Professional Ethics and Law in California, 2nd Edition _ ____________________________________________
Among the behavioral symptoms are hypervigilance and an elevated startle response. According to the Administration for Children and Families (n.d.), an impaired immune system can be a physical symptom of this condition. According to Harr and colleagues (2014, citing Forster, 2009), a contributor to compassion fatigue is the “moral stress caused by the various ethical and value conflicts social workers often encounter in practice.” Moral stress can result from situ- ations such as being unable to provide adequate care because of a client’s inadequate health insurance or the urge to skip reporting child abuse for fear of causing more harm than good or the urge to give money to a destitute client (Fried, 2016). These scenarios can place the practitioner in ethical and legal jeopardy, as the wrong choice can lead to conflicts with ethical codes, state laws, and other rules. DEALING WITH BURNOUT AND COMPASSION FATIGUE A professional mental health practitioner can take steps to increase her or his ability to cope and achieve balance in life. Maintaining a healthy lifestyle balance and recognizing the signs of burnout and compassion fatigue are important. The responsible mental health clinician will take action, which can range from a vacation break to a change in schedule or job duties. Practitioners also need to be aware not only of the signs and symptoms of burnout and compassion fatigue but, more importantly, of the situations that may set the stage for their occurrence. Ongoing supervision is the mental health practitioner’s best defense. In addition to ongoing supervision, regular supportive contact with other practitioners to prevent isolation is rec- ommended as well as the following measures to help prevent burnout or compassion fatigue: • Listen to the concerns of colleagues, family, and friends. • Conduct periodic self-assessments. • Take needed “mental health days” and use stress- reduction techniques. • Arrange for reassignment at work, take leave, and seek appropriate professional help as needed. PRACTITIONER IMPAIRMENT Ethics complaints and lawsuits may be the result of practi- tioner impairment. Impairment may involve failure to provide competent care or a violation of social work’s ethical standards. Social workers who engage in egregious ethical misconduct, especially cases involving inappropriate dual relationships and incompetent practice, are often impaired in some manner (Reamer, 2015). According to Reamer, impairment may take the following forms:
• Impairment may take such forms as providing flawed or inferior services to a client, sexual involvement with a client, or failure to carry out one’s duties as a result of an addiction to alcohol, drugs, gambling, sex, or mental illness. • Research suggests that distress among human service professionals falls into two categories: environmental stress—which is a function of employment conditions such as stressful working conditions or inadequate professional training—or personal stress—caused by problems with one’s marriage, relationships, emotional and physical health, legal difficulties, and finances. • In recent years, strategies for dealing with impaired practitioners have become more prevalent. Some professional associations are examining the extent of impairment among colleagues to address the problem. • Despite discussions of specific forms of impairment, such as alcoholism, there is little discussion of the general problem of impairment in social work literature. • Research on impairment among professionals suggests that many struggling practitioners do not seek assistance, and colleagues who are concerned about them may be reluctant to share their concerns. • Some impaired professionals may find it difficult to seek help because of an erroneous belief in their own competence and invulnerability. They believe that a therapist is not available or that therapy will not help. They often prefer to seek help from family members or friends, or they believe they should be capable of resolving problems on their own. • Professionals may not seek assistance because they fear exposure and the disclosure of confidential information. They may be concerned about the amount of effort required, the cost, have a spouse or partner who is unwilling to participate in treatment, or they do not comprehend (or cannot admit) the seriousness of the problem. ETHICS RELATING TO A PUBLIC HEALTH CRISIS When a public health crisis such as the one surrounding the COVID-19 pandemic arises, social workers and other providers of services to already troubled populations can experience greater stress. The National Association of Social Workers (2020) offers ethics-related suggestions for getting through an especially difficult time:
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