Wednesday, May 26, 2021

Self-care and Cultural Humility in the 2021 NASW Code of Ethics: Interview with Allan Barsky, MSW Ph.D.

Allan Barsky [Episode 130] Today’s episode is about the 2021 revision of the NASW Code of Ethics to include self-care and cultural humility. To unpack these two new additions, I spoke with Allan Barsky, Professor of Social Work at Florida Atlantic University and former Chair of the National Ethics Committee of the National Association of Social Workers. 

Bio [CV]

Allan Barsky received his Ph.D. from the University of Toronto Faculty of Social Work, his MSW from the Wurzweiler School of Social Work at Yeshiva University, and his Juris Doctor from the University of Toronto Faculty of Law. His teaching and research interests include social work practice theory and skill development, pedagogy, conflict resolution, professional ethics, and substance abuse. His book credits include Ethics and Values in Social Work (Oxford University Press), Clinicians in Court (Guilford Press), Conflict Resolution for the Helping Professions (Oxford University Press), Interprofessional Practice with Diverse Populations (Greenwood), Successful Social Work Education: A Student’s Guide (Cengage), and Alcohol, Other Drugs and Addictions (Cengage). Dr. Barsky was awarded the “Distinguished Teacher of the Year” by CDSI students in 2005 and 2020, the “Researcher of the Year – Scholarly and Creative Works” by FAU in 2007, and FAU Scholar of the Year in 2020. Dr. Barsky chaired the National Association of Social Workers “Code of Ethics Review Committee” (2016-2017) and was awarded NASW’s “Excellence in Ethics Award” (2015).

Download MP3 [33:40]

Transcript

[Transcript generously donated by Grace McLeod, a social worker and keen supporter of the podcast from Sydney, Australia.]

Introduction

Hey there. It’s Jonathan. I know it has been a long time since I published an episode. But it is good to be back. And I hope you like what you hear. Today’s episode is about including self-care and cultural humility in the 2021 revision of the NASW Code of Ethics.

For the first time, NASW added selfcare to the Code of Ethics. Back in 2009 I did an episode that explored the idea that social workers do a much better job of identifying and responding to depressive symptoms in clients than we do with ourselves or our colleagues. (https://socialworkpodcast.blogspot.com/2009/04/social-workers-and-depression-interview.html). Even though the whole episode was about what we as social workers can do to look out for ourselves and our colleagues, neither my guest nor I ever used the word “selfcare.” In fact, it wasn’t until my 2018 episode with Erlene Grise-Owens, Jay Miller, and Mindy Eaves that word “selfcare” appeared in a podcast episode. That’s a problem. When social workers don’t take care of themselves, when social service organizations are not prioritizing the care of their employees, it affects our personal and professional lives. This inevitably affects our services. The Code of Ethics now encourages  “Social work organizations, agencies, and educational institutions to promote organizational policies, practices, and materials to support social workers’ self-care.”

The second addition is that social workers are now expected to engage in culturally competent practice with clients, which includes addressing oppression, racism, discrimination, and inequities, and acknowledge personal privilege. If your client is a trans athlete and you live in a state that passed laws preventing them from participating in sports, you have an ethical obligation to address that discrimination at a micro-level as well as a macro-level. Although the NASW Code of Ethics doesn’t make a connection between these issues and self care, there is a connection. When organizations and institutions disregard the health and wellbeing of staff, when social workers are employed by institutions that systematically discriminate against them, it affects their well-being. Dr. Maxine Davis wrote a piece in Nature about how her experience of race-based discrimination at work affected her wellbeing. She wrote, “Anti-Black racism is not the only reason for worsening health, but it is also responsible for curtailing successful careers and continued underrepresentation of historically excluded groups.”  (https://twitter.com/nresearchnews/status/1361352076786343945).

To unpack these two new additions, I spoke with Allan Barsky, Professor of Social Work at Florida Atlantic University and former Chair of the National Ethics Committee of the National Association of Social Workers. He is the author of Ethics and Values in Social Work (Oxford University Press), Conflict Resolution for the Helping Professions (Oxford University Press), and Clinicians in Court (Guilford Press). He was also chair of the NASW committee responsible for the 2018 revision of the NASW Code of Ethics, which Allan and I covered in a three-episode series. Luckily for you, we were able to cover the 2021 changes in about 30 minutes.

