Karen M. Nielsen, PhD Athabasca University Edmonton, Alberta
Flying Without a Safety Net
Slide 2
Building a Safety Net: Why? Private practitioners work alone
When there are competing demands, ethical decision making is not
always easy
Slide 3
Ethical Decision Making The process of ethical decision-making
may be influenced by a number of factors such as: internalization
of professional values education experience ethics training
professional identification
Slide 4
Process of Ethical Decision Making 1. Practitioner recognizes
that an ethical dilemma exists 2. Identifying the ethical
components of a situation Identification of ethical dilemmas can be
influenced by personal value preferences or intuitive thinking
rather than on a reflection of ethical principles and code of
ethics The value system of the decision maker shapes and influences
the ethical decision-making process For example, family
re-unification and a belief system that view some actions as beyond
redemption
Slide 5
Process of Ethical Decision Making Resolution Choose course
action Assess priority Identify possible course action/ projected
outcomes Identify principles in code ethics which bear on case
Identify value tensions Identify ethical components Background
information/case details
Slide 6
Family Violence, Ethical Practice and Non-offending Spouses and
Children 3 rd party expectations, demands and pressures. Management
of contracted service agreement while managing the evolving needs
of the direct client. Lack of balance in knowledge Third party may
unclear on role of therapy Disparate feelings of hope Impact of
system demands on case management
Slide 7
Family Violence, Ethical Dilemmas and Non-offending Spouses and
Children Working with systems that may have competing obligations,
mandates and ethical principles Pressure from Legal System
Vulnerable child testifying Pressure from Child Protection Services
to: Use therapy as an investigatory tool Use assessment/therapy to
support family dissolution or to facilitate premature family
reintegration
Slide 8
Ethical Dilemmas and Non-offending Spouses and Children
Pressure from family/non-offending spouse to: Reintegrate due to
financial hardship Social function/status reasoning (keeping
secrets) Belief System:Children need an intact family
Slide 9
Building the Safety Net: Peer Consultation with
Interdisciplinary Team Voluntary collaboration of peers Clients are
aware of process & give informed consent Psychologists
(counseling & forensic), Clinical Social Workers Deliberately
chosen for peer status & diversity of practice area
Slide 10
Process Self-directed: Participants express needs Case
presentations Research presentations Practice strategies Formal
structure Monthly meeting One year commitment Group decision making
re new member
Slide 11
Peer Consultation & Multidisciplinary Responses to Ethical
Dilemmas Maintain professional perspective Develop expanded
perspective on competing needs. Bring diversity of thought and
different ethical decision making models
Slide 12
Peer Consultation as an Ethical Act Focus is maintained on: Who
is the client? Who is working harder/hardest in this case
situation? What are the competing agendas that put my ethical
practice at risk? Where is my involvement in this case going? Whose
needs are best served by my actions with this family.
Slide 13
Meeting Demands for Competency Legislation (Health Professions
Act) demands that professionals have a continuing competency
program. Consultation /clinical supervision is one strategy of
meeting the demands
Slide 14
Evaluation Group Is this helpful? Are members needs being met?
Individual Self Reflection
Slide 15
Group Evaluation Peer Supervision Group Session Rating Scale
(PSGSRS), based on Group Session Rating Scale (Barry L. Duncan and
Scott D. Miller, 2007) Relationship Needs Format Overall
Slide 16
Personal Reflection How aware was I of my personal biases or
preferences? To what extent did my personal values or philosophy
influence choice of action? To what extent did I attempt to keep
these from unduly influencing the outcome. If outside agency
policy/demands conflicted with other obligations to the client,
what was the ethical dilemma; how did I get stuck? If the case
involved a conflict between client self- determination and
paternalism, which value did I judge to be more essential to honor
foremost?
Slide 17
Building a Safety Net: Why? Private practitioners work alone
When there are competing demands ethical decision making is not
always easy
Slide 18
The End
Slide 19
References Abramson, M. (1989). Autonomy vs. paternalistic
beneficence: Practice strategies. Social Casework, 70, 101- 105.
Abramson, M. (1996). Reflections on knowing one-self ethically:
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ethical decision making. Hastings Center Report, 18, 914. Joseph,
M. V. (1985). A model for ethical decision making in clinical
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practice (pp. 207-217). Silver Spring, MD: National Association of
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Peacock. Ethical Decision Making: The Person in the Process.
Mattison, M. (2000). Ethical Decision Making: The Person in the
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