Ethical Issues in Practicum

UW School of Social Work

Field Instructor Training Program

Competency Objectives

• Demonstrate knowledge of the important ethical issues related to field instruction

• Describe areas of potential liability in field education

• Identify strategies for incorporating ethical responsibilities into practice

Ethical Issues Related to Field EducationCSWE Guidelines - Dettlaff

• Field supervision has potential for ethical violations that could result in civil or criminal action;

• Field instructors, as supervisors, are responsible for the actions of their students;

• Field instructors have the responsibility to model ethical practice for their students.

Professional Liability in Field Education-Bogo & Vayda, Dettlaff

• Malpractice: an omission or a commission resulting in harm to a client;

• acting in a negligent manner or failing to perform according to the accepted level of care (Cohen, 1979, Reamer, 1989);

• malpractice complaints in social work are increasing against supervisors as a result of the actions of their supervisees (Reamer, 1995, 1998).

• based on the legal principle of vicarious liability: supervisors can be held liable for the actions of their supervises when these actions result in negligence or harm to a client (Cohen 1979, Reamer 1989).

Professional Liability in Field Ed

• For a supervisor to be held liable for the actions of a supervisee, two conditions must be met:

• The supervisor must have the authority to supervise the supervisee; and

• The supervisee must be acting as a representative of the agency.

Student Examples

• Elicit examples of student risk and ethical challenges at participant’s agencies

• Think about agency tools, processes, and tips for teaching ethical practice, for next exercise

Areas of Potential Liability in Field Education - Dettlaff

• Failure to notify clients of student status

• Incorrect intervention

• Disclosure of confidential information

• Failure to protect a third party from potential harm

• Failure to prevent a suicide

• Failure to refer clients to a specialist when beyond their level of skill

Areas of Potential Liability in Field Education, 2 - Dettlaff

• Failure to refer clients to a specialist when beyond their level of skill

• Professional misconduct• Failure to report child abuse or neglect

This list is not comprehensive. Any ethical violation or lack of care can result in malpractice. Review NASW Code of Ethics with student for agency applications

Code of Ethics contains standards in six categories

- Congress

• Responsibilities to clients

• Responsibilities to colleagues

• Responsibilities to practice settings

• Responsibilities to professionals

• Responsibilities to the social work profession

• Responsibilities to society

Strategies for Addressing Ethics in Field Supervision

• Access Handout 9A

• Write down any techniques you have used to incorporate some of the ethical issues into your supervision of students

• Share in small groups

• Invite feedback and clarification

Minimizing Liability for Field Instructors

• Insure adequate supervision is provided, appropriate to the student’s level of skill and experience;

• Meet regularly with students to review all significant client and project decisions;

• Thoroughly document supervisory meetings and decisions

• Review written documentation completed by your student, insure correctness

Minimizing Liability for Field Instructors, 2

• Continually assess student performance to insure that tasks and assignments are appropriate for student level of skill;

• Arrange for supervisory coverage when you are away and for assistance when you are not available;

• Provide written documentation of agenyc policies and procedures for handling at-risk situations, esp. of potential client harm

Minimizing Liability for Field Instructors, 3

• Thoroughly review agency policies regarding disclosures of confidential information and reporting requirements;

• Insure all clients are informed of student status and provide your name and contact info to clients;

• Regularly discuss with your student potential ethical dilemmas and value conflicts that may arise at the agency

Additional Ethical Applications

• responsibility to teach students about conflicting values in social work ethics,

• ethical dilemmas in supervision,

• ethical challenges for faculty advisors and practicum instructors – conflicting duties and responsibilities to

school, agency, and student, and– regarding dual relationships.

Tools for Ethics Consultations

• Access Handout 9B: Four-Box Method • Review quadrants with case example

– Medical indications– Patient Preferences – Contextual Issues– Quality of Life Issues

• Review Handout 9C: Ethics In Community Organizing– Mezzo and macro ethics applications

Community Practice Ethics Differ-Hardina

• No use of ‘clients’ but ‘constituents’ in partnership;

• Worker may be member of community• Community events are part of networking and

building trust• Actions are for social justice and may involve

confrontational tactics• Requires informed consent re consequences• Weigh values, risk to individuals vs. outcomes

Supervisory Record Keeping

To further minimize liability, field instructors should thoroughly document their supervision of students in practicum, in both client and supervisory records:

Client Records• Documentation by the field instructor for all client

records handled by student;• PIs should approve and sign all significant

contacts in client record;• PIs should note supervisory conferences in

which client’s case was reviewed.

Supervisory Records

Munson (2002) suggests that PI records about student supervision include:

• The supervisory (learning) contract;• Brief statement of supervisee experience,

training, learning needs;• Summary of performance evaluations;• Notation of all supervisory sessions;• Records of cancelled of missed sessions;• Notation of cases/projects discussed; decisions;• Problems encountered in supervision, resolution

or plan for resolution, steps taken with UWSSW.

Social Work Obligations in Decision-Making

Teach students that social workers must be prepared to justify in court:

• the action selected by the process;• procedures followed in selecting the action;• documentation of the systematic steps used in

arriving at the decision, • professional conduct, • use of consultation and supervision, and • practice guidelines.

Gatekeeping: Academic Obligations

• Dismissals: Courts defer to the expert judgment of faculty and institutions to make dismissals based on a student’s failure to meet academic standards, including clinical competency. Judicial intervention requires:

• Deprivation of due process; • invidious discrimination; • denial of federal constitutional or statutory rights;• Or clearly unreasonable, arbitrary or capricious

actions.

Inherent Dilemmas for Supervisors

• Developing competencies towards outcomes, while attending to processes of teaching and learning

• Eliciting personal values and thinking processes of students affecting decision-making while safeguarding clients and agency

• Helping student integrate cultural background and social work values

• Determining which ethical principles and values should be prioritized in practice situations

Areas for Improvement

• Access Handout 9D: Areas for Improvement

• Write down areas you need to consider further in teaching ethics in practicum

• Share in dyad/small group and report learnings to large group

• DISCUSSION

Personal Influences in Ethical Decision-making

- Mattison

• Prior socialization and developmental stages• Situational factors, e.g., organizational or

professional context• Characteristic of the worker’s role• Cultural background and beliefs• Stereotypes and biases about ethical issue• Personal philosophies and attitudes about right

and wrong

Personal Influences, 2

• Individual decision-making styles

• Self-awareness of reasoning processes

• Attention to self-reflection

• Adequacy and use of supervision and consultation

• Tools and processes for ethics deliberations

Bridging Culture and Professionalism - Chung

• Education as a process of acculturation, internalizing social work norms and values

• Challenge for students not from Western mainstream heritage, may feel have to choose between identity and profession

• Cultural differences can be seen as a problem or a strength, adding choices

Supervisory Responses:

Rather than reprimanding, suggest• solution-finding as a joint project; • examples from other disciplines;• sharing own situation turns attention from client;• self-disclosure may show a desire for authority

or client approval;• exploration of identification with client;• student explore life situation and feelings• student provide reasoning for all decisions

Supervisory Reponses, cont’d

Rather than reprimanding, review• role as agency representative, not individual;• principles of empathic listening;• rationale for all unusual contacts or concrete

assistance;• reasonable level of service and functions of

emergency services• dynamics of rescuing, potential harm, power

alterations