If you like what you hear today and want to learn more about any of the resources mentioned in the episode, check out our website at socialworkpodcast.com. You can follow the podcast on Twitter at @socworkpodcast and Facebook at facebook.com/swpodcast.

And now, without further ado, on to episode 130 of the Social Work Podcast: Self-care and Cultural Humility in the 2021 NASW Code of Ethics: Interview with Allan Barsky, MSW Ph.D.
 

Interview

[05:10] Jonathan Singer: Allan, thank you so much for being back, again, on the Social Work Podcast to talk about the NASW Code of Ethics. It is a real honor and pleasure and I appreciate you coming back.

[05:22] Allan Barsky: Thank you for inviting me. It is a pleasure as well.

[05:24] Jonathan Singer: In your New Social Worker magazine column Ethics alive!, you wrote: "For the first time in the history of the National Association of Social Workers, the Code of Ethics will include specific provisions for selfcare and cultural humility". So, can you talk a little bit about these two provisions?

[05:47] Allan Barsky: Absolutely. The first one is about selfcare, and up until this point we've never actually had the term 'selfcare' mentioned in the Code. There were a couple of provisions about how we would react if we had personal problems – if we were going through a divorce or mental health issues or financial issues – and making sure that they don't have an impact on our clients, and if we're working with a colleague who is having personal problems, then we have responsibilities to talk to them about it, and if they weren't able to address those issues and they were having a negative impact on clients, then we were directed to talk to our agencies, our professional organisations, our licensing bodies, in order to make sure those concerns were being addressed. Unfortunately we were never really proactive about selfcare, and if you look at the various sections of the Code of Ethics, it starts with obligations to our clients, obligations to our employers, obligations to our profession, obligations to our community, but there were never any obligations to ourself. And so for the first time, the NASW Code of Ethics does have a section now on selfcare, and I'm not saying that selfcare is selfish, it's actually something that's important for us to be able to pursue our other ethical responsibilities, including caring for our clients and promoting social justice in the community.

[07:11] Jonathan Singer: I think it's really interesting – and I appreciate you pointing out the historical context – there's been a lot of conversations about clients and others in the profession, but never the self. And I know that Jay Miller and Erlene Grise-Owens wrote a piece saying that selfcare is not selfish. What is the specific language in the 2021 revision around selfcare?

[07:38] Allan Barsky: So the first thing to note is that the language that was added was added to the preliminary sections, the Purpose sections, which don't give us the specific standards or ethical guidelines that are enforceable.  So these are really aspirational statements, statements for education, encouraging us of what to do in terms of good practice, but it's not intended to be something that we can be punished for, like a baseline. It's not saying, you know – like the prohibition against having sexual relationships with clients – that we're going to get punished if we don't do it. So it's really telling us it's a good thing but not necessarily something that's enforceable as a baseline. So, the first part in the ‘Purpose’ section of the Code of Ethics, there's a section (Number 5) that says the Code socializes practitioners to the field (social workers) mission values, ethical principles and ethical standards, what's been added is and encourages all social workers to engage in selfcare, ongoing education and other activities to ensure their commitment to the same core features of the profession. So it's really linking the importance of selfcare to being able to pursue social work's mission, values, and ethical principles.

[08:52] Jonathan Singer: Is there something in the actual principles or standards that specifies selfcare?

[08:57] Allan Barsky: So there is another paragraph in the Purpose section that goes a little bit further, it says that professional selfcare is paramount for competent and ethical social work practice. And so one of the things that we have to distinguish is what's personal selfcare and what's professional, and personally I think there's a lot of overlap between the two; if I'm taking care of myself personally (I'm taking care of my physical needs, I'm eating nutritiously, I'm getting good exercise, I'm getting good sleep), that's going to help me professionally. But also in terms of selfcare, they talk about some of the professional concerns. We have professional demands, challenging workplaces, exposure to trauma experienced by our clients, and we need to be able to use selfcare in that professional capacity as well as our personal capacity. So that could include things like, you know, just being able to say 'no' to work to our administrators and our supervisors if we're being overwhelmed with the clients that we're serving. Or, if during the situation of COVID, we're not feeling like we're being protected in terms of our mental health and our physical health, then we need to be able to advocate for us. The other thing that it actually adds is that social work organisations, agencies, and educational institutions are encouraged to promote organisational policies, practice, and materials to support social workers' selfcare. So here there's a kind of paradox: we call is selfcare, but we can't do selfcare alone. We need to do it with our professional colleagues, our peers, our administrators, our teachers, our agencies, even the funding bodies - they all have to be supportive of our health and wellbeing including our professional wellbeing in order for us to be able to serve our clients, and, frankly, just to take good care of ourselves.

