Resolving Ethical Dilemmas Using the CRCC Ethical Code

Resolving Ethical Dilemmas Using the CRCC Ethical Code: Approaches for VA VR Professionals The Association of VA Vocational Rehabilitation Professionals (AVAVRP) May 5, 2021 Meeting Dr. Rob Froehlich, Associate Professor of Counseling

GW Center for Rehabilitation Counseling, Research, and Education • The GW Center for Rehabilitation Counseling Research and Education (GWCRCRE) aims to enhance research and provide opportunities for growth and development to a diverse population including persons with disabilities.

GW CRCRE: What Do We Do? • Technical Assistance/Continuing Education – more on that in a bit • Education – Master’s in Rehabilitation Counseling (both online and on campus) – Ph. D. in Counseling (on campus) • Research – Each project has a research component as well

CIT VR • Center for Innovative Training in Vocational Rehabilitation – Mission: The Center's focus is on developing innovative methods to train VR personnel in their work at State Vocational Rehabilitation agencies to deliver services to improve employment outcomes for individuals with disabilities. – Upcoming Webinar (June 16) - Now, More Than Ever: The Ethical Practice of Rehabilitation Professional Self Care

Website The Center is funded via a five-year grant, i. e. , October 1, 2019 – September 30, 2024, from the US Department of Education, Rehabilitation Services Administration under the Innovative Rehabilitation Training Program (CFDA 84. 263 C). https: //trainvr. org train. VR. org

National Technical Assistance Center on Transition: The Collaborative – NTAC-C

Website and Mission • https: //transitionta. org/ • “Supporting you to improve opportunities and outcomes for students and youth with disabilities. ”

Vocational Rehabilitation TA Center on Quality Management

Website and Mission • https: //www. vrtac-qm. org/ • Partnering with State Vocational Rehabilitation Agencies (SVRAs) to enhance service delivery and maximize outcomes through quality program and resource management.

3 Areas of Technical Assistance • Resource/Fiscal Quality Management • Program/Performance Quality Management • General Quality Management – Upcoming recorded webinar “Boundaries, Supervision, and Technology: Some Contemporary Ethical Considerations”

What Can You Find at Our Website? https: //gwcrcre. org

Some Resources You All Can Use • 5 part webinar series on Pre. Employment Transition Services • Telecounseling Resources Collection • State VR Agencies Training Needs Report • Project E 3 Webcast Series

More Resources on Website • LGBTQ+ Training Series • Tools to Finding Employment: Disclosing a Visual Disability • CPID Webinar Series • Links to all Projects • Links to Graduate Programs

Approach/Format for Today • I plan on covering some information on: – CRCC Code Sections: A (Roles and Relationships with Clients); E (Relationships with Other Professionals and Employers); G (Assessment and Evaluation); and L (Resolving Ethical Issues) – This is your time; we can also move away from those issues and I’m open to questions or discussion at any point.

Before we even start… • From recent training, several new or updated thoughts about seeing clients virtually: – Turn off Alexa/Bluetooth – starting cars and breaking into sessions; – Hopscotch – Platform for clinicians working with kids – Specific Releases of Information for contact during emergency or technology failure

My Ethics Story • Doctoral Studies Course • Research Publications with Dr. Jorge Garcia • Development of Ethics Course at University of South Carolina

My Ethics Story • Back to GW • Regional Ethics Training Events – Social Media, Leadership, Code Updates • National Invited Presentations and Sessions – NRA, NCRE, NAMRC, VR Summit • Ethics and Return on Investment • Instructor Professional and Ethical Orientation to Counseling (CNSL 6151)

More Recent Developments • CRCC Ethics Committee Member 2017 - 2020 • VCA Ethics Committee Member 2019 Current • CRCC Ethics Committee Chair (2021 – 2024) • CRCC At Large Director on Board of Directors

Would you be interested in hearing a bit about how Ethics committees function?

Disclaimer • Statements included in this presentation are on behalf of myself • Board Member and Chair of Ethics Committee, however I am not officially speaking on behalf of CRCC today

CRCC Advisory Opinions (Check out CRCC’s New Website Format!) • CRCC's Ethics Committee routinely responds to requests for advisory opinions related to the application of CRC/CCRC Code of Ethics. Available for review is a compilation of the essence of the questions presented dating back to 1996, as well as the Committee’s response and Code citations. A convenient index allows individuals to review all opinions relating to a particular Standard of the Code. Not all Standards will have inquiries or advisory opinions. • https: //crccertification. com/code-of-ethics-4/advisory-opinions/ • https: //crccertification. com/code-of-ethics-4/grievance-process/

Potential Action and Levels of Sanctions • • • ACTION LETTER OF INSTRUCTION In the event it is determined that the applicable Code has been violated, the Committee may consider the degree of harm and significant mitigating circumstances and may issue of letter of instruction, which is not a sanction. SANCTION RATIONALE/MEDIATING FACTORS Reprimand A finding of clearly ethical misconduct, when the rehabilitation counselor should have known better, although the consequence of the action or inaction may have been minor. May include remedial requirements. Probation Deliberate or persistent behavior that could lead to substantial harm to the client or public, although little harm may actually have occurred. May include remedial requirements. Suspension Continuing or dramatic misconduct producing genuine hazards to clients, the public, and the profession; questionable motivation to change or demonstrate concern for the behavior in question. May include remedial requirements. Revocation Individual clients or others with whom one worked are substantially injured with serious question about the potential rehabilitation of the rehabilitation counselor in question.

