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 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.
wrong choice can lead to conflicts with ethical codes, state laws, and other rules.
In addition to ongoing supervision, regular supportive contact with other practitioners to prevent isolation is recommended. Houston-Vega, Nuehring, and Daguio (1996) recommend 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 practitioner 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 crisis involves a communicable disease, special ethical issues arise around testing and reporting. Social workers need to understand the law as well as the ethical issues around confidentiality and the disclosure of information. ● In keeping with Standard 6.03, Public Emergencies, “Social workers should provide appropriate professional services in public emergencies to the greatest extent possible.” The NASW also instructs social workers to check with their licensing boards, their liability insurance providers, other regulatory bodies, and their employers for changes in policy and exceptions in the time of crisis. A public health crisis can give rise to numerous stressful ethical dilemmas for individual professionals, their employing agencies, and all levels of government. Compromises may need to be made in standards of care (Leider, DeBruin, Reynolds