To get some clarity on how social workers should go about managing ethical dilemmas, I spoke with Allan Barsky. You might remember Allan from Episodes 76, when I we discussed Social Workers in the Court. You might also recognize him from his ethics column in The New Social Worker online or you might have even heard him talk about Ethical Issues in End of Life Care in that other social work podcast from the University of Buffalo, The inSocialWork Podcast. (It's a fabulous podcast, so I would recommend that you check it out). Finally, you might know Allan from his books, Clinicians in Court or the book that we are going to be talking about today, Ethics and Values in Social Work.
Clearly, Allan is kind of ubiquitous when it comes to ethics, so I figured he's a good person to talk to. In today's interview, we discussed Allan's relational 6-stage model of managing ethical issues. We also talked about dual relationships, role-played an ethical situation, and analyzed the role play. We ended our conversation with a discussion of additional ethics resources for social workers.
If you want to find additional references and resources, as well as a transcript of my conversation with Allan, please go to the Social Work Podcast website at socialworkpodcast.com. If you want to join the conversation about clinicians in court, go to our Facebook page at Facebook.com/swpodcast. If you’re on Twitter, you can follow the podcast at twitter.com/socworkpodcast. And now, without further ado, on to Episode 78 of the Social Work Podcast: Social Work Ethics: Interview with Allan Barsky.
Bio
Allan Barsky, JD, MSW, PhD is Professor of Social Work at Florida Atlantic University in Boca Raton and Chair of the NASW National Ethics Committee. He has a background in social work, law, and mediation. His book authorships include "Conflict Resolution for the Helping Professions" (Brooks/Cole), "Ethics and Values in Social Work" (Oxford University Press), and "Clinicians in Court" (Guilford Press). Dr. Barsky is a Florida State Accredited Family Mediator and has published articles in the Journal of Social Work Values and Ethics, Family Court Review, and Conflict Resolution Quarterly.TRANSCRIPT
Introduction
Jonathan Singer: Hey there podcast listeners, Jonathan here. Today's episode is on social work values and ethics. You can be in your first day of your undergrad social work class or you can have practiced for 40 years in the profession and you know and that we've got these ethical values and principles that are at the core of our service to people (NASW, 1996/2008). In fact, service is one of those core values. Social justice is another one. Dignity and worth of the person, importance of human relationships, integrity and the – what's the sixth one?... Competence. Right. Classic. So I forgot that one. But competence is the last core value.
You know, I just gave a workshop on ethics and technology and I started the workshop by saying: "Don't have sex with, do drugs with or steal from your clients. That's it. Thanks a lot for coming. Goodbye." It was intended to be humorous, right, to kind of loosen up the crowd to say, “This is not going to be boring ethics,” but it was also intended to say "Look, those aren't actually ethical dilemmas. This is wrong. You shouldn't do them." And the thing that trips up most social workers is when it's not clear. What is the right thing to do? I don't know. It's an ethical dilemma.
So, in order to get some clarity on how social workers should go about resolving these ethical dilemmas, I spoke with Allan Barsky. You might remember Allan from a couple of episodes [76] ago when I talked with him about Social Workers in the Court or you might recognize him from his ethics column in The New Social Worker online or you might have even heard him talk about Ethical Issues in End of Life Care in that other social work podcast from the University of Buffalo, The inSocialWork Podcast. It's a fabulous podcast. If you don't know it, check it out. Or you might know him from his books, Clinicians in Court or the book that we are going to be talking about today, Ethics and Values in Social Work.
Clearly, Allan is kind of ubiquitous when it comes to ethics, so I figured he's a good person to talk to. So, we started our conversation today talking about his model for resolving ethical dilemmas. He defined, gave some examples about what an ethical dilemma is and we talked about dual relationships and we talked about the difference between boundary crossings and boundary violations. Allan identified and described the six stages of his ethical decision making model and he clarified and emphasized that his model, rather than being simply this rational problem solving model, was a relational approach to resolving ethical dilemmas. And then it got fun.