CRCC Consultations and Actions by the Numbers • • CRCC https: //www. crccertification. com/actions-taken Year 2018 -2019 3 – Cases Adjudicated 4 – Cease and Desist Ordered 6 – Advisory Opinions Issued From 1994 – current day – – – Letter of Instruction* 15 Reprimand 11 Probation 8 Suspension 7 Revocation 29

Topics I’ve Run Into Most Frequently • Grievances with other colleagues • Grievances with systems • Failure to adhere to proper business practices (Documentation, Billing) • Non-Professional Interactions • Conflict of Interest

Beyond Consultations and Complaints • Updates to the Codes of Ethics (New Code Revision Taskforce begins work in May!) – Draft; Public Comments; Final Version – Social Justice, Technology and Meetings/Virtual Services/likely an even more clinically focused approach • Publications • Presentations representing the Organizations – upcoming presentations with CRCC for NAMRC and VCA for 2021 Convention.

Newly Formed VCA Ethics Committee • • The Ethics Committee shall be responsible for promoting ethical standards for counselors as set forth by the current iteration of the ACA Code of Ethics. Services provided: Ethics Trainings - The Chair and/or Committee Members will provide annual ethics training to the VCA membership. The Ethics Committee develops an annual training plan, and updates the plan throughout the year as needed. Original Intention - Ethics Consultations - The Ethics Committee provides ethics consultations as a service for VCA members. Ethics consultations are rooted in the ACA Code of Ethics. The Committee does not provide legal consultations or consultations for emergency or time-sensitive matters. The Ethics Committee meets regularly and consultations will be put on the agenda for the next meetings as they are received. This will not continue going forward. Other services may be developed by the Ethics Committee as needed by the VCA membership.

VCA Ethics Committee Limitations: • Although ethics and risk management are related, the VCA Ethics Committee does not offer risk management services such as advice to minimize risk in the event of lawsuits and/or criminal charges. Whenever legal questions arise, counselors should consult with a lawyer licensed in the jurisdiction in which they practice. • The Ethics Committee does not provide disciplinary oversight of VCA members. In the event that a disciplinary inquiry is required, the Ethics Committee Chair will work with the VCA President to address the matter.

ACA • The Ethics Committee protects the public through the adjudication process and assists ACA with educating the membership concerning the Code of Ethics, monitoring and providing input into the revision of the Code of Ethics, and receiving and processing complaints of alleged violations of the Code of Ethics of the association. The Ethics Committee shall assist with the development of an annual statistical report of cases, which is published in an ACA publication.

Questions on Any of This So Far?

Section A – The Counseling Relationship

Intro • There’s a reason this is the first section of the code. • Trust • Respect for clients making own decisions • Informed Choices • Cultural Competency

Subsections of A 1. Welfare of those served (focus on autonomy) 2. Respecting Diversity (Culture; Nondiscrimination) 3. Client Rights (Informed Consent) 4. Avoiding Value Imposition

More on Subsections 6. Multiple Clients 7. Group Work 8. Termination and Referral (values and termination; abandonment prohibited) 9. End of Life Care – Terminally Ill Clients

What about A. 5? • There’s a reason I have A. 5 – Roles and Relationships with Clients alone… • Sexual or Romantic Relationships with Clients/Former Clients/Vulnerable former clients.

More on A. 5 • Service provision with former romantic partners or family • Personal virtual relationships with clients • Accepting Gifts

A. 5. g – This is an important area • Extending professional boundaries and documenting boundary extensions…

Issues? Questions? • What challenges have you experienced in the area of Roles and Relationships with Clients? • What questions do you have relative to this practice area?

Ethical Issues and Assessment: What Guidance Does the Code Provide?

Intro • More than just tests. • Also includes qualitative measures. • Evaluation – Process of assessing living, learning, and working environments. • Must take into account client’s personal and cultural context. • Prevent the misuse of obsolete measures and data by others.

Section G – General Topics • Results: Interpretation and context with clients • Careful consideration of “who” and “what” to release • Diagnosis – Cultural sensitivity, historical prejudices in diagnosing pathology, and option to refrain from diagnosing.

