Ethical Issues in Offender Treatment Professional Competence Roberta

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 : Ø Ø 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 2/22/2021 2

Ask Yourself Module I: Research “What was your motivation for becoming a treatment professional? 2/22/2021 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. 2/22/2021 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. 2/22/2021 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. 2/22/2021 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. 2/22/2021 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. 2/22/2021 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. 2/22/2021 10

PROFESSIONAL COMPETENCE Taken from 2005 ACA Code of Ethics 11

Case Scenarios Module I: Research Dual Relationships Ø 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. Ø 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. 2/22/2021 12

Boundaries of Competence Ø Provide only those services for which you are qualified Ø Represent accurately your professional qualifications 2/22/2021 13

Case Scenarios Module I: Research Dual Relationships Ø 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. Ø 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. 2/22/2021 14

Qualified for Employment Ø Only accept employment for which you are qualified Ø Hire for professional treatment positions only those who are qualified 2/22/2021 15

Case Scenarios Module I: Research Dual Relationships Ø 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. 2/22/2021 16

New Specialty Areas of Practice Ø Practice in new specialty areas only after appropriate education, training, supervision and experience 2/22/2021 17

Case Scenarios Module I: Research Dual Relationships Ø After five years of RSAT funding, there has been no efforts made to track recidivism. Ø 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. 2/22/2021 18

Monitor Effectiveness Ø Make continued efforts to monitor and improve efficacy and outcomes 2/22/2021 19

Case Scenarios Module I: Research Dual Relationships Ø 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. Ø 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? 2/22/2021 20

Consultation on Ethical Obligations Ø Consult with colleagues and other relevant professional regarding ethical issues Ø Clinical Supervision 2/22/2021 21

Case Scenarios Module I: Research Dual Relationships Ø One of the RSAT counselors has never been to an outside training or workshop, other those mandated yearly by the State DOC. Ø You’ve implemented a new risk/need assessment instrument in your RSAT funded program. How will you ensure that it is being utilized correctly? 2/22/2021 22

Continuing Education Ø Grow professionally through involvement in continuing education Ø Take steps to insure non-maleficence in using the new specialty area 2/22/2021 23

Case Scenarios Module I: Research Dual Relationships Ø 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. Ø 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. 2/22/2021 24

Impairment Ø Seek assistance in solving personal issues Ø Refrain from your professional services if a client may be harmed by your physical, mental, or emotional problems 2/22/2021 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 2/22/2021 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 2/22/2021 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) 2/22/2021 29

Multiple Relationships Module I: Research Dual Relationships Ø 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 2/22/2021 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 …” – 2/22/2021 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 2/22/2021 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 2/22/2021 33

Impairment Ø Seek assistance in solving personal issues Ø Refrain from your professional services if a client may be harmed by your physical, mental, or emotional problems 2/22/2021 34

Working Alliance Ø A good working alliance is one of the most important factors in successful treatment outcomes Ø An effective working alliances depends on the personal well-being and mental health of the staff person: • Trusting relationship • Collaborative goal setting • Task accomplishment 2/22/2021 35

COMPETENT PROFESSIONALS Ethical Decision Making 36

Consider This! It is your Ethical Responsibility to: Ø Be as emotionally healthy as possible Ø Be aware of how your “unfinished business” could potentially influence your work with others Ø Seek professional help as soon as you are aware that some part of your life is infringing on your work 2/22/2021 37

Ask Yourself Ø Am I doing this for the best of the client or some other motivation? Whose needs are being served? Ø Am I feeling angry? Frustrated? Resentful? Towards the client or for other reasons? Ø Am I treating this client differently? Ø 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 2/22/2021 38

What Should I Do? Ø Pay attention to any uneasy feelings, doubts, or confusion you may have Ø Recognize your own strengths and weaknesses Ø Participate in critical and honest self-examination Ø Reach out to colleagues, clinical supervisors, trusted advisors Ø Limit your services to your professional role / capacity and refer to others when a problem arises that is outside your knowledge and responsibility 2/22/2021 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 2/22/2021 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 (5 th ed. ) 2/22/2021 41

Ask Yourself Module I: Research “Are my actions more about my needs than about the needs of the client? ” 2/22/2021 42

Competent Professionals Ø Accept the complexity of ethical dilemmas Ø Admit when they need help Ø Acknowledge their professional limitations and discuss them with colleagues “Whose needs are being met? ” “Do no harm. ” 2/22/2021 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 (7 th ed. ). Belmont, CA: Brooks/Cole. Mc. Guire, 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 (5 th ed. ), Pearson Education, Inc. , Upper Saddle River, New Jersey. Trotter, Chris (2010) Effective Supervision of Offenders, 145 th 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. 2/22/2021 44