
MEET HUMAN NEED IN HIS NAME WITHOUT
DISCRIMINATION
› And whatsoever ye do, do it heartily, as to
the Lord, and not unto men; Knowing that of
the Lord ye shall receive the reward of the
inheritance: for.
 COLOSSIANS 3:23-24
 And
it was He who gave some to be
apostles, some to be prophets, some
to be evangelists, and some to be
pastors and teachers, 12 to
equip the saints for works of
ministry, to build up the body of Christ,
 EPHESIANS 4:11-12
REVIEW BASIC ETHICAL PRINCIPLES
 CONTEMPORARY ISSUES
 PROFESSIONAL BOUNDARIES

Responsibility to the public
 Confidentiality
 Professional Competence and integrity
 Responsibility to research participants
 Education and licensure
 Informed consent
 Prohibition of boundary violations
 Duty to Warn/Protect


CLINICAL PRAGMATISM
› Values of the dominant social system

HUMANISTIC ETHICS
› Based on human needs

SITUATIONAL ETHICS
› Uniqueness of the situational

RELIGIOUS ETHICS
› Based in religious believes
 Lowenberg and Dolgoff
Autonomy
 Beneficence
 Non-maleficence
 Justice
 Fidelity
 Obedience
 Conscientious Refusal
 Gratitude
 Competence

Stewardship
 Honesty
 Loyalty
 Diligence
 Discretion
 Self-improvement
 Restitution
 Self-interest

DIGNITY
 SELF-DETERMINIATION
 HOPE
 STRENGTHS PERSPECTIVE

 FAITH IN ACTION SECOND EDITION
The Salvation Army Policy and Guidelines
on Confidentiality
 The Salvation Army Policy on Conflicts of
Interest
 The Salvation Army Policy on Social
Media


CORE BELIEFS LEAD US ON OUR
JOURNEY:
› Core beliefs: Effect how we view the world
› Determine our personal and professional
›
›
›
›
philosophies and choices
Determine personal biases and values
Are chosen feely from alternatives after
consequences are considered
Action is taken on beliefs through a pattern of
consistency and repetition
Effect our view of how people change
Determined by our beliefs
 A result of our self perception
 Outward indication of values
 Dictated by background, experiences,
education and personal growth
 Learned
 Examples of how behaviors are
determined by beliefs?

Values Determine:
 Our choice of profession
 Why we chose our profession
 Our choice of therapeutic modalities
 Populations with whom we choose to
work
 Our interactions with clients
 Our interactions with other professionals
 How we handle therapeutic power






Cultural competence is an ethical
obligation among all disciplines
Falls under discrimination when persons are
not treated equally and fairly
Most disciplines have requirements for
cultural competence
Example: NASW has developed “Standards
for Cultural Competence in Social Work
Practice”
Chapter 10 of Tip 47 Addresses Cultural
Competence in Intensive Outpatient
Substance Abuse Treatment





How others interpret their environment
(cultural filters)
How others see the world and function in it
How culture shapes personal and group
values and attitudes
Perceptions about what works, what
doesn’t work, what’s helpful, what’s not ,
what makes sense, what doesn’t make
sense
All of this impacts the therapeutic
environment and relationship
Examine your own biases
 Be sensitive to, acknowledge and
confront differences directly
 Ask questions when you don’t
understand
 Be aware of power differential due to
diversity issues
 Seek feedback from colleagues of
different race, age, etc.

FRAME OF REFERENCE
 WHERE AND IF OUTSIDE HELP IS SOUGHT
 PEOPLE DIFFER IN:

› How they experience pain
› How they label symptoms
› How they communicate the symptoms
› Beliefs about the cause
› Attitudes about therapy
› What to expect of treatment

These are the core values of Cultural
Proficiency:
› Culture is a predominant force: you cannot NOT
›
›
›
›
be influenced by culture
People are served in varying degrees by the
dominant culture
People have individual and group identities that
they want to have acknowledged
Cultures are not homogeneous, there is diversity
within groups.
The unique needs of every culture must be
respected

Provides the standards for individual
behavior and organizational practices
› Name the differences: Assess Culture
› Claim the differences: Value Diversity
› Reframe the differences: Mange the
Dynamics of Differences
› Train about differences: Adapt to Diversity
› Change for differences: Institutionalize
Cultural Knowledge
Does not hold one as an authority on the
values and beliefs of every culture
 It is:

