client money?
  • Rationale

23
Boundary Scenario
  • One of your clients is interested in earning
    some extra money and has offered to wash your
    car. Would you always, sometimes, or never ask a
    client to wash your car? Rationale

24
Boundary Transgressions
  • Physical Boundary Transgressions
  • Emotional Boundary Transgressions
  • Psychological Boundary Transgressions
  • Sexual Boundary Transgressions

25
Physical Boundary Transgressions
  • A client comes into your office and picks up
    papers on your desk.
  • You are meeting with a co-worker and a colleague
    opens the closed door, sits down, and begins
    talking about a crisis.
  • Your supervisor hugs you without your permission
    after a negative performance review.

26
Emotional Boundary Transgressions
  • A client shares memories of sexual abuse with
    members of the support staff in a crowded program
    office.
  • A staff member shares the gruesome details of his
    divorce during a staff meeting.
  • A staff member acts as therapist for a supervisor.

27
Psychological Boundary Transgressions
  • A white client calls a black client a racist
    name.
  • Your supervisor answers the phone three times
    during a meeting that you requested.
  • A staff member shames a co-worker by indirect
    criticism, ridicule, or sarcasm, such as, Your
    clients sure have a lot of problems. Whats that
    say about you?

28
Sexual Boundary Transgressions
  • A client winks at you seductively during class.
  • A staff member tells off-color stories or makes
    references to sex that make you very
    uncomfortable.
  • A supervisor wants to know details about your
    students sex lives. Each time you try to
    discuss other relevant information, your
    supervisor steers the topic back to sex.

29
Gift Giving Accept or Decline?
  • Your agency policy states that it is okay for
    employees to accept homemade gifts from clients.
    A client gives you an ornately carved cradle that
    sells for 800 each. Would you always,
    sometimes, or never accept a gift like this from
    a client?
  • Rationale

30
Boundary Scenario
  • A client asks you for a ride to an appointment
    since you are driving in a similar direction.
    Would you always, sometimes, or never give a
    client a ride in your car?
  • Rationale

31
Boundary Scenario
  • A former client owns an auto repair shop and
    offers to fix your car for the same cost as any
    other shop would charge, but the client will
    take good care of your car. Would you always,
    sometimes, or never take your car to this auto
    repair shop?
  • Rationale

32
Boundary Scenario
  • An interpreter scheduled for a meeting in your
    agency is sick and you have no coverage. Would
    you (or a colleague) always, sometimes, or never
    offer to interpret for the meeting?
  • Rationale

33
Dual Relationships A National Study
  • 4,800 psychologists, psychiatrists and social
    workers
  • were surveyed (return rate of 49) to examine
    attitudes and
  • practices regarding dual relationships, social
    involvements,
  • financial involvements and incidental
    involvements.
  • 800 male and 800 female clinicians were
    randomly selected from the membership directory
    for American Psychological Association,
    American Psychiatric Association and the National
    Association of Social Workers
  • Survey forms sent out and 1,108 individuals
    returned surveys that could be used.

34
Dual Relationships A National Study
35
Dual Relationships A National Study
36
Dual Relationships A National Study
37
Self Reported rates of Boundary-Related Behaviors
  • Description
  • Telling a client you are angry with him or her
  • Using self-disclosure
  • Hugging a client
  • Accepting a clients gift worth at least 50
  • Accepting a gift worth less than 5 from a client
  • Accepting favors (e.g. a ride home) from clients
  • Lending money to a client
  • Inviting clients to a party or social event
  • Reported Rate
  • 42.5 responded sometimes to very often
  • 69.4 responded sometimes to very often
  • 41.7 responded from sometimes to very often
  • 19.1 responded rarely
  • 58.1 responded from sometimes to very often
  • 35.7 responded rarely
  • 23.9 responded rarely
  • 15.4 responded rarely or sometimes

38
Self Reported rates of Boundary-Related Behaviors
  • Description
  • Disclosed details of current personal stresses to
    a client
  • Went out to eat with a client after a session
  • Accepted a clients invitation to a special
    occasion
  • Reported Rate
  • 38.9 did this with a few other clients
  • 11.6 did this with a few other clients
  • 35.1 did this with a few other clients

39
  • What does Power Differential mean?

