Transcript RSAT Training Tool: Trauma-Informed Correctional Care

Ethical Issues in Offender Treatment:
Professional Competence
Roberta C. Churchill M.A., LMHC
ACJS, Inc.
Course Objectives
Upon completion of this presentation, participants will
be able to :




Define the concept of “power differential”
Describe the six ethical principles for treatment
professionals
List at least three areas of Professional Competence
Develop a plan of action if Professional Competence or
any ethical principle is in danger of being / has been
infringed upon
7/18/2015
2
Ask
Yourself
Module I: Research
“What was your motivation for becoming
a treatment professional?
7/18/2015
3
SIX ETHICAL PRINCIPLES
Remley and Herlihy (2007)
4
Beneficence
Module I: Research
The responsibility to do good and to contribute
to the welfare of the client.
Treatment staff are expected to do the best for
the client and if unable to assist, to offer
alternatives as appropriate.
Staff engage in professional activities that
provide general benefit to the public.
7/18/2015
5
Non-Maleficence
Do no harm.
Treatment staff have a responsibility to avoid
using interventions that could or have the
potential to harm clients.
Staff are expected to complete a thorough
assessment of the client’s needs and apply
appropriately determined and explained
interventions.
7/18/2015
6
Autonomy
The freedom of clients to choose their own
direction.
The role of treatment staff is to
acknowledge client autonomy and to
respect this right.
Clients are to be aware of the choice taken and
the effect / consequences it has on others and
themselves.
7/18/2015
7
Justice
To act in a fair and just manner.
It is expected that staff will act in a nondiscriminatory manner to individuals and
groups.
It does not mean treating all individuals the
same – rather it relates to equity.
7/18/2015
8
Fidelity
Refers to the trust relationship between staff
and client.
The interests of the client are placed before
those of the staff person even if such loyalty is
inconvenient or uncomfortable.
Clients need to be able to trust that the words
and actions of staff are truthful and reliable.
7/18/2015
9
Veracity
The principle of truth telling.
Staff are obligated to deal honestly with
clients and others with whom they relate
professionally.
This applies to a broad range of issues including
documentation standards, community relations,
regulatory reporting, and compliance.
7/18/2015
10
PROFESSIONAL
COMPETENCE
Taken from 2005 ACA Code of Ethics
11
Case
Scenarios
Module I: Research
Dual Relationships

A correctional case worker with her B.A. in Criminal Justice
consistently diagnoses her clients with ADHD, Bi-Polar
Disorder, and other mental health diagnoses on progress
notes, reviews and treatment plans.

You’re a Job Developer within a RSAT funded program and
find yourself more and more in a counseling relationship with
one of your clients.
7/18/2015
12
Boundaries of Competence
 Provide only those
services for which
you are qualified
 Represent accurately
your professional
qualifications
7/18/2015
13
Case
Scenarios
Module I: Research
Dual Relationships

You’ve been offered a re-entry position within a RSAT
program for male inmates however you’ve only ever worked
at an afterschool program for elementary school children in a
music program.

There’s an opening for a RSAT Treatment Director: you have a
choice between a 20 year DOC worker with a BA in Liberal
Arts who has no other certification – but is being “pushed”
for the position – OR the current RSAT Asst. Director who has
a MA in Social Work and is a Licensed Social Worker with
three years experience.
7/18/2015
14
Qualified for Employment
 Only accept employment for which you are
qualified
 Hire for professional treatment positions only
those who are qualified
7/18/2015
15
Case
Scenarios
Module I: Research
Dual Relationships

A Probation Officer who is part of the treatment team just
went to a EMDR (Eye Movement Desensitization and
Reprocessing) training last week. He believes that this is an
effective way to treat trauma and is now meeting with his
probationers to practice this new treatment on them.
7/18/2015
16
New Specialty Areas of Practice
 Practice in new
specialty areas only
after appropriate
education, training,
supervision and
experience
7/18/2015
17
Case
Scenarios
Module I: Research
Dual Relationships

After five years of RSAT funding, there has been no efforts
made to track recidivism.