About 13 minutes into our discussion, Allan kindly agrees to do a role play with me so that I can get a better sense of how this thing works in practice, and so that you can hear how Allan uses his model to resolve an ethical dilemma. And I picked kind of a juicy ethical dilemma. I think you'll appreciate it. So then he dissects what we just did in the role play and we talked about the role of power in ethical dilemmas in the provider-client as well as the supervisor-staff relationship. We ended our conversation with Allan providing some resources for social workers who want to know more. And so without further ado onto episode 78 of the Social Work Podcast, Social Work Ethics: Interview with Allan Barsky.
Interview
Jonathan Singer: All right. Allan thanks so much for being here and talking with us today on the Social Work Podcast about ethics and my first question for you is, what is an ethical dilemma?Allan Barsky: An ethical dilemma is a situation where there's some sort of tension. It could be that there are two ethical standards or rules, and they conflict. Or it might have a conflict between our values and our clients' values or our obligations to the agency versus the obligations to the client or perhaps even to our own religious or cultural beliefs. So some sort of tension, where there isn't a perfect answer that satisfies all of our obligations and all of our ethical and legal directives.
Jonathan Singer: And so it's a dilemma because there's no clear answer?
Allan Barsky: Right. There are a lot of ethical issues that aren't clearly dilemmas. If you look at, “What am I supposed to do if a client is actively suicidal or threatens to hurt their children,” and there's pretty clear directives on what to do and it may be difficult to do those. But in a true dilemma, you're right, there isn't a clear single answer that satisfies all of the different ethical and legal imperatives.
Jonathan Singer: So, I know that students oftentimes say well, “I can't come up with an ethical dilemma.” Do you have an example?
Allan Barsky: Some of the classic ethical dilemmas are the things that are really the hot button issues in the public. So, there are issues like end-of-life decision making. If somebody is in end of life stage, they have a right to terminate their life or some people would say commit suicide. There's real tension between peoples' religious beliefs, professional beliefs, and what would a social worker do if they were either pro-life or pro-choice on that sort of issue, or on an issue like abortion. So, those are the ones that are easiest for people to understand.
Jonathan Singer: Social workers occasionally get dinged, right for violating the code of ethics and so what are the ethical issues that most often come up?
Allan Barsky: I serve actually as the chair of the National Association National Ethics Committee and one of the main issues that come up is boundary issues, people who take on dual roles. They are the social worker for the client and they do something like lend them money or offer them help outside of their professional role, some people getting romantically involved, so things that you wouldn't think are not ethical dilemmas. We have clear boundaries about what we should do or shouldn't do as social workers, but there's still a number of people who do get involved in inappropriate relationships or cross boundaries that they shouldn't.
Jonathan Singer: It's one of these things where well maybe there's a therapeutic value to it or maybe there's some sort of benefit to the client that's above and beyond what I can provide as a professional and so, is that what you mean whether that would be the dilemma?
Allan Barsky: So, those wouldn't be the classic definitions of dilemma because there's probably something that you can do that would be a solution that really satisfies the client's needs and interests and fulfills your ethical obligation. I was street outreach worker in Toronto and we had exactly the type of situation that you're talking about. As I'm working with street youth, they might need a hot meal. They might need a place to stay that night. They might need clothes and we actually literally gave some of our clients our clothes, but there's a way to do that in a way that's appropriate, ethically and maintains your boundaries.
So, for instance, I have a client who needs to go for a job interview and doesn't have nice clothes to wear and we really don't have time to go shopping or go to some place where he can get the clothes. So, I talked to my supervisor and we say hey, I've got my gym clothes I can change into, I mean, I can literally give the client the clothes off my back, is it okay if we do this? And so, I am entering a bit of a dual relationship. I'm lending clothes at the same time that this is my social work client, but I've got the consent of my agency.
They're not telling me that I'm breaching any boundaries and you know, I've got a client who understands that this isn't a normal part of my function. So, I've crossed the boundary. I haven't necessarily breached the boundary. Now, some agencies may say that is totally inappropriate and so it does depend on the context including cultural context and context of the agency.
Jonathan Singer: What the difference between crossing a boundary and breaching a boundary?
Allan Barsky: There's no definition in our code of ethics or in the legal system on what's crossing a boundary. When we say that we're breaching a boundary, we're crossing the line that would be against the code of ethics, so crossing a boundary would be acting in a way that's outside the usual course of action, outside the usual professional role of a social worker, but not necessarily in a high-risk situation. So, if we breach a boundary, we are acting in a way that is not in the usual course of what a social worker does, but it's also putting the client at risk so perhaps because they're vulnerable.