40
Exploitation of Relationship Power Differential
  • Exploitation occurs when the professional uses
    the power of his/her position for personal gain
    from the client in some way
  • Although the counseling relationship will
    end, the power differential remains
    indefinitely and affects any
    future non-therapeutic relationships

41
POWER DIFFERENTIAL
  • 1. The ideal - The professional is close enough
    to be emotionally involved. Clients feel
    protected and supported in their vulnerability.
    Te professional is also distant enough to allow
    clients the autonomy they need to heal.
  • 2. Shrinking the boundary space - If we are
    uncomfortable with our power, we may reposition
    ourselves a buddies or peers. We come in too
    close. Clients may feel confused, angry, or
    unsafe they know that we have more power, though
    we are acting as if we dont.
  • 3. Expanding the boundary space - If weve been
    too close, we might react by moving too far away.
    We forget clients vulnerability and abandon
    them. We remove ourselves from the complex
    emotional relationship and thus act outside it.
    We may begin to think of clients as walking
    diagnoses objects to be acted upon. Clients
    may feel alone, unheard, confused, unsafe.

42
  • POWER DIFFERENTIAL SCENARIO THE APPOINTMENT

43
POWER DIFFERENTIAL
  • 1. How is The appointment similar to or
    different from what your clients experience?
  • 2. Will your clients speak up directly if they
    dont like something you say or do?
  • 3. Will your clients directly refuse to follow a
    recommendation?
  • 4. What are examples of ways you have power over
    your clients?

44
Dual Relationships in the Workplace

45
Dual Relationships
  • …when professionals assume two roles
    simultaneously or sequentially with a person
    seeking help (Herlihy Corey)
  • May occur beginning, during, or after a
    counseling relationship
  • Not always problematic or unethical
  • Greatest potential for harm may result from the
    power held, or perceived as being held, by the
    counselor or other professional

46
What Makes Dual Relationships Problematic?
  • They can be difficult to recognize
  • They can be very harmful, but they are not always
    harmful
  • They are the subject of conflicting views
  • They are not always avoidable

47
Maintaining Neutrality
  • Avoid dual relationships that could impair
  • the professionals judgement or objectivity
  • in the manner of treatment of the case.

48
Sexual Relationships
  • Most professional associations agree that
    concurrent sexual and professional relationships
    are unethical (sexual relationships comprise 20
    of complaints and other kinds dual relationship
    complaints 7.)
  • Even after termination, some professionals
    believe once a client, always a client

49
Ethical Issues regarding Dual Relationships
  • 1. Most ethical codes draw strong distinctions
    between sexual and nonsexual dual relationships.
  • Although the codes considered here prohibit the
    counselor from having a sexual relationship with
    a current client, variation occurs in the
    prohibition of such a relationship with former
    clients and the length of time that must pass for
    such a relationship to be permissible.
  • 2. Other relationships cited in the ethical
    standards include those of friendship, business
    association and supervision.
  • These interactions also lie on a time line
    encompassing outside relationships that existed
    before counseling, those that develop during
  • the course of counseling and those that arise
    following termination.
  • 3. One variable in determining the ethical
    ramifications of a potential dual relationship is
    its avoid ability.

50
Ethical Guidelines regarding Dual Relationships
  • Former Clients
  • Sexual dual relationships with clients are among
    the most serious of all ethical violations
  • Some codes say that counselors should not engage
    in sexual relationships with former clients
    within a minimum of two years after ending the
    counseling relationship (per some licenses, two
    years recommended in other situations, some feel
    it is never appropriate) .
  • THOUGHTS??????

51
Ethical Guidelines Regarding Dual Relationships
  • 1. Counselors make every effort to avoid dual
    relationships with clients that could impact
    professional judgement or increase the risk of
    harm to clients.
  • 2. When a dual relationship cannot be avoided,
    counselors should take appropriate professional
    precautions such as informed consent,
    consultation, supervision and documentation to
    ensure that judgement is not impaired and no
    exploitation occurs.

52
Recovering Counselor
  • Self disclosure of personal recovery, should be
    used judiciously.

53
Social Relationships Role Conflicts
  • The roles of friend and counselor are not
    compatible
  • A counselors objectivity is compromised when the
    client is also a friend
  • Clients may hesitate to reveal sensitive issues
    for fear that the counselor/friend will lose
    respect for them

54
Social Relationships Role Conflicts for Deaf
Counselors
  • Clients may be former schoolmates of the
    counselor, and this can lead to conflicts in
    role.
  • How the Deaf professionals social relationships
    are perceived by others is a potential problem
    area
  • The social relationships that partners of Deaf
    counselors have can cause a conflict with the
    counselors professional relationships.

55
Social Relationships Role Conflicts for Hearing
Counselors
  • In order to gain respect and credibility, the
    hearing person must be visible in the Deaf
    community
  • Some professionals prefer not to socialize within
    the Deaf community due to confidentiality and
    trust issues.
  • Professionals may feel an obligation to interpret
    when no interpreter is available and the need is
    crucial.

56
Social Relationships Role Conflicts for Deaf
Hearing Counselors
  • It can be awkward for a professional who attends
    a friends party and finds clients there
  • Consumers who discuss confidential issues at a
    social gathering are encouraged to save it for
    the office
  • Some professionals indicate that they would
    accept an invitation from former clients for
    events such as weddings, graduations, etc.