› Possessing a deep respect for cultural similarities and
differences
› Eagerness to learn
› Willingness to accept that there are many ways of viewing
the world.
› Ability to respond respectfully and effectively to people of
all ethnic backgrounds in a manner that recognizes,
affirms, and values the worth of individuals and families,
preserving the dignity of each.
Lack of awareness of professional faux
pas
 Offensiveness
 Creating misunderstandings
 Harming clients
 Creating hostility toward and from clients
 Loss of Clientele
 Ethical violations
 Loss of professional reputation
 Legal actions

RIGHTS TO SELF DETERMINATION
 CONFIDENTIALITY
 COMMISSION OF ILLEGAL ACTS
 CROSSING BOUNDARIES








1 IDENTIFY THE PROBLEM
2 APPLY THE APPROPRIATE CODE OF ETHICS
3 DETERMINE THE NATURE OF THE DILEMMA
4 GENERATE POTENTIAL COURSE OF ACTION
5 CONSIDER THE POTENTIAL
CONSEQUENCES OF ALL OPTIONS AND
CHOOSE A COURSE OF ACTION
6 EVALUATE THE SELECTED ACTION
7 IMPLEMENT THE COURSE OF ACTION

MR SMITH RECIEVES SERVICES AT CORPS FOOD
PANTRY. IN A RECENT VISIT MR. SMITH UPDATES
HIS HOUSEHOLD INFORMATION AND ADDS A
FEMALE TO HIS HOUSEHOLD AND LIST HER AS HIS
PARTNER/SIGNIFICANT OTHER. MR. SMITH HAS
BEEN ATTENDING CORPS WORSHIP SERVICES
AND IS CONSIDERING BECOMING A SOLDIER
THE CASE MANAGER KNOWS THAT MR. SMITH IS
CONSIDERING BECOMING A SOILDER SO THAT
HE CAN BECOME A OFFICER . THE CASE
MANAGER IS WONDERING IF THE CORPS
OFFICER KNOWS ABOUT MR. SMITH’S NEW LIVE
IN COMPAION AND WHETHER SHE SHOULD
MENTION IT.

MS KATHY LIVES AT THE SHELTER AND HAS
BEEN WORKING HARD TO GET HERSELF OUT
OF THE SHELTER. SHE HAS FOUND A JOB BUT
SHE DOES NOT HAVE TRANSPORTATION SO
SHE WALKS AND TAKES PUBLIC
TRANSPORTATION TO WORK. MS. SMITH
WORKS AS A SHELTER MONITOR AND SHE
GETS OFF WORK AT THE SAME TIME MS
KATHY LEAVES FOR WORK. IT IS STORMING
OUTSIDE AND MS SMITH WANTS TO OFFER
MS KATHY A RIDE TO THE BUS STOP.

CAPT AMERICA IS THE CORPS OFFICER FOR
A CORPS THAT IS CO-LOCATED WITH A
SHELTER. SEVERAL OF THE SHELTER RESIDENTS
HAVE STARTED ATTENDING THE CORPS
WORSHIP SERVICES. SOILDERS IN THE CORPS
SHARED WITH SOME OF THE RESIDENTS THAT
THEY ARE FACEBOOK FRIENDS WITH THE
CORPS OFFICER. TODAY CAPT AMERICA
HAS RECEIVED 3 FACEBOOK FRIEND
REQUEST FROM SHELTER RESIDENTS.

Informed Consent- clients have the right to be
informed of their rights and responsibilities as
they relate to the counseling process. Client
have a right to obtain clear information about
their case records, treatment plans, discharge
summaries and recommendations for
aftercare. Clients have a right to expect
confidentiality. Clients have a right to refuse
recommended services and be informed of
the consequences of their refusal.
Make every effort to respect the dignity
and protect the welfare of each client
 Show respect for each client by
maintaining an objective professional
relationship
 Remain aware of skills and limitations and
not practice outside of scope of expertise
 Provide appropriate arrangements for
continuation of treatment during
interruptions and following termination









Clients are entitled to confidentiality
Professionals should resist the temptation to gossip,
tell war stories and NEVER identify client when using
examples
Clients have the right to be informed of exceptions
Records to be maintained and preserved
Client’s rights to waive confidentiality in writing
Confidentiality is preserved after death of therapist
or client
Least amount of information possible should be
released
All agency personnel are bound by confidentiality
Obligation of professionals to respect the
privacy and the information the client
provides
 Adherence to federal,state and local
lwas regarding confidentiality.
 Informing clients of the limitation of
confidentiality.