We don't date our clients not because we don't care about them, but because they're in a vulnerable situation and if you start to get romantically involved in a client, they may suffer from it. They are not ready emotionally to get into that sort of relationship and they may get really confused about what sort of help a social worker is providing.
Jonathan Singer: Yes. And I would imagine one would get romantically involved with a client because you actually do care a lot about the client.
Allan Barsky: And that's actually what I've seen in some of the cases that have come up - and not necessarily even romantically involved - but people who do things for their clients because they really care for them. They're doing it out of the goodness of their heart and they think that, “You know, if I offer my client a ride in a snowstorm, that's a good thing.” You know the client is getting a safe ride and maybe 99.9% of the time, it’s not a problem.
But what happens if you're in an accident and the client gets severely injured. Who is responsible? What's the agency's responsibility and liability? This is going to come back to haunt you. Whenever there's a boundary crossing, if it turns into a violation, you as the social worker have to be ready to say, “Hey, I'm going to accept accountability for this.”
Jonathan Singer: So, you mentioned that when you were a social worker working with a homeless youth that talking with a supervisor about what was going on would be a way in which it wouldn't necessarily be unethical to provide clothing or something and that's speaks to your model, right which is sort of a relational model. Could you talk about your approach to addressing ethical dilemmas?
Allan Barsky: Sure. A lot of times what happens with ethical issues is we have an ethical decision making model, and that's really a cognitive process. “How do we think through the issues of an ethical dilemma and deconstruct them and figure out what's the best response?” In social work, we're a practice profession, so there has to be consideration of the relationship. The approach that I use is one that has six steps and several steps really look at how do we deal with it in terms of relationships and conversations with people.
A lot of times, if you would only talk through the issues with your clients – when you have an ethical conflict with them – you can come up with a solution that satisfies both of you. If you're sitting in your office and try to figure out, “What's the best thing in this situation? Do I need to report my client or not?” You might decide, “Hey, I need to report my client.” You haven't really investigated all of the other options with the clients themselves, so the first stage of the model that I use is similar to other ethical decision making models is identifying what the issue is. And so if you've got an ethical dilemma, you need to look at, “What really is in conflict: Is it our ethical code of ethics or is this our agency policies or does it have to do with client expectations versus our religious beliefs?” So, what's the nature of the conflict? And different people might look at the same time fact situation and pull out different ethical issues. It’s really important that we look at what exactly are we trying to solve.
The second stage is what you were talking about in terms of reaching out for help. Step two is, “Hey, who do I talk to about this in order to get clarification, get support, get some legal advice, or get some ethical advice?” We could talk to supervisors, agency administrators, legal advice, ethical advisors, or ethical committees, and sometimes we can even talk to the clients because they may have some information if we need to have more of an idea of what their cultural values and beliefs are. We might actually get it from the clients themselves.
The next stage of the process is that critical thinking: How do we look at the ethical issues from the perspective of what are our obligations? What are the options that are available? Doing some self-reflection to see, “What are my values and beliefs and how do they affect the way that I think about it?” Then also doing some perspective taking, looking at it from the perspective of the agency, of the community, of the social work profession and whoever else might be involved. Then we might look at if we have to make a choice between different perspectives, “Which of those perspectives really helps us most with this particular scenario?”
Once we have an idea of what the options are and the directions that we might go, or the factors that have to be part of the consideration, the fourth stage is the conflict resolution stage. So, we have to look at how do we have conversations and with whom. Now, a lot of times we will think, “Well, if it's an ethical dilemma then we need to have a debate,” but a debate has a winner and loser. My preference is to look at well, how do we have a conversations, how do we have dialogues, how do we do conflict resolution in a way that looks at people's underlying interest and try to come up with consensus. We know that there are lots of conflict resolution approaches out there, and conflict resolution theory, so why not bring that in and make use of that with the ethical dilemma that we're working with?
The fifth stage of the model is once we've got a resolution, how do we implement it? So, we need to have plans to make sure that whatever we decide, whether it's you and your agency, you and the client, or you and the community, how are we going to make sure that it's going to have as much chance as possible of succeeding? So, we want to be able to monitor it. We want to decide who's responsible for doing what. How does it actually get implemented?