57
Survey Results Dual Relationships
  • An obligation to interpret for consumers or Deaf
    friends when no interpreter available
  • A struggle to clearly define their role and
    limitations
  • Attempts at respecting the Deaf community may be
    misinterpreted as being aloof, or trying to meet
    their own financial or professional needs

58
Survey Results Dual Relationships
  • Jobs have multiple roles and difficult to define
    or clarify positions such as administrator,
    counselor, interpreter, friend, colleague
  • Difficulties if seen at a social gathering when
    working in certain kinds of confidential
    positions
  • Dilemmas related to determining when socializing
    within the Deaf community is appropriate in case
    they run into clients.

59
Unavoidable Relationships
  • In rural areas, professionals may play several
    roles and may find it more difficult to maintain
    clear boundaries than professionals who practice
    in more suburban or urban areas.

60
Unavoidable Relationships
  • Professionals who are asked to provide
    individual services to clients with close
    associations,(for example, husband and wife
    close friends or enemies) will likely feel role
    conflicts.

61
Unavoidable Relationships
  • There are situations in which refusing to
    provide counseling to individuals with whom one
    has another relationship, would prevent people in
    need from receiving assistance.

62
Unavoidable Relationships Internet, E-mail
Instant Messaging
  • Set clear and consistent boundaries re internet
    communication, anticipating how it could be
    abused.
  • What are you agency policies around E-mail
    and confidentiality issues?

63
Private Therapists E-mail Policies
  • If you have already read my email policies (see
    below) and consent to the use of email as a form
    of communication, please click here.  If you are
    uncomfortable with email as a form of
    communication, please contact my office directly
    at _________.
  • Thank you

64
E-mail Informed Consent
  • I understand that by initiating email
    correspondence and/or providing you with my email
    address, I am agreeing to use email as an
    acceptable form of communication for confidential
    information.

65
Exploitation of Relationships Bartering
  • Bartering is not generally encouraged
  • It may be a standard practice in certain cultures
    and communities
  • It can lead to conflicts when the services being
    exchanged are not viewed by one of the parties as
    being equitable

66
Potential Role Conflicts Interpreting
  • May be difficult to explain why the professional
    would not interpret for them
  • May be a struggle to define their role and
    limitations for those involved

67
Jobs with Multiple Roles
  • May be difficult at times to clarify the various
    roles (i.e. positions such as administrator,
    counselor, interpreter, friend/colleague
  • Deaf counselors who have other positions in
    the Deaf Community (e.g. NAD, AAAD) may feel
    conflicted when clients join.

68
Dual relationships Among Co-workers
  • There are many kinds of relationships at any
    worksite. Overlapping roles with co-workers
    make boundary setting even harder.
  • It can be difficult to approach a co-worker
    with a boundary concern. This becomes even more
    difficult when layers of relationships exist
    among the staff.
  • We benefit by making dual relationships
    explicit.

69
Dual relationships Among Co-workers
  • We can decide if such relationships energize or
    deplete the staff by positively or negatively
    affecting the team and thus clients.
  • Example You and a colleague play on a softball
    team after work.
  • 1. How would this relationship be viewed by the
    rest of the staff?
  • 2. Would your colleagues know about the
    boundary youve set? Will they trust that the
    boundary is upheld?
  • 3. Even if the dual relationship is explicit,
    would colleagues feel that the relationship is
    affecting work?
  • 4. Can colleagues raise their concerns?
  • ARE THERE ANY EXAMPLES OF DUAL
    RELATIONSHIPS THAT OCCUR IN YOUR OFFICE?

70
Dual relationships Among Co-workers
  • In order to keep a system focused on client
    care, we need to monitor and maintain our
    boundaries with co-workers.
  • When youre angry or upset with a colleague or
    distrust a co-worker, where is your energy going?
  • The amount of energy we expend in self
    protection, anger, and disagreements with
    co-workers takes away from what we can give to
    our clients immediately and in the long term.
  • Caring for ourselves is important so we can care
    for others. When we take care of ourselves, we
    can better take care of clients.

71
Confidentiality
  • Is information obtained about clients, outside of
    the agency still confidential?
  • When questions are asked about clients without
    releases signed, it is important to be clear
    about roles, so that silence is not
    misinterpreted.

