Lesson 3: Ethics in Case Management

Attention

Judge me not is a look at the National Association of Social Workers code of ethics through the experiences of others.
To view this video on YouTube click HERE

Learning Outcomes

Upon completion of this lesson's material, students will be able to:

• Express knowledge of confidentiality
• Identify ethical considerations when encountering a dual relationship

Teaching

A good ethical base ensures our professionalism in the field.   It is important that you commit much of this information to memory and ensure your understanding.  

Concepts related to ethical practice include:

Dual Relationships

• Read this article about Dual Relationships. It focuses on mental health workers who work with individuals who are deaf or hard of hearing. I feel you the messages and concerns provided in the document can be applied to working with a variety of different populations, such as clients from your home community, clients in rural areas, clients with trauma and who display poor boundaries.

Informed Consent

• Read about the Components of Informed Consent

Conflicts of Interest

• There are a number of examples of what constitutes a conflict of interest in mental health treatment. Just as in medicine, treating certain patients may not be in the best interest of the patient or the mental health worker. A mental health worker, for instance, would have a direct conflict in trying to provide case management services to his or her own family members or close friends, just as a doctor would be unlikely to treat the illnesses of his or her own immediate family (beyond offering some basic care as needed). The premise of most mental health treatments is that the mental health worker is to bring objectivity to sessions/meetings, and he or she cannot bring the same level of distance to those people who he or she knows very well (http://www.wisegeek.org/in-therapy-what-is-a-conflict-of-interest.htm)

Value Conflict

• A value conflict can occur when your personal values do not align with the needs of professional situation. For example there was a court case where counseling students (interns) were unwillingness to counsel gay clients because of their personal, religious values opposing homosexuality. While conflicts regarding sexual orientation and gender identity often receive attention, other value conflicts may emerge in the counseling process both for practicing counselors and counselors-in-training; e.g., counseling issues related to termination of pregnancies, euthanasia and the “right to die,” sexual relations outside of marriage, counseling offenders, and counseling individuals from cultural and racial backgrounds different from that of the counselor (Consoli, Kim, & Meyer, 2008). In all these situations, counselors who have very strong beliefs and values regarding these issues may experience serious dissonance between their values and beliefs and the requirements of their professions Code of Ethics. (http://files.eric.ed.gov/fulltext/EJ954289.pdf)

Confidentiality

• There are specific rights that consumers of mental health services in Maine are expected to be provided. This document summarized the Maine Rights of Recipients of Mental Health Services Brochure provided to consumers.

Self-Determination

• According to The Social Work Dictionary, self-determination can be defined as, "An ethical principle in social work that recognizes the rights and needs of clients to be free to make their own choices and decisions. Inherent in the principle is the requirement for the social worker to help the client know what the resources and choices are and what the consequences of selecting any one of them will be. Usually self-determination also includes helping the client implement the decision made" (Barker, 2003). - See more at: www.therapistdevelopmentcenter.com

Privileged Communication

• Privileged Communication is an interaction between two parties in which the law recognizes a private, protected relationship. Whatever is communicated between these pairs of parties shall remain confidential, and the law cannot force disclosure of these communications. The individual that initially makes the privileged communication legally has the ability to prevent the other party in the relationship from disclosing the content of the privileged communication. Typically, privileged communications refer to communications between attorney and client, accountant and client, doctor or therapist and patient, priest and parishioner or husband and wife (and, in some states, reporters and their sources). The recipient of the information must keep the communication private, unless the privilege is waived by the discloser of the information. There are conditions that must be met in order to preserve the confidential status of these communications. First, the communication must be between people in a legally recognized protected relationship. Next, the communication must take place in a private setting, where the communicators have a reasonable expectation of confidentiality (like a private office). Lastly, the privileged status of the communication is lost if or when the communication is shared with a third party that is not part of the protected relationship (however, agents of the recipient of the information - such as an accountant's secretary or a doctor's nurse - would generally not be considered a third party that defeats the privileged status of the communication) (http://www.investopedia.com).

Mandated Reporting

• Reading Maine Statutes takes a bit of practice and patient to get through the legal language to the parts that actually make sense. The mandated reporting statute is fairly brief so I would encourage you to read through it: Maine Mandated Reporting Statute
  

Diagnostic Labeling

• Read the web article about Psychological Diagnosis: Dangerous, Desirable, or Both? There are definitely pros and cons to diagnostic labeling and all mental health professionals need to be thoughtful about when the verbalize a label, how they verbalize a label and to whom they verbalize a label. (Link for article is: https://www.psychologytoday.com/blog/resolution-not-conflict/201202/psychological-diagnosis-dangerous-desirable-or-both )

Click HERE to download the "Recovery for ME: Mental Health Services Practice Guidelines for Recovery Oriented Care"

Click HERE to download the "DHHS Overview of Application of Confidentiality Laws to Adult Consumers of Mental Health Services"

Click HERE to view the NASW Code of Ethics (Link is: http://www.socialworkers.org/pubs/code/code.asp )

Assessment

Lesson 3 Quiz

Explain client confidentiality rights, ethical considerations to confidentiality, and times it is acceptable to break confidentiality.

Lesson 3 Discussion

Give an example of a potential dual relationship you may encounter as a case manager. Describe potential conflicts of interest and ethical issues you would need to take into consideration when determining a course of action.