And then the sixth and final stage is the evaluation and follow up. So, what happens after you've implemented it? How do we make sure that our ethical goals were achieved? If they weren't achieved, what could we have done differently and from a macro perspective? What do we need to do differently within our agency, within agency policies or laws or community approaches to dealing with the issue? A lot of things come up again and again and again, so why keep facing the same ethical issues and dilemmas over and over and over again when we might be able to do something that's corrective.
Jonathan Singer: So, it sounds a lot like problem solving in the sense that you identify the problem, you come up with some solutions, you evaluate – you implement them, you evaluate them. Am I hearing that correctly? Is there a piece that is different that I'm missing?
Allan Barsky: Absolutely. It's for problem solving, but it's also problem solving not by you alone but you with people around you who may include the clients and others. We don't just take responsibility, “Hey, I know the ethical code and I know and I'm the professional so I'm the one to make decisions.” We empower our clients and we empower everyone that we're working with to resolve those issues together. It might even be more solution-focused rather than problem solving, because a lot of times when ethical issues come up we look at all the bad things that can happen. We should also look - just like from the social work strengths perspective - what are the possibilities? This is an opportunity for something wonderful. A lot of crises are actually opportunities for something positive.
Jonathan Singer: So, can you recap the – can you summarize those six stages again?
Allan Barsky: Absolutely. Stage 1: Identify what is the ethical issue or dilemma. Number 2: What are the sources of help that you can use to help you resolve the dilemma or think about the dilemma? Stage 3: Critical thinking: How do we think about? How do we analyze? How do we try to problem solve around the dilemma? Step 4: Conflict resolution: Once we know “what are the factors that we need to consider and how it might be analyzed and resolved,” how do we work with our clients, our agency and others in order to come up with some sort of consensus approach, if possible? Step 5: How do we implement the decision? Who is responsible for doing what? How do we implement the decision and make sure that everything gets done in the way that's likely to be most successful? And the sixth step is evaluation and follow up.
Jonathan Singer: So, I got to say, you know, if somebody who's listening I would imagine that that would be – it would make sense, but it might be a little abstract. I'm wondering can we do a role play to sort of demonstrate how this would work out in the real world?
Allan Barsky: We're a practice profession, so let's do it.
ROLE PLAY
Jonathan Singer: Okay. All right. How about you are a social worker and I'll be a supervisor and our executive director is having sex with a client? How about that? Will that sound like a juicy ethical dilemma?
Allan Barsky: It's certainly an interesting dilemma and something that's you know within the realm of possibility.
Jonathan Singer: Yeah, yeah absolutely, unfortunately. Okay, so let's do it.
Allan Barsky: Jonathan, I needed to talk to you about our executive director, Don. Something has come to my attention and it's sort of a sensitive issue. I'm really concerned about clients, but I'm also concerned if I raise this issue, you know, what's going to happen to me, what's going to happen to my job?
Jonathan Singer: Sure, absolutely. I'm glad that you came to me. I mean usually we talk about billing. What's going on? What's on your mind?
Allan Barsky: Well, I'm a little bit reluctant to bring this up because I don't know what the options are, how you'll react and what we can do to make sure that this is safe for you and for me. Basically I'm concerned that Don has been having sex with one of my clients and I know that from my client that she's felt pressured into it. I don't think it's what someone would say, you know, as a sexual assault situation. She did consent, but really it's just not appropriate and I think that we have to do something about this.
Jonathan Singer: Okay. This is – wow, this is not – I was not expecting this.
Allan Barsky: And I was floored as well. I had never heard anything like that before.
Jonathan Singer: Because Don has got a great reputation. I mean, you know, I know it's a huge agency and we've got – I don't know, probably 500 employees and like we serve 10,000 clients. I've never once heard anybody say anything bad about him. Are you sure that this is going on?
Allan Barsky: You know I'm getting this second hand from the person who is saying that this had occurred, but I've been working with her for a long time. I don't see that she would have any reason to make up information, so she does come across as being honest about it and I don't think we can just say we're going to drop it and do nothing. She said that she was concerned about it. She wanted me to deal with it and so that's why I thought, you know, let's bring it to your attention. Because if we just bring it straight to the executive director, you know, I'm not sure how he'll react.