72
Measuring Potential for Harm
  • The greater the incompatibility of expectations
    in a dual role, the greater the risk of harm
  • The responsibilities associated with dual roles
    diverge, the potential for divided loyalties and
    loss of objectivity increases
  • Clients by virtue of their need for help, are in
    a dependent, less powerful, and more vulnerable
    position

73
Safeguards to Minimize Risks
  • Set healthy boundaries from the onset
  • Involve the client in setting the boundaries of
    the professional relationship
  • Informed consent needs to occur at the beginning
    and throughout the relationship
  • Discussion and clarification needs to be an
    ongoing process

74
Safeguards to Minimize Risks (continued)
  • Consultation with other professionals can be
    useful in getting an objective perspective and
    identifying unanticipated difficulties
  • Practitioners should work under supervision
  • Documentation is an important ethical precaution

75
Dual Relationship Considerations
  • Recognize the complexity of therapeutic
    relationships
  • Attend to self-care
  • Engage in peer consultation
  • Engage in ongoing self-evaluation
  • Acknowledge potential for multiple relationships
    and possible harm to clients
  • Use sound clinical judgment

76
Dual Relationship Scenario
  • Youre a program supervisor and develop a close
    friendship with one of the program staff. Its
    obvious to everyone in the office that youre
    friends. However, after a somewhat negative
    performance review, one of your other staff
    members complains that you dont treat everyone
    fairly. What would you do?
  • Rationale

77
Dual Relationship Scenario
  • You and Keisha, a deaf woman, have been close
    friends for a long time. Keisha has recently
    moved and will become a client in your office.
    You are the only counselor in the office who
    knows sign language. Would you always,
    sometimes, or never agree to work with this
    client?
  • Rationale

78
Dual Relationship Scenario
  • You are a VR counselor, and a client with whom
    youre working is newly in recovery from alcohol
    and other drug problems. You see this client is
    sometimes struggling with recovery, and often is
    not able to get much support. You consider
    sharing with the client that you are in recovery
    yourself.
  • Rationale

79
Dual Relationship Scenario
  • Your community has a very limited number of
    interpreters, most of whom are children of deaf
    adults. Several of the interpreters who are
    available to work in your program are siblings or
    cousins. Is this a problem? Would you always,
    sometimes, or never agree to hire family members?

80
Ethical Dilemma
  • You are a rehabilitation counselor in a small
    town and, while at a social function, you see a
    client with whom you have been unsuccessful
    contacting for an appointment. You take the
    client into another room, and proceed to discuss
    her vocational plans.
  • What do you see as the ethical issue(s)?
  • How would you handle this situation?

81
Competent Professionals
  • Competent professionals have the
  • knowledge, skills, and abilities necessary to
    perform the tasks relevant to that
  • profession as well as
  • understanding when
  • it is appropriate to
  • provide services or to
  • refer a student.

82
Competence
  • Level of skill
  • Objectivity
  • Recognition of existing problems
  • Asking for assistance
  • Referrals
  • Peer consultation
  • Ongoing professional development

83
Personal Conduct Self Care Skills
  • Are you working regular overtime?
  • Are your personal relationships fifty-fifty
    That is, do you get as much from these
    relationships as you give?
  • Do you take all of your vacation days?
  • Do you have friends who are not related to your
    work?
  • Do you have friends who are not in the helping
    fields?

84
Personal Conduct Self Care Skills
  • Do you play as hard as you work?
  • Do you really leave work at work? Are you having
    fun in your life?
  • Who are your mentors? What characteristics of
    theirs do you admire?
  • How do you keep your work and life separate?

85
Making Ethical Decisions
  • 1. Review your code of ethics and legal mandates.
  • 2. Seek input from a second party.
  • 3. Determine the values (motives) involved.
  • 4. Evaluate the long-term effects of your choices
    on the individual.

86
Steps in Making Ethical Decisions
  • 1. Identify the Problem
  • Gather information in a comprehensive
  • manner
  • No clear right or wrong..one has to deal with
    ambiguity
  • 2. Identify potential issues that might be
    involved
  • Collect critical issues and discard
    irrelevant ones

87
Steps in Making Ethical Decisions
  • 3. Review relevant ethical guidelines
  • Do the guidelines, standards or principles of
    your organization or profession offer a possible
    solution?
  • Consider whether your own values and ethics
    are considered or in conflict with relevant
    guidelines
  • If in conflict, do you have a rationale

88
Steps in Making Ethical Decisions
  • 4. Obtain Consultation
  • Objectivity can be difficult when on your own
  • Consulting can help you think about possible
    ramifications that might otherwise be overlooked
  • Allows for feedback regarding your
    justifications

89
Steps in Making Ethical Decisions
  • 5. Consider possible and probably
    courses of action
  • Brainstorming can be useful
  • Enumerate the consequences of various
    decisions
  • Ponder the implications (pros and cons)
  • 6. Decide best course of action
  • Avoid second guessing

90
Considering Ethical Principles (Kitchener)
  • Respect autonomy
  • Do no harm
  • Benefit others
  • Be just
  • Be faithful
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