[10:39] Jonathan Singer: Well, one of the things that I love about that is that for all the schools of social work that teach the NASW Code of Ethics, that talk about social workers, social work students practicing the Code of Ethics, abiding by it, there's a piece in there that says 'and now schools of social work, there's a piece in here for you too'. Are you asking students about how they're taking care of themselves? Are you responding when faculty and staff are saying 'this is something that would be helpful for my selfcare', and that is actually consistent with the Code of Ethics, not that there's a specific thing that is delineated in the NASW Code of Ethics, but that the act of acknowledging selfcare and working with your organization is something that is now in there.

[11:33] Allan Barsky:  I think that you've hit it right on the head because it's acknowledging the importance of selfcare. We can't tell any of these organisations that they have to do it, and we're not holding them accountable, but I think a social worker could take this to their agency or a student could take it to their school and say 'hey, your Code of Ethics says that selfcare is important – where is it in our policies? Are we getting appropriate paid leave? Are we getting appropriate supervision? Does the agency or organisation have provisions for an employee assistance program for people who may not have healthcare coverage that covers it?'. So, we're all in this together. And for schools of social work, when COVID hit, we needed to make accommodations for our students, and part of the accommodations were for, you know, students who weren't just taking care of themselves but taking care of children and family and maybe weren't able to perform their required tasks in the usual way, so could we make more accommodations like, serving clients online, or chaining the hours, or changing the way people complete their hours in the field?

[12:40] Jonathan Singer: I think it's interesting that you brought up the pandemic because in the 2018 Code of Ethics revision that you were apart of and that we talked about on previous episodes of the podcast, you know that revision really did drill down into technology, and I can't imagine how much more confusing it would have been during the pandemic if the NASW Code of Ethics still talked about technology is if it were 1996. So, thank goodness that you and your colleagues were able to get through this technology revisions for the 2018 Code of Ethics. I also think it would have been amazing had schools been able to say 'yes, addressing these selfcare needs is also part of our Code of Ethics', and I think a lot of schools did that - I know that Loyola University Chicago, where I am, we certainly did a lot of that`. But it was piecemeal. It was 'we're doing this because it's the right thing to do’, not necessarily because it's part of our Code of Ethics.

[13:42] Allan Barsky:  So, in addition to everything you said I would like to note that technology standards that were developed in 2017 or up until that point were done in collaboration between the NASW, Council on Social Work Education, the Association of Social Work Boards, and the Association for Clinical Social Work. One of the things that that did I think was that it also set up that these organisations were going to work together on future policies. And so some of the policies at the national level with the NASW and CSWE were working together to figure out how to respond to COVID. And some of the resources on their websites were a result of those collaborations, so, yes, it wasn't in the Code of Ethics in terms of selfcare, but it was one of the things that was highlighted by those organisations and it was encouraging to see them post polices and resources on their websites and to continue to work together. And the same thing with the issues around diversity equity and inclusion have been developing in an inter-associational way for a while, and the fact now that they're in the Code of Ethics as well (using new wording) I think is also part of the context of what's going on. So these latest revision certainly do reflect our time, so what's happened during COVID in terms of the trauma that people are experiencing also look at the issues of racism and police brutality, the political polarisation that's been going on in this country, so that's also affected our selfcare and I think that was also a motivating factor for people to say to NASW 'hey, we need something on selfcare in our Code of Ethics, and now is the time'.