Jonathan Singer: Well, I'm very glad you didn't go straight to Don. I think – wow, so wait has it – does anybody else know about this because this could be, this could be devastating? I mean this could be huge for the agency if it turns out to be not true. I don't even want to think about them.
Allan Barsky: Whether it's true or not true, it can have an impact on the agency. So I don't know that my client has told anybody else. I certainly haven't told anybody else, but you know if one of the things that you don't want me to talk about is talking with her about how to bring this up without going directly to the news, then you know certainly that's a possibility. We have to look at what's the important thing here, so today is our discussion really about keeping this quiet or what's really the issue we need to deal with it?
Jonathan Singer: Yeah, no. I mean obviously our consumer, our clients' needs come first. So, I guess I'm just concerned about liability. I'm concerned about what might happen to your job and my job. Of course, I mean I'm also concerned about Don because I think he's done a great job in general, and I'm talking about this, is it – I mean, is it even clear that he knows that this woman is a client of the agency? He doesn't do direct service, right? The woman is your client, not his client.
Allan Barsky: They met here in the agency, so he would know that she is a client.
Jonathan Singer: Okay. All right.
Allan Barsky: I think though you picked up on a couple of things, so you know we need to be concerned about this particular client's safety and emotional well-being. We have to be concerned about the agency itself and its reputation, the ability to be trusted by clients, and also by our funding sources. And we also have to be concerned that Don gets a fair hearing in this as well, that we're not just making accusations and putting his reputation on the line. So, I think there's a number of different things that we need to be concerned about there. Are there any other factors that we need to consider?
Jonathan Singer: You know I mean, I'm always – I hate to say it but sort of you know as management I'm always thinking about the agency and I'm wondering if we should get our legal counsel involved in this.
Allan Barsky: Okay, so one possibility for additional help is to bring in a legal counsel. Is it possible for us to consult with legal counsel without Don knowing or is it that as soon as we talk to legal counsel he's going to know what's going on and that's going to affect things?
Jonathan Singer: That's a good question. Well, I could talk to my supervisor, the associate director. His wife is a lawyer. I wonder if we could talk to her.
Allan Barsky: Okay. So, it is possible for us to look at attorneys outside of the agency, but maybe aside from the legal aspect of it we can just sort of think through, you know, what are our goals and what are some of the options. We do have an agency policy that says that we're not allowed to have personal relationships or sexual relationships with clients. I think that applies to Don as well as to frontline staff
Jonathan Singer: Yeah. Well, I mean and he is a social worker by training so.
Allan Barsky: Okay. So, it's part of his code of ethics as well.
Jonathan Singer: Code of ethics, yeah.
Allan Barsky: Okay. But at the same time you don't want to do something that ruins somebody's reputation and we also want to make sure that the client is on board with whatever we do, so maybe what we can look at is, you know, what are the different processes for bringing this issue forward. You know, is it a matter of we go up the chain of command and you talk to the associate director and he could bring it up higher.
You know, do we go to the board of directors because they're the ones who are responsible at that higher level or is there some sort of grievance process that we have or should have within the agency where these matters can brought up? Or can we offer something that's more private situation like mediation or some sort of process where they can be kept quiet? It doesn't have to go to the public and maybe not even have to go to the board of directors.
Jonathan Singer: I think part of me wants to do it quietly with mediation and you know I got to be honest, I'm still reeling from this news. This is a lot to take in, but you know we do have the client's – the, you know, consumer complaint department and I think that would – I don't know if this is ever – I can call the officer. I can call that officer and just sort of hypothetically say is this something that you guys would typically deal with?
Allan Barsky: So, we don't really have to disclose which social worker, which client is involved and at least get some consultation on what are the options available for bringing this up and is there something where we can bring it up where, you know, the client is safe and we can also give the director a fair opportunity to respond as well.
Jonathan Singer: Yeah. I think that would be the best way to go about doing this. Yeah.
Allan Barsky: Okay. So, it sounds like the next step is for you to talk to them about what the process is, how it would get initiated and in a hypothetical situation what might be some of the challenges and what might be some of the opportunities as well.
