ETHICS Ethical Care Looks Like……?

1. ETHICS • Ethical Care Looks Like……?

2. Don Streit, LCSW • (501) 416-8334 • Newopportunitiessite.com • don_streit@yahoo.com

3. NASW Code of Ethics • www.socialworkers.org • Careless Use of Facebook Can Jeopardize Your Career Social Networks are Everywhere: Consider the Ramifications- Frances Patterson, PhD, MAC ACA Code of Ethics 2014 SOURCES

4. Act 1170 of 2015 • MSWGuide.org • Ethics Resources: • Ethics Hotline • Ethics Shared Interest Group (formerly COI) • Ethics Education • SWLB Regulations SOURCES

5. Ethics consultation telephone calls are answered on a first come first • served basis and are not pre-scheduled. If you call during consultation • hours and receive a voice-mail response, we request your patience as we • complete earlier member calls, Please leave a brief message clearly stating • your name and contact number and we will return your call. Due to the high • call volume, we ask that you allow 24 hours for a return call. Free Consultation for NASW MEMBERS

6. The American Counseling Association is pleased to help members with inquiries on ethical practice. This service is not designed to function as a real-time hotline; inquiries are prioritized and the ACA standard is to respond within three business days of receipt. • For questions on ethics, contact the ACA Center for Policy, Practice, and Research at (800) 347-6647, ext. 321 or through the online  Ethics Consultation Services

7. Practicing distance therapy, legally and ethically by Tori DeAngelis, March 2012, Vol 43, No 3 • (APA.org) • Is It Ethical to Skype with Patients? Claire Zilber, M.D. Psychiatric News, 2 August 2016 https://doi.org/10.1176/appi.pn.20168a14 • Ethical Resources

8. Be knowledgeable about the laws governing distance counseling and social media. • Only utilize distance counseling after gaining competence through training and supervised experience in this specialty area. • Inform clients about the limits of confidentiality and potential Internet interruptions due to the nature of technology. • Understand the benefits and drawbacks related to distance counseling • Utilize a professional presence if they choose to use social media platforms • Avoid disclosing confidential information through social media. • Utilize informed consent to explain the boundaries of social media. Distance Counseling, Technology, and Social Media (Section H)

9. National Association of Social Workers. (1996, rev. 2008). Code of ethics. Washington, DC: Author. Retrieved June 10, 2012 from http://www.socialworkers.org/pubs/code/default.asp. National Association of Social Workers & Association of Social Work Boards (2005). Standards for technology and social work practice. Washington, DC: NASW. Retrieved June 10, 2012 from http://www.socialworkers.org/practice/standards/NASWTechnologyStandards.pdf ACA Code of Ethics 2014 References

10. As a patient care coordinator, you will assist the care team with setting goals for quality assurance and best practices. Specific duties including assessing and screening patients as well as providing them with education about medical processes and procedures. You provide referrals for continuing care and locate community resources for patients.  With input from patients, families, and the care team, you create outcome goals and an overall care plan. Some patient care coordinators may also assist with locating funding for special procedures or other patient needs. Care CoordinatorLearn.org/articles/Whats_the_Job_Description_of_a_Patient_ Care_Coordinator_

11. Compassionate, respectful, team player, critical thinking skills, resourcefulness, leadership skills, emotional stability Your job requires attention to needs of many moving parts– THIS REQUIRES RECORDS BEING COMPLETE and ready for any provider to pick up the file for a seemless Transition. BRAVO to You!!!!!! Challenges of Care Coordinator

12. It is formal and can be complicated…..but also simple! As formal as an ethical violation…as simple as making eye contact while asking permission to enter a member’s home As simple as listening to a member’s needs before delivering your business with them. • Like a robocall DOES NOT Ethics Sounds so Formal!

13. Values Beliefs, preferences, or assumptions about what we think is good and desirable Ethics reflect our values. What we value….whom we value….how we protect what we value….how we acknowledge and respect what others value. You Couldn’t Steal Them From Me If You Tried

14. What/Whom Do You Value? • Property, relationships, job, keepsakes, meaningful documents, memories, promises, etc. • How do you protect “Valuables”– Objects, property, relationships, information, future opportunities? • “Ethics address what to do with or how to apply those beliefs” (Kirst-Ashman 2007) Ethics Reflect our Values

15. Values- a principle considered worthwhile or important. • “Values determine what beliefs are appropriate.” (Kirst-Ashman 2007) • Ethics are derived from values. Guide people on what is “good” and what is “bad.” • “Ethics address what to do with or how to apply those beliefs” (Kirst-Ashman 2007) • *****Beliefs and Values must be experienced in real life situations or else they are only ink on a page. What good does ink do anyone? DJS Values and Ethics

16. They drive our significant & meaningful choices in relationships and life goals. AND They can create obstacles to impartial, unbiased treatment of others Dual Nature of Values

17. You have been informed that you need to have surgery on your heart. You don’t understand all the “doctor talk” explanation of what the surgeon needs to do to make your heart function correctly, but you DO know you need to have the surgery. How Do You Choose When Your “Heart” is Involved?