 [15:31] Jonathan Singer: I really appreciate you talking about the fact that there is inter-organisational collaboration. You know, obviously, coordination is something that social workers in the field do all the time so it's nice to know that our national organisations are doing that, and it's also nice to know that that narrative exists, that this isn't just a siloed initiative on the part of NASW, that this is part of the larger profession's recognition of selfcare and response to what's been going on for decades, but certainly was highlighted after the Black Lives Matter movement started and certainly with George Floyd's death in 2020. So, since you've already kind of alluded to it, I know that there's this change in our understanding of cultural humility, that's what you talked about in the New Social Worker article, the Standard 1.05 was renamed - it used to be called Cultural Awareness and Diversity and now it's called Cultural Competence, which is different than cultural humility, but can you talk about this switch from Cultural Awareness and Diversity and what's changed?

[16:54] Allan Barsky: So, in the 1996 Code of Ethics it was called Cultural Competence and so it was only called Cultural Awareness for the last few years. And I think there's been a struggle within the profession - you can see it in the literature - about what's the appropriate language that we should be using in terms of how do we engage with people from diverse backgrounds whether it's race, ethnicity, sexual orientation, socioeconomic status, disability, all those different ranges of cultures. So, what's the appropriate terminology? And so I am only speaking for myself, I can't speak for NASW (I was not involved in the choice of language this time), but one of the things that NASW did talk about in the webinar when they introduced the revisions to the 2021 Code of Ethics is they said 'regardless of whether you prefer the term cultural competence, cultural awareness, cultural responsiveness, or cultural humility, there's something in there for everyone to like, and there's. also something in there probably for people to not to like'. And I think what may have been the reason that they chose the term Cultural Competence for the heading is that when we look at the Code of Ethics' setting standards, it's setting standards for behaviours and behaviours are recognised within the term competence. Now, there's been a huge critique about the term cultural competence because it sounds as if you're saying 'I could take a couple of classes, read some books, do a little bit of work, and then I can become fully knowledgeable about what's best to serve a particular client group'. I think what we need to do in order to fit with the new definitions in 1.05 of the  Code of Ethics is to broaden cultural competence to include the notion that we do have to work on developing skills and knowledge. Part of that skills and knowledge and attitudes is a sense of cultural awareness and cultural humility, and humility being the sense that we don't know everything about the clients that we are serving. And so we need some guidance from the people that we are serving ourselves, and we should act from this point of humility rather than this view of, you know, I am the expert in somebody else's life and I know what to do for them. So they've included the language of cultural humility in 1.05 C where it says social workers should demonstrate awareness of cultural humility by engaging in critical self reflection, understanding their own bias, and engaging in self-correction, recognising clients are experts of their own culture, committing to lifelong learning, and holding institutions accountable for advancing cultural humility. So for those people who believe in cultural humility, one of the things that this revision does is that it actually educates social workers and our agencies and the people we serve about what are some of the key components about cultural humility, and this was never included in prior explanations about cultural competence or cultural awareness.

[20:08] Jonathan Singer: I think that it's really interesting, you mention that behaviours are measured through this idea of competence and of course the Council on Social Work Education's educational policies and accreditation standards talk about the competencies that social work students have to meet in order to walk across the stage. I think it's really interesting that there's a directive in 1.05 B about taking action. Can you talk about that section?

[20:47] Allan Barsky: Sure. So people who read this will notice there were a couple of places where there was language like understanding and knowledge and they have added the word 'demonstrate' understanding or 'demonstrate' knowledge so there has to be an action, it's not okay for there to be something about culture in our head, it has to be something that we demonstrate through skills. But I think what you're really talking about here is that last sentence in 1.05 B that says 'social workers must take action against oppression, racism, discrimination, and inequities and acknowledge personal privilege'. So, a couple of things here that are brand new. First of all, this is in the part on our obligations to clients. We already have in Part 6 in the Code of Ethics our obligations to society, and within those obligations to society we already had an obligation to promote social justice and to take stands against oppression and racism and inequities in all of their forms. So it's kind of interesting that they placed this here in obligations to a particular client, but what I can imagine it saying that's different from before is - I'm working with a client and it may be on a mental health issue or it may be a divorce issue, and in the background of it there might be some inequities that they're experiencing. Maybe they've been mistreated by the criminal justice system, the child welfare system, they've got some health inequities, whatever it is we have an obligation to take a stand against that and so I think perhaps what this may be doing is bridging the, sometime the chasm between micro work and macro work, and I'm not sure if that was actually the intention but when I'm teaching my clients that I think I'm going to hold this out as saying, you know, there isn't really a difference between micro, macro, and meso - they're all linked - and guess what? Look at how it's worded in 1.05. The language of the word 'must', that's kind of unusual for the Code of Ethics, usually it says 'should', so 'must' is stronger language and I'm not sure if that was deliberate but it may be part of the movement towards anti-racism. It's not good enough for me to be unbiased, I have to be actually be anti-racist, anti-oppressive, I have to take a stand on these issues and not just be silent and say 'well, I'm not being racist so that's good enough'.