Jonathan Singer: Mm-hmm. Now, so you said you haven't talked to anybody else about this, right.
Allan Barsky: Nobody within the agency.
Jonathan Singer: Okay.
Allan Barsky: Just the client.
Jonathan Singer: Okay. All right. I want you to make sure you don't say anything to anybody until I get back to you on this. Okay?
Allan Barsky: Yeah. If we can, you know, work this out, if you're able to get me some information the next day or two, I don't think the client is pushing that quickly, but doesn't want to – a resolution soon.
Jonathan Singer: No. I'll call as soon as we finish this meeting because this is important. Well, I appreciate you coming to me with this and get retrospect. I do wish it had been a billing issue. Those are really boring, but at least I understand Medicaid so – and I'll get back to you on this.
Allan Barsky: Okay. Thank you. Thanks for following up, too.
END ROLE PLAY
Jonathan Singer: And… Scene! Okay [laughs]. So, let's pretend that this is like, you know, Sports Center or whatever. Let's rewind the videotape. What just happened here? Talk us through this.
Allan Barsky: One of the things that sometimes happens is there are power issues in relationships. Things can be uncomfortable, so when I'm playing the social worker and I'm looking at well, “How do you bring up an issue against the executive director?” that person has the power to hire, fire and you know, assign you to things that you like or don't like within the agency. It's a part of it is a power issue as much as anything else… and I'm not really certain how my own supervisor is going to respond.
Hopefully, I've got a good relationship and can trust. We talked about whom do you reach out to for help. You want to reach out to people who are knowledgeable and have decision-making authority, but also people that you can trust. If I didn't trust you, I probably wouldn't have come to you first. But that is a good way to approach most dilemmas within the agency… is to go up within the hierarchy.
Jonathan Singer: And so within your decision making model, if your client had come to you and said, you know, “Don and I are having sex and it's – I feel really uncomfortable about it.” And you had said, “All right, just keep this to yourself.” Like if you had not even identified that as an issue then that would have been a problem in and of itself, but you did, right and isn't that the first step that–
Allan Barsky: Yeah. If we can't recognize that there's an ethical issue, we're not going to deal with it. We're going to ignore it. It could exacerbate or it could spin out of control. Sometimes it could disappear, but, more likely, things get worse. So, yes, you have to be able to identify that there's an issue, articulate it for yourself… and then here I had to start to articulate it, although I did it sort of jointly between the supervisor and myself.
Jonathan Singer: Oh, by the way, did we do this sequentially? Like I guess that's one of the other things, so you had all those – you had the – there's a stage model like you do these things and you have to do this other thing and did our conversation follow that model?
Allan Barsky: When you look at the model, it doesn't have to be done exactly sequentially. So to an extent we didn't do it sequentially because I reached out for help and it was only when the two of us talk together that we actually articulated what the ethical issue was. In my mind, I sort of knew what it was but it was really only through talking with you that we sort of figured out okay, well these are really the conflicts. These are really the interests that are competing. And I think that's natural. Sometimes individually you're not quite sure what the issue is. You know there is something and to really put your hands on it, it's helpful to have a conversation with someone else.
Jonathan Singer: Okay. So, one would not have to go step by step in order to, you know, resolve an ethical dilemma.
Allan Barsky: Absolutely. There could be some situations where you look at just one step in the process and it sort of comes clear and so why go through all of the other steps. It might get to looking at, “What are the different options?” I might be able to brainstorm some options and they look really good and there's one that just sort of emerges as the best one, and I don't even need to consult with my supervisor or anybody else. I might not even need to do conflict resolution. I just need to figure out okay, “How am I going to implement it and track how it's being implemented?”
Now usually we do suggest that social workers don't suffer alone. If you've got an ethical issue and it's a tough one, reach out and consult with other people. It's also a part of our risk management process. If you ever get held responsible for harm that's done to your clients or to people in the community, they look at “Did you do what a reasonable professional would do?” Social work believes and uses supervision, so if you didn't contact the supervisor, people would wonder did you really fulfill your duty of care in resolving the ethical issue.
Jonathan Singer: Right. There's that the “reasonable person” standard.
Allan Barsky: Right. And in this case, the reasonable person is the reasonable social worker with your background.
