Ties we Find: Ethical Social Work in Rural Practice and in Communities within Communities Elaine Spencer MSW, RSW March 2006 ACSW Conference Insider Social Work Insider Social Work: when you are a member of the community you serve. A safe, well-boundaried approach - Insider Practice Codes have generally been written with urban, clinical practice in mind. Insider social work, in the last 20 years, has not been well documented, and has been “underground” to a certain extent. Underground practices can lead to ethics concerns, ethics complaints. Non-sexual multiple relationships (nsmr) are “inevitable” and we must learn to be open and supportive, reflective and proactive to define best practices. Boundaries Give each person a sense of legitimate control in a relationship and set limits that establish a safe connection between practitioner and person seeking service. Boundary violations are distinct from boundary crossings, though often misunderstood. Boundary Crossings Non-sexual dual or multiple relationships (nsmr) are considered boundary crossings Interests of the client(s) is the primary test Harmful, neutral, salutory Few absolutes Contextual (rural/urban, cultural) Dual/Multiple Relationships Professional relationship plus any other relationship(s). Examples include social, financial, cultural, sexual. Growing recognition that rural or small community within community practice cannot be “black and white” on dual/multiple relationships. Insider practitioners may be expected to provide professional services when they are personally impacted by community events (ie suicide) Professional Regulation CASW Code 1983 – no exploitation of clients, supervisors, students, employees, or research participants sexually or otherwise. CASW Code 2005 – not yet proclaimed. Standards of Practice (1999) – explicit reference to dual relationships of all types, noting exceptions to the obligation to terminate (special skills, services, emergencies). Guidelines critiqued as vague and simplistic, without guidance to make ethical decisions about nsmr, and inevitability in insider practice. Critiques and Calls for Change Helpful Dual Relationships Open recognition of multiple roles and support for Insider practitioners (ie aboriginal practice late at night, child welfare, called to auntie’s house) Thoughtful, reflective, decision-making Client first, client need first Practitioner responsibility for maintaining safety for clients ACSW – no rural nsmr complaints Components of Ethical Practice* *c BJ Antle (2005) Sensitivity and Empathy Intersect all Spheres Human Rights Charter UN conventions Prov/Terr Codes Client Culture and values Priorities/resources Context Relevant laws Workplace culture/policies Social Worker Ethical orientation Codes/standards Risk tolerance Framework for Managing Insider Practice Issues Wide diversity on potential harm/benefit of nsmr. Have a plan, any plan, and voice the plan, discuss the plan, change the plan if necessary, consult if necessary, seek supervision if uneasy. More writing on non-clinical multiple, non-sexual relationships, in rural settings, in insider groups research on the effects of nsmrs shows argument for positive and negative, I suggest assess on a situation by situation basis. Managing Multiple Relationships: A Framework for Decision-Making* *Gripton and Valentich’s 10 Factor Model: 1. Vulnerability of the client 2. Power Differences 3. Risks for the Client 4. Risks for the Practitioner 5. Benefits for the Client 6. Benefits for the Practitioner 7. Clarity of Professional Role Boundaries 8. Specificity or Diffuseness of Professional Roles 9. Access to Alternative Sources of Professional Services 10. Community Values and Cultural Norms Implementation 1. Assess (understanding codes, policies, legislation). Collaborative approach if possible. 2. Reconsideration (read Marilyn Peterson [now Armour]) for clinical “red flags”. 3. Consultation. 4. Documentation. (including steps taken and rationale). Real Examples Jenny and Beulah, both family therapists at a small agency plan to meet at Jenny’s house to attend a music festival in your community, after a long and stressful week. When Beulah shows up, your friend, Ryan and his partner, are present. Beulah recently worked with this couple, and had some quite negative feelings about the choices they made. You all attend the music festival for a bit, Jenny goes off with another friend, and later meets you back at the house, after Ryan and partner have gone home. Beulah shows up with Naomi, whom Jenny has worked with at the agency, a couple of years ago, while Beulah was on a leave of absence. Jenny feels quite positively about the work Naomi and she did, though her recall is fuzzy, as time has passed. Beulah makes comments that she really didn’t want to “deal with clients” that day, so was glad your friends had left. She is obviously unaware of the previous client relationship with Naomi. Apply the model to decide if any action could be taken in this situation. Real Examples Kulah is organizing a protest over living conditions in her tied to income housing. She asks Zalim, a local social worker, to help her, as he lives in the building. Zalim works as a community organizer for the Town, which is the technical landlord of the housing in question. Using the model, identify issues and actions. Real Examples Belinda is in clinical private practice in a small town. She sees a couple for counseling. At the first day of school, she notes her daughter and their daughter are in the same class. The client couple greet Belinda in front of the teacher, and explain to the teacher how neat it would be if their daughter could play with their social worker’s daughter, as they feel that might help their daughter with issues around socialization. A few weeks later, a birthday invitation is sent home with Belinda’s daughter. Belinda is aware of alcohol use issues and violence in the home. Belinda’s daughter expresses she does not want to attend this party, as the client couple’s daughter has been physically aggressive to her at school. Using the model, decide what would be best to do. Real Examples June has been seeing you for counseling, referred by a colleague of yours. June asked that you receive some vital history from that colleague and you have complied. During counseling, you begin to believe that you are not being effective, as June remains very depressed, and in a lot of pain most sessions. She is let go from her job, where she worked for your colleague. You believe the firing is unfair, and due to her health issues. Also, you see June in a parade the next day, riding a big float, smiling and laughing, and she pelts you with a snowball as she goes by. Assess and decide. The End References on ACSW website Acknowledge sources when using model. Questions.