18. 1. One has been performing surgery for several year. He has an excellent reputation for successful surgeries, but he has been questioned about the “shortcuts” he uses in surgical procedures. He doesn’t like to be questioned because he is a “pro who’s been doing this for a long time.” • 2. The one who has only been a surgeon for two years. Besides knowing long-time standard procedures, she has also learned new techniques developed in the last couple years. No one is certain about her “success rate” because she is new to the community. Choice of Surgeon

19. **What would you want a client/patient or their family to say about how you provided service to them– outside of your hearing? • How do you provide care in a way that might warrant that kind of comment? Your Own Value as Service Provider

20. Property—Who is allowed within boundaries? • Relationships– Inner and outer circle? • Privacy– Who has the right to know family business? • Keepsakes– What is SACRED? • Communication (Secrets-Sensitive information) • Traditions– Who is family contact person? House rules? • Trustworthy friends– Network– Secret keepers • Identity………Reputation........Self Respect What/Who Are Your Valuables?How do you preserve– protect?

21. Property • Relationships • ++Privacy +++Keepsakes Communication Identity +Who is allowed within my boundaries? Inner and Outer circle +++Who has the right to know my(family business)? What is sacred? Secrets-Sensitive Communication Self-image What Does Respecful Engagement Look Like?

22. If/when you are in need of some service….AS A RECIPIENT….. What do you need? • What do you need to experience from/in the person serving your needs? • How does a provider convey • Interest…..caring….competence…respect? • Safe place….attention to needs? Client Needs-Engagement

23. If/when you are in need of some service….AS A RECIPIENT….. What do you need? • If you were in need of services what words would you like to hear your service provider say to you? Client Needs (our needs) Engagement

26. Professionals should inform clients as soon as feasible and in language that is understandable about the nature of the professional relationship, the nature of the professional intervention, the professional’s delegated authority and the limits of that authority, which decisions the client can make and which decisions the child welfare professional will make. • Professionals should inform clients of the role of the court, if any, and of their legal and procedural rights. • Professionals should keep clients informed about the case plan throughout the entire intervention. Informed Consent

27. Be sure to get clarification about Release of Information documents. Schools???? • “If there are multiple people that you will be dealing with (e.g. a case worker at a facility and a family guardian) then you may need multiple HIPAA Authorization Forms.” • Check with your ____ to specify who has permission to see documents. • If at schools….. Is it administrator, counselor? Just a Reminder

28. Webster’s– a choice between equally unfavorable or disagreeable alternatives • When a worker has to choose between and among conflicting duties and values. Weigh which duty/values tip the scale toward one choice rather than another. (Paraphrase from NASW video) SWA Oxygen DILEMMAS

29. Communication (Sensitive-Secret) • Text to WRONG person • Conversation w/trusted friend • Emails to or about significant people • Protection- Passwords & Codes • Locked access • Electronic Protection, Accuracy of Complete records B.6.b ACA What Does It Look Like?

30. “Clients who have access to social workers’ social networking sites may learn a great deal of personal information about their social worker(such as information about the social worker’s family and relationships, political views, social activities, and religion), which may introduce complex transference and countertransference issues in the professional-client relationship.” (p. 186) REAMER ( 2013 ) RE: FacebookACA Ethical Standards Casebook 2015

31. The following steps allow for best practices in decision-making with technology: 1 Develop clear, written guidelines for electronic communication with clients (social media policy). Include use of texting, cell phones, e-mail, distance treatment, and social media. 2 Maintain accurate documentation of services provided electronically, including client authorization for disclosure and informed consent. 3 Obtain client confirmation of notice of privacy practices. 4 Use security measures such as encryption, firewalls, and pass codes. 5 Get adequate technical and policy supports, including privacy and security procedures, protocols, and technologies. SKYPE is not a secure platform GOODGRID is secure------- with training FACEBOOK is full with potential problems Monday, January 27 PROTECT: Technology Tips for Ethical Decision-Making Considerations Ruth Lipschutz, LCSW, ACSW NASW Chapter Illinois

32. 6 Get adequate clinical, legal, and ethical support (supervision or consultation). 7 Create a reasonable balance between protecting the public and facilitating access to care. - See more at: http://www.naswil.org/news/chapter-news/featured/protect-technology-tips-for-ethical-decision-making-considerations/#sthash.X2GUOa8p.dpuf Monday, January 27 PROTECT: Technology Tips for Ethical Decision-Making Considerations Ruth Lipschutz, LCSW, ACSW NASW Chapter Illinois

33. Care Coordinator Training • “…important for you to develop rapport and trust with the member and their representatives.” “…take things slowly at your first visit, explaining the services you will provide and answering member’s questions about case coordination.” Engagement

34. Permission to engage • Statement/clarification of your role and intention • Ask and listen…..ask and listen….ask and listen • Eye contact • Finding common ground/interest • Dance with your member and member’s family Engagementreflects your respect, interest, capability, dedication…..