Jonathan Singer: Right. Okay. So, I guess something else that I noticed about this role-play was that even though I was the supervisor, in a lot of ways you were really kind of managing the conversation. You weren't saying, you know, "I think there's a problem, tell me what to do."
Allan Barsky: Right. We tried to make it look like it was a conversation, a dialogue, so each of us had input into it and it maybe that the person who is lower on the hierarchy in terms of job descriptions might be the one who can really take the lead in thinking through and initiating the discussion. But if I'm not valuing and showing you that I value the expertise and input that you have, I'm going to lose you in the process. So, you do want to take a look at what the power and the relationships are between people who are having these conversations.
Now, it could have been that you could have been completely adamant that we're not going to do this. It's just too risky, you know, this client hasn't been harmed. She's not threatening to sue. We're just going to bury it. And so then there might be a conflict because I would say, “You know what, I don't think that I can live with that. I've got a client who has been inappropriately treated and it may not be just her, it might be others.” And you might be very protective and you might have good reason to be.
Maybe the agency is struggling and if we lose any more funders, then the agency could go under. So, you might have a pragmatic concern. It may not be, “What I think is the most ethical,” but “How am I going to deal with that when my own supervisor is not supportive of me?” So, I'm trying to reach out and be collaborative with you and you we're collaborative back with me. So, we didn't have a huge conflict there, but we could have… and I'd still have to figure out how do I deal with that.
Jonathan Singer: Well, that was one of the things that I noticed about your affect, your presentation was that clearly I was anxious and I kind of did want to bury it, but you were pretty... I mean–
Allan Barsky: Assertive.
Jonathan Singer: Yeah. You were assertive and you were open to my experience, you know, so even though I'm the supervisor, you were like "wow, you know, yeah, you know, I can see how that – you'd want to do that and I'm wondering if there's anything else that we could do kind of thing," so because you knew – I guess my bottom line, my basic point, is that it was helpful that you had a framework, right for addressing this dilemma because I didn't.
I wasn't thinking about resolving the dilemma. I was thinking about, you know, covering my own ass and maybe protecting your job and protecting Don, but also the client – so I was really – I was a little bit thrown, so it was good that you thought about this and we're able to do this.
Allan Barsky: And I think what you picked up on is, if I would just tell you what I think is right, you might have said no to it. But I can facilitate instead. We can do collaborative problem solving by asking questions. A lot of people don't think you're assertive by asking questions, but that really is a way to not just be assertive, but also to be collaborative. We're thinking through this together and so I think we're less likely to knock heads.
Jonathan Singer: And I could see as a supervisor asking questions, not just Socratic questioning, but just sort of really thoughtful curiosity. It could be a great way of addressing ethical dilemmas or really anything.
Allan Barsky: And I actually would say, including Socratic method. If we teach our supervisors, “If you want to empower people to make their own decisions and to be able to learn critical thinking, you could model that Socratic inquiry.” And so it becomes really a learning conversation. We're not there to debate each other, but to just think about things from different perspectives. If I hadn't thought of it from the police perspective or I hadn't thought about it from the client's perspective or the funding perspective, you could ask me about those things. It just brings issues to light and it's not really a threatening way. You're not telling me, “Hey, you're wrong.” You're just saying, “Hey, let's think about it in different ways and then let's decide what's right.”
Jonathan Singer: So Allan, first of all, thank you for talking with us about ethical decision making, about your collaborative model, for doing the role play. You have a book, right through Oxford, Ethics and Values in Social Work and you have other resources, could you talk about those briefly?
Allan Barsky: Sure. You know, there's a number of great scholars, Rick Reamer, Kim Strom-Gottfried, Elaine Congress. Also for resources, just look to the NASW website. They've got “Legal Issue of the Month.” They've got “Law Notes.” They analyze a lot of the legal and ethical issues that we have and there's so many things that are coming up. There are always issues and new technologies, reproduction technologies, use of Internet, social networking media, even use of cellphones. So, it's good to keep abreast of what's the latest and the greatest information and support in those types of areas.
There's also an association called The Association of Practical and Professional Ethics. They're interdisciplinary so that's usually a nice way for social workers to learn to think about things from different perspectives. And many communities have universities that have bio-ethics committees and organizations. You might even just look to your own communities and see what bio-ethics organizations are in the universities or hospitals.