Section G – More Topics • Competence to use and interpret tests/instruments. • Test/Instrument selection • Test/Instrument administration conditions • Test/Instrument Scoring and Interpretation • Obsolete Tests/Instruments and Outdated Results • Test/Instrument Construction

Issues? Questions? • What challenges have you experienced in the area of Assessment? • What questions do you have relative to this practice area?

Questions • Assessment: – What else would you like to know? – What other questions do you all have for me?

Section E: Relationships with Other Professionals and Employers

Intro • Know about others’ roles • Respect different approaches • Develop positive working relationships/communication • Commitment to equitable treatment of clients • Client focused and seek to work in or collaborate to make changes in employment settings to achieve that goal.

E. 2. a • TEAMWORK. Rehabilitation counselors who are members of interdisciplinary teams delivering multifaceted services to clients must keep the focus on how to serve clients best. They participate in and contribute to decisions that affect the wellbeing of clients by drawing on the perspectives, values, and experiences of their profession and those of colleagues from other disciplines. Rehabilitation counselors promote mutual understanding of rehabilitation plans by all team members cooperating in the rehabilitation of clients.

E. 2. b • TEAM DECISION-MAKING. Rehabilitation counselors implement team decisions in rehabilitation plans and procedures, even when not personally agreeing with such decisions, unless these decisions breach the Code. When team decisions raise ethical concerns, rehabilitation counselors first attempt to resolve the concerns within the team. If they cannot reach resolution among team members, rehabilitation counselors recuse themselves and consider other approaches to address their concerns consistent with the well-being of clients.

Questions • Teams and Other Professionals: – What else would you like to know? – What other questions do you all have for me?

Section L: Resolving Ethical issues The ‘What Do I Do Now? ’ Section

Intro Statement • Rehabilitation counselors behave in an ethical and legal manner. They are aware that client welfare and trust in the profession depend on a high level of professional conduct. They hold other rehabilitation counselors to the same standards and are willing to make reasonable efforts to ensure that standards are upheld. Rehabilitation counselors strive to resolve ethical dilemmas with direct and open communication among all parties involved and seek consultation with colleagues and supervisors when necessary. • Rehabilitation counselors incorporate ethical practice into their daily professional work and engage in ongoing professional development on current topics in ethical and legal issues in counseling. Rehabilitation counselors become familiar with the CRCC Guidelines and Procedures for Processing Complaints and use it as a reference for assisting in the enforcement of the Code.

Common Questions Shared Relative To This Area: • How do I navigate/work with various personalities? • How do I report unethical behavior and address dilemmas I encounter? • What should be reported and not reported? • How do I address equity in work load? • How do I set boundaries with staff/consumers/clients? • Do I report doing more than my fair share when another professional is slacking off?

What resources do you currently use to resolve dilemmas?

L. 1. c CONFLICTS BETWEEN ETHICS AND LAWS • Rehabilitation counselors obey the laws of the legal jurisdiction in which they practice unless there is a conflict with the Code. If ethical responsibilities conflict with laws, rehabilitation counselors make known their commitment to the Code and take steps to resolve conflicts. If conflicts cannot be resolved by such means, rehabilitation counselors may adhere to the requirements of law.

I think I’ve observed something unethical… now what? • L 2 c - Informal Resolution – • L 2 d Reporting Ethical Violations (and exceptions where Informal Resolution may not be appropriate) – • L 2 f – Organization Conflicts. • Interesting addition to 2017 Code – L 2 E Self-Reporting

I have a dilemma… what should I do? • L 1 – Knowledge of Ethical Standards and the Code – A – “I didn’t know” won’t get you out of a speeding ticket and it won’t get you out of an ethical finding • L 2 a Ethical Decision Making Models and Skills

Resolving Ethical Dilemmas • Section I (ACA) and Section L (CRCC) • Require familiarity with ethical decision making models • https: //crccertification. com/code-ofethics-4/decision-making-models/

Comprehensive Step by Step Model • Corey, & Callanan (2014) may be used as a foundation: – – – – recognizing a problem; collaborating with the client to define the problem; developing solutions with the client; choosing a solution; reviewing the process with the client and re-choose; implementing and evaluating with the client; and continuing reflection.

Don’t Forget About… • Justice – Would you treat others the same in this situation? • Publicity – Would you want your behavior reported in the press? • Universality – Would you recommend the same course of action to another professional in the same situation? • And the ever popular, but less scientific – What would your mother say?

Questions • Ethical Decision Making: – What else would you like to know? – What other questions do you all have for me?

General Question and Answer Section • It’s ok to phrase your question in the form of, “I have a friend, who totally doesn’t work for the VA, who has this problem/question…”

Reach Out If I Can Be of Help • I’ve worked in the ethics and counseling space for quite a period of time • I can help you find resources if I can’t assist with your issue. • If you have a question and think I can be of help, don’t hesitate to reach out Rob Froehlich, Ed. D. , LPC, CRC Associate Professor of Counseling rfro@gwu. edu (804)794 -6667