Client is a threat to self or to someone else
 Client provides a release of information to
 Client is a minor (younger than 18)
 Clients share the information with a third party in
the room
 Client discloses information to advance criminal or
fraudulent activity
 Child or vulnerable adult abuse or neglect
 If we receive a court order to release the
information
 Within the agency for the purpose of better serving
the client



HIPPA, 42CFR Part 2, State Mental Health Laws
Exceptions to the rule
›
›
›
›
›
›
›
›
›
›
›
Written Consent
Internal communications
No patient identifying information
Medical emergency
Suicidal/Homicidal threat
Court Order
Crime at the program/against program personnel
Research/audit and evaluation
Child/elder abuse
QSOA (Qualified Service Organization Agreement)
Duty to Warn/Protect
Patient specific permission to release
sensitive information
 Health insurance cannot deny payment
if client refuses to release information
covered under the psychotherapy note
provision
 Notes must be kept separate from the
rest of the client record

Where are phone messages left, how do
you collect voice messages?
 Where is the fax – where are you faxing?
 Where is your computer
 How are files deleted, disk discorded
 How secure are your emails
 What level of participation in social
media is acceptable






Ethical values and principles involved
Dignity and Worth of the Person – You want to respect your client’s right
to self-determination.
Importance of Human Relationships – Social media is a ubiquitous part
of modern culture, particularly for younger clients. Your client may feel
personally rejected or slighted by your decision not to “friend” them.
Integrity – Social workers must act in a way that is consistent with agency
policies, even if that creates a bump in the smooth working relationship
you have with a client. Some things to consider are how your client’s
perception of you may be impacted by the things they learn about you
through social media and what your comfort is with them being able to
see your personal information and activities.
Competence – In addition to being a competent social worker, you
need to be a competent user of technology. Handling this ethical
dilemma involves working knowledge of the privacy capabilities and
limitations of both the devices and applications involved.

Dual Relationships Can:
› Impair judgment and objectivity
› Interfere with treatment
Sexual dual relationships always
unethical and always avoidable
 Non sexual dual relationship not always
avoidable
 Non sexual dual relationships not always
unethical

Make every effort to avoid dual
relationships with clients: familial, social,
financial, business , etc
 Take appropriate professional
precautions to ensure that judgment is
not impaired and no exploitation occurs.
 Do not service superiors or subordinates
with whom they have administrative,
supervisory or evaluative relationships
with.





Whether it’s the holidays, a special occasion, or some
other milestone, your client may try to thank you for
your hard work by giving you a gift. These situations
are much more complicated than they seem
because there are cultural, societal, and relationship
factors to consider on top of the bond you and your
client share.
Ethical values and principles involved
Importance of Human Relationships – Rejecting the
gift may taint the rapport you’ve built, perhaps over
several years, or leave the client feeling like you are
personally rejecting her.
Integrity – Part of our job is to serve as role-models by
maintaining healthy and appropriate boundaries in
professional relationships.

Boundary Crossing- any association outside
of a traditional working relationship
› e.g. –touching-socializing, bartering –errand
running, mutual business transactions, gifts,
home visits, attending weddings,
› Boundary Violation- involves harmful exploitive
acts in conflict with preservation of the clients
dignity and the integrity of the helping
relationship
 Sexual and financial relationships
Do not engage in sexual intimacies with
former clients within a minimum of two
years after terminating services
 Do not cultivate and must avoid any
type of personal relationships with former
clients for a period of two years. This
includes Familial, social, financial,
business, etc..

When providing services to two or more
persons who have a relationship (spouse,
parents, children) the primary client must
be identified
 If it becomes apparent that there may
be conflicting roles then you must clarify
your role, adjust and withdraw form the
conflicting roles


If a client is receiving services from
another professional, then you must
obtain a release of information and
inform the professional person so that a
clear agreement to avoid confusion and
conflict for the client.








Inaccurate/fraudulent documentation
Use of position for personal/professional gain
False advertisement
Superior/Subordinate Relationships (Clinical
Supervision)
Unprofessional Conduct
Inter-Professional Relationships
Unlawful Conduct
Violating or Circumventing the credentialing
process
Firsthand knowledge of actions of an
ethical breech should be reported to your
supervisor immediately. If the breach
involves the supervisor then it should be
reported up the chain of command.
 Staff who is credentialed by the state have
a obligation to report suspected incidents
to the state or face disciplinary action if it is
determined they were aware of and did
not report a breach of ethics.