Jonathan Singer: I encourage folks to go out and get your book because it goes into much more detail about all of this. So, thanks a lot.
Allan Barsky: Thank you... my pleasure.
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References and Resources
- Anderson, S. K., & Handelsman, M. M. (2009). Ethics for psychotherapists and counselors: A proactive approach. New York: Wiley.
- Association for Advancement of Social Work with Groups (2006). Standards for social work practice with groups. Retrieved http://www.aaswg.org/standards-social-work-practice-with-groups
- Barsky, A. E. (2009). Ethics and Values in Social Work: An Integrated Approach for a Comprehensive Curriculum. New York: Oxford University Press.
- Barsky, A. E. (2012). Clinicians in court: A guide to subpoenas, depositions, testifying, and everything else you need to know. New York: Guilford Publications.
- Csikai, E. L., & Chaitin, E. (2006). Ethics in end-of-life decisions in social work practice. Chicago: Lyceum.
- Dolgoff, R., Harrington, D., & Loewenberg, F. M. (2012). Ethical decisions for social work practice (9th ed.). Belmont, CA: Brooks/Cole. (www.cengage.com)
- Gushwa, M., & Chance, T. (2008). Ethical dilemmas for mental health practitioners: Navigating mandated child maltreatment reporting decisions. Families in Society, 89(1), 78–83.
- Gutheil, T. G., & Brodsky, A. (2008). Preventing boundary violations in clinical practice. New York: Guilford Press.
- McIlwain, J. (2012). Consent: Practical principles for clinicians. Oak Park, IL: Bentham Science. doi: 10.2174/9781608050932100ii
- National Association of Social Workers (NASW) (2008). Code of Ethics. Washington, DC: Author. Available Online: http://www.naswdc.org.
- Reamer, F. G. (2006). Social work values and ethics (3rd ed.). New York: Columbia University Press.
- Reamer, F. G. (2009). The social work ethics casebook: Cases and commentary. Washington, DC: CSWE Press. (Chapter 1 available at http://www.socialworkers.org/nasw/memberlink/2009/supportfiles/ethicsCasebookCh1.pdf).
- Scales, T. L., & Wolfer, T. A. (2006). Decision cases for generalist social work practice: Thinking like a social worker. Belmont, CA: Brooks/Cole.
- Strom-Gottfried, K. (2008). The ethics of practice with minors: High stakes, hard choices. Chicago: Lyceum.
- Strom-Gottfried, K. (2007). Straight talk about professional ethics. Chicago: Lyceum.
Ethics Websites
- American Society for Bioethics and Humanities: http://www.asbh.org
- Association for Practical and Professional Ethics: http://www.indiana.edu/~appe
- Association for Specialists in Group Work (Group Work Standards): http://www.asgw.org
- Foundations of Critical Thinking: http://www.criticalthinking.org
- Journal of Social Work Values and Ethics: http://www.socialworker.com/jswve
i liked Basky's model for dealing with ethical dilemas. The role play was not so great. He was obviously a skilled personality and you should havew switched roles. But otherwise good. Thanks. SArah J
ReplyDeleteI currently study social work in a class of predominantly women. I don’t aim to stereotype but I believe that women have a more nurturing nature/mothering role. Often the subject of physical contact with a child arises in seminars. Some women believe it is acceptable to have physical contact with a child to fulfil its physical and emotional needs. I believe this creates an ethical dilemma. I find it pertinent when you mention the difference between boundary crossings and violations. Our codes of practice in Scotland include “don’t form inappropriate personal relationships” (SSSC, 2009).
ReplyDeleteIt could be difficult to identify when a boundary has been crossed, or differentiate between comforting a child and fulfilling a parental role. Whether it is for the child’s or more wrongly for personal needs. You mention dual relationships; the difficulty here is a young person, especially those with learning difficulties, may not understand the difference between a caring, yet, professional relationship and an intimate one.
I think some teachers, social workers, police and others who abuse their positions really ought to know better and act better. But cheers to the good ones. They are worth their weight in gold.
ReplyDeleteIt is inate really. Women generally are ipso fact and by nature the better @ nurture.
ReplyDelete