[23:12] Jonathan Singer: You know, it's really saying that ethical social work practice must acknowledge personal privilege, right? It must take action. So people who are taking action, who are acknowledging their personal privilege, who are acting against racism, anybody that says 'well, that's just you, personally', right, that's not 'you being a social worker' now there is actually this space in the Code of Ethics that's like, no this is actually what it means to be an ethical social worker.

[23:44] Allan Barsky: Right. And I think it's saying whether you're working with individuals, families, groups, or doing policy or community organisation, you have those obligations. Cause I think we did have them already under Part 6 of the Code, but I think this strengthens it, and also acknowledgment of personal privilege was never explained before in the Code of Ethics. I'm not sure about the language of personal privilege, I tried to do some research on that. You know, privilege, social privilege - that comes up a lot. Personal privilege in terms of Robert's Rules of Order but I think what they're talking about is privilege in terms of race, ethnicity, gender, etc - so white privilege, heterosexist privilege, cisgender privilege, that we need to be aware of that. And that may be part of biases, the way that we assess or intervene, and we need to take corrective action there, so when you look at the language there in 1.05 C where it says 'critical self reflection', it's acknowledging that we do have biases and we need to figure out how to deal with those and that could be through journaling, work with supervisors, with peer consultation, and just this commitment to lifelong ongoing learning.

[25:03] Jonathan Singer: The last letter in the 1.05, letter E - 'social workers who provide electronic social work services should be aware of cultural and socioeconomic differences among clients' use and access to electronic technology and seek to prevent such potential barriers', I think that 'clients' use and access' is new and also 'seek to prevent such potential barriers' is new. And if I'm correct, that's another one of those places where it's seems like, yes, you might be working indicuaully with someone using telephony or telehealth, but you can't just say 'oh, there's a barrier that's out of my micro practice realm. That's not really something for me to deal with'. In the individual Responsibilities to Clients section it is saying that part of what is ethical practice is seeking to prevent such potential barriers to this use of electronic technology.

[26:07] Allan Barsky: Yeah, so again I think the framers wanted us to be proactive not just in selfcare but proactive in terms of social justice and discrimination issues. So rather than me saying 'we're going to do video conferencing from now on', making sure that people have access to the technology, that people have the training and use of technology, making sure that if there are some points of reluctance to use of technology that we assess where is that coming from, and that maybe there are some cultural differences or socioeconomic differences that we need to attend to.

[26:41] Jonathan Singer: So, in 1.05 C it says 'social workers should demonstrate awareness in cultural humility by engaging in critical self-reflection (understanding their own bias and engaging in self-correction). What is critical self-reflection mean to you?