35. Rules of Engagement- • How to approach • Enter someone’s turf-privileged boundaries-- • Language & Purpose • No tech talk • Clarify • Listening • Talker-Listener • No Robo-Calls Ethical Principle: Social workers respect the inherent dignity and worth of the person. Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients' socially responsible self-determination. Social workers seek to enhance clients' capacity and opportunity to change and to address their own needs.  What Does Respectful Engagement Look Like?

36. Conflict of Interest(1.06) • Dual Relationships • The mother of one of your clients expresses gratitude for the way you have managed her daughter’s case. She says should would like to discuss this further and to “show my gratitude” by having coffee sometime. • Build rapport??? Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. What Does THIS Standard Look Like?

37. Demographic data regarding an individual’s past, present, or future physical or mental health conditions and payment for the health care provided to the individual. • Information related to the provision of health care to the individual. HIPAA PROTECTED INFORMATION

38. The Purpose of The Health Insurance Portability and Accountability Act of 1999 is to protect individually identifiable health information while increasing the flow of information between health care providers, health plans, and health care clearinghouses. • Pics HIPAA

39. Mrs. Cranley! You need to sign this HIPAA privacy form before the doctor can look at those warts on your stomach. Hospital buzz

40. I didn’t have a dual relationship………… • A dual relationship had me! Dual Relationships

41. Text the Wrong Person? • What were– or COULD BE- the consequences? • It’s just a text, right?

42. Privacy- • Meeting times • Rooms/space • Engagement- eye contact; acknowledge the value of their “turf” 1.07 Privacy and Confidentiality(NASW) Workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client. Workers should take reasonable steps to protect the confidentiality of electronic communications, including information provided to clients or third parties. ACA– B.1.b Counselors respect the privacy of prospective and current clients. Coun- selors request private information from clients only when it is beneficial to the counseling process. What Does Code Standard Look Like?

43. Communication (Sensitive-Secret) • Conversation w/trusted friend • Emails to or about significant people • Protection- Passwords & Codes • Locked access Protection of records B.6.b ACA Confidentiality of records and documentation What Does It Look Like?

44. Conflict of Interest(1.06) • Dual Relationships • The mother of one of your clients expresses gratitude for the way you have managed her daughter’s case. She says should would like to discuss this further and to “show my gratitude” by having coffee sometime. • Build rapport??? Social workers/counselors should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, workers/counselors should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. What Does Code Standard Look Like?

45. Non-discrimination 4.02 • 4.05 Impairment • Protection of Records– Protection through electronic communication • Privacy and Confidentiality • Competence (4.01) (ACA) C.2.a • Sexual intimacy with Clients (1.09) (ACA) A.6.e • Private conduct(4.03) Social W should not permit their private conduct to interfere with their ability to fulfill their professional responsibilities. • Conflict of Interest • Informed consent RANK- Your PrioritiesThe Most(1) to Least(5) Important

46. Impairment-Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. (NASW 4.05) (ACA C.2.g) • Conflict of interest(NASW) 1.06 (a) Social workers should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgment.  • (NASW 1.03) ACA A.2.a Informed Consent • Most basic right: Clients have the right to know what they are getting into. Include counselor’s qualifications, techniques, procedures, limitations, limits of confidentiality, potential risks and benefits of services. PUT THESE IN WRITING. • Counselors must be aware of and avoid imposing their own personally held values on clients. (ACA A.4.b) • RANK 1-5

47. Competence • Counselors should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience. Counselors who use technology in the provision of social work services should ensure that they have the necessary knowledge and skills to provide such services in a competent manner. • Nondiscrimination • Do not condone or engage in discrimination against prospective or current clients, students, employers,..based on age, culture, disability, ethnicity, race, religion/spirituality, gender identity, sexual orientation, language preference, socioeconomic status, immigration status, etc. • Protection of Records—Privacy & Confidentiality • Through electronic communication Counselors should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that counselors will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or others. 

48. Sexual Relationships • Social workers should under no circumstances engage in sexual activities, inappropriate sexual communications through the use of technology or in person, or sexual contact with current clients, whether such contact is consensual or forced. Should not engage in sexual activities or sexual contact with clients' relatives or other individuals with whom clients maintain a close personal relationship that has the potential to be harmful to the client and may make it difficult for the counselor and client to maintain appropriate professional boundaries. • 4.03 Private Conduct • Social workers should not permit their private conduct to interfere with their ability to fulfill their professional responsibilities.

49. Be sure to get clarification about Release of Information documents. Schools???? • “If there are multiple people that you will be dealing with (e.g. a case worker at a facility and a family guardian) then you may need multiple HIPAA Authorization Forms.” • Check with your ____ to specify who has permission to see documents. • If at schools….. Is it administrator, counselor? Just a Reminder

50. You have long been a friend with Merlita who has a large extended family that she sees only once a year for a family reunion. She has introduced you to several of those family members when they have been in town. In fact one family member(Natasha) thinks so highly of you that she asked Merlita to ask you if you would be her counselor now that Natasha is divorced and will move into the Little Rock area to help her adjust to the divorce. • Is it ethical for you to be her counselor? What do you need to consider to make that decision ACA (A.5.d) Friends of Family Members