Since you began working in the RSAT Program as a counselor
over two years ago, your Program Director has never
observed you facilitating a class, asked for your lesson plans,
or reviewed your case management work.
7/18/2015
18
Monitor Effectiveness
 Make continued efforts to monitor and improve
efficacy and outcomes
7/18/2015
19
Case
Scenarios
Module I: Research
Dual Relationships

You’re a Adult Educator within a RSAT funded program and
find yourself becoming too friendly with one of your
students. You’ve been able to handle it so far but now you’re
really feeling uneasy.

You’re feeling uncomfortable with the confrontational
techniques that some other colleagues take with the RSAT
clients. You think it might even be unethical. Who can you
talk to about it?
7/18/2015
20
Consultation on Ethical Obligations
 Consult with colleagues
and other relevant
professional regarding
ethical issues
 Clinical Supervision
7/18/2015
21
Case
Scenarios
Module I: Research
Dual Relationships

One of the RSAT counselors has never been to an outside
training or workshop, other those mandated yearly by the
State DOC.

You’ve implemented a new risk/need assessment instrument
in your RSAT funded program. How will you ensure that it is
being utilized correctly?
7/18/2015
22
Continuing Education
 Grow professionally through involvement in
continuing education
 Take steps to insure non-maleficence in using the
new specialty area
7/18/2015
23
Case
Scenarios
Module I: Research
Dual Relationships

A RSAT Officer has offered to facilitate a “Feelings” group but
you notice that he usually talks about his own relationship
with ex-wife and his current girlfriend.

You’re recently divorced, living alone for the first time and
emotionally fragile. Although you don’t talk about your
private life at work, it’s slipped out to a RSAT client with
whom you’ve been working with closely over the last few
months. This client is understanding, listens to you and knows
what you’re going through. You look forward to seeing this
client every day you go into work.
7/18/2015
24
Impairment
 Seek assistance in solving personal issues
 Refrain from your professional
services if a client may be
harmed by your physical,
mental, or emotional problems
7/18/2015
25
THE PROVIDER-CLIENT
RELATIONSHIP
26
The Power Differential
The unbalance of
power between
provider and client
Control over the
services provided to
the client
Access to private
knowledge about the
client
7/18/2015
27
Examples
of
the
Power
Differential
Module I: Research
Set the time, place and stage
Authority to determine the rules
of the relationship
Right to ask questions
Maintain anonymity
Power to label, name and
diagnose
7/18/2015
28
Module I: Research
"Because a relationship begins with a power
differential, I shall not exploit relationships with
current or former clients for personal gain, including
social or business relationships."
(National Association of Alcoholism and Drug Abuse Counselors, 2004)
7/18/2015
29
Multiple
Relationships
Module I: Research
Dual Relationships

When staff relates to a client in a professional role
and concurrently or sequentially in another
professional or non-professional role with the client
• Friend
• Intimate partner
• Financial partner
• Peer
7/18/2015
30
Sexual
Relationships
Module I: Research
Dual Relationships
“The most devastating multiple relationship occurs
when a counselor engages in a sexual relationship with
a client …”
–
7/18/2015
Hermann & Robinson Kurpius, 2006
31
Sexual
Relationships
Module I: Research
Dual Relationships
“The most devastating multiple relationship occurs
when a counselor engages in a sexual relationship with
a client …”
–
Hermann & Robinson Kurpius, 2006
“Having a sexual relationship with a client is the most
consistently violated ethical standard among
psychologists and the second most frequently claimed
violation against counselors.”
‒ ASPPB, 2001; Herlihy & Corey, 1992
7/18/2015
32
Sexual Victimization
Staff includes anyone
working within the
correctional facility.
Prisons: 2.4% of the
total inmate
population
Jails: 1.8% of the total
inmate population
Allen J. Beck, Bureau of Justice Statistics,
“Sexual Victimization in Prisons and Jails Reported by Inmates, 2011-2012,” May 2013
7/18/2015
33
Impairment
 Seek assistance in solving personal issues
 Refrain from your professional
services if a client may be
harmed by your physical,
mental, or emotional problems
7/18/2015
34
Working Alliance
 A good working alliance is one of the most
important factors in successful treatment
outcomes
 An effective working alliances depends on the
personal well-being and mental health of the staff
person:
• Trusting relationship
• Collaborative goal setting
• Task accomplishment
7/18/2015
35
COMPETENT PROFESSIONALS
Ethical Decision Making
36
Consider This!
It is your Ethical Responsibility to:
 Be as emotionally healthy as possible
 Be aware of how your “unfinished business” could
potentially influence your work with others
 Seek professional help as soon as you are aware that
some part of your life is infringing on your work
7/18/2015
37
Ask Yourself
Am I doing this for the best of the client or some other
motivation? Whose needs are being served?
 Am I feeling angry? Frustrated? Resentful? Towards the
client or for other reasons?
 Am I treating this client differently?
 How would my interactions be viewed by:

•
•
•
•
•
My supervisor
The client’s family or partner
My family and my partner
My co-workers
A licensing agency
7/18/2015
38
What Should I Do?
 Pay
attention to any uneasy feelings, doubts, or
confusion you may have
 Recognize your own strengths and weaknesses
 Participate in critical and honest self-examination
 Reach out to colleagues, clinical supervisors, trusted
advisors
 Limit your services to your professional role / capacity
and refer to others when a problem arises that is
outside your knowledge and responsibility
7/18/2015
39
Competent Professionals
Receive routine Clinical Supervision
• Be familiar with your code of ethics / agency rules and follow them
Respect Chain of Command
• Use supervisors as a source of information
• Keep them informed of problems and/or questions
Educate Yourself
• Participate in trainings, continuing education, re-certification & relicensing mandates, supervised experience, recent research and
literature
Document – Document - Document
• If it’s not in writing, it never happened
7/18/2015
40
Consider
This
…
Module I: Research
It is unethical when treatment staff are primarily
meeting their own needs and imposing their
personal values in the treatment relationship.
Adapted from Robinson Kurpius, S. E., Dixon, S. K., & Stauffer, M. D. (2008).
Ethics and the beginning counselor: Being ethical right from the start.
In Capuzzi, D., & Gross, D. R. (Eds.), Introduction to the counseling profession (5th ed.)
7/18/2015
41
Ask
Yourself
Module I: Research
“Are my actions more about my needs
than about the needs of the client?”
7/18/2015
42
Competent Professionals
 Accept
the complexity of ethical dilemmas
 Admit when they need help
 Acknowledge their professional limitations and
discuss them with colleagues
“Whose needs are
being met?”
7/18/2015
“Do no harm.”
43
References

•
•
•
•
•
•
•
•
American Counseling Association. (2005). Code of ethics and standards of practice.
Alexandria, VA: Kurpius.
Bissell, L., Royce, J., (1994) Ethics for Addiction Professionals, Hazelden Educational
Materials, Center City, Minnesota.
Corey, G., Corey, M.S., & Callahan, P. (2007). Issues and ethics in the helping professions
(7th ed.).Belmont, CA: Brooks/Cole.
McGuire, S. (1996) Subtle Boundary Dilemmas: Ethical Decision Making for Helping
Professionals, Hazelden Educational Materials, Center City, Minnesota.
Capuzzi, D., & Gross, D. R. (Eds.),(2005) Introduction to the Counseling Profession (5th
ed.), Pearson Education, Inc., Upper Saddle River, New Jersey.
Trotter, Chris (2010) Effective Supervision of Offenders, 145th International Training
Course
Trotter, Chris (2009) European Journal of Probation, 1 (2), pp. 142 – 152.
White, William L. (2007) Ethical Guidelines for the Delivery of Peer-based Recovery
Support Services, ATTCC / SAMHSA
Zur, O. (2010) Power in Psychotherapy and Counseling, Online Publication by the Zur
Institute.
7/18/2015
44