[27:02] Allan Barsky: When I'm working with people who are different from me in terms of part of their social identity or social affiliation, perhaps from a different sexual orientation, perhaps a person with a disability, I may think I've got some knowledge of that group, I may have even worked with that group in the past. But for each and every client that I'm serving I have to perhaps sit down ahead of time, before I even meet with the client and sit down and maybe write down or go into my mind, what are some of my beliefs and what might some assumptions be that might hold or might not hold in working with a particular group? And it doesn't necessarily mean that I've got strong bias against a particular population, but I might just have a belief that is perhaps skewed in some way. I'm working with a person who's blind and, you know, when I see a person who's blind who's graduated from college I think 'wow, how fantastic they are', and I have to look at that as being, you know what? If I use that word enough, I give a person accolades for doing something which is normal for them, good for them, it's not something that's a reflection of them being some super being because they've got a disability. Perhaps I can modify how I'm going to work with that client, and work with them in a way that's more conducive to their exceptions, their hopes, and what would be supportive of them. There's a lot of a time where I've caught myself in engaging in a micro-aggression with a student. I had a student who was performing some services at an agency and I said 'wow, you were able to do that as a student?!', and when the student reacted I said 'what's going on for you?' and she said to me 'well you're kind of telling me I'm not good enough because I'm just a student as opposed to just validating me for what I'm already doing'. And so sometimes we may think we're doing something positive for a client, the critical self-reflection helps us to check out those assumptions and be aware of them. And so, you know, we can self-correct and sometimes our clients are teaching us but we have to be aware to be aware to hear those messages, to respond, to apologize when appropriate, to take those corrective actions in working with them in the future.

[29:27] Jonathan Singer: I really appreciate you teasing this apart because I can see this being something that a good clinical supervisor – and it doesn't even have to be just clinical work, even though this is in responsibly to client section – says let's work on figuring out what your biases are with these clients. Especially clients that you've worked with for a while. And you mention students, I know that I got feedback from one of my students about how I was not being critical in my self-reflection in class because, she said 'my classmates were expressing opinions about what the LGBTQ community thought and did, and you did not open up any space for those of us who are also in the community who think about things differently and who do things differently, to share that perspective', it was almost like they were right, and that was the only way to see things or do things. And for me, that was a really important moment to, again, you had a student who called you out, or called you in, and this student did the same thing for me about thinking through my own bias and it allowed me to do some self-correction, to make sure I was thinking about, 'am I making this group that is not a monolith, a monolith?' by basically saying 'thank you for sharing with me how you see the world'. So I think that's a really important piece of being self-reflection and critically self-reflective.

[31:21] Allan Barsky: Absolutely. And it fits with the commitment to lifelong learning. You know, we don't have fewer opportunities for critical self-reflection as we get more experienced, we have to continue in the same vein and continue to be open to learning. Also in conjunction with technology, more people are involved in cross-border social work – across state borders, across international borders – and so I think this is going to give even more rise to look at cultural humility and awareness when working with people we're not even physically connected with and we don't even know their communities that they're exisiting in in a day-to-day basis. Or when a humanitarian issue happens in another country, for us to jump to conclusions or use the social media to decide what's going on and what people need in those areas, again, go back to the Code of Ethics, it says 'recognise clients are experts in their own culture', and that includes communities and what their expertise is, what they need. Let's partner with, let's support, let's not tell people what they need.

[32:35] Jonathan Singer: Well, Allan, thank you so much for taking the time to talk with us again about the NASW Code of Ethics, this time about the 2021 revisions that you were not involved with, so I particularly appreciate you talking this through. Of course resources will be available on the Social Work Podcast website, the New Social Worker article you wrote, and I know a webinar through NASW about this. But, again, I really appreciate your insight and your expertise. Thank you so much for being here.

[33:03] Allan Barsky: Fantastic. Thank you also for being an inspiration for social work and for the ethics of our profession.

[outro]

[33:09] Jonathan Singer: I'm Jonathan Singer, and thanks for being with me today for another episode of the Social Work Podcast. If you missed an episode, or have suggestions for future episodes, please visit socialworkpodcast.com. To all the social workers out there: keep up the good work. We'll see you next time at the Social Work Podcast.

Transcription generously donated by Grace McLeod, a social worker and keen supporter of the podcast from Sydney, Australia.  

Resources 

The New Social Worker article that inspired this podcast episode: 

 Self-care resources:

 Cultural competence, awareness, and humility resources:

NASW Code of Ethics 2021 revision 


APA (7th ed) citation for this podcast:

Singer, J. B. (Producer). (2021, May 26). #130 - Self-care and Cultural Humility in the 2021 NASW Code of Ethics: Interview with Allan Barsky, JD, MSW, PhD [Audio Podcast]. Social Work Podcast. Retrieved from https://www.socialworkpodcast.com/2021/05/2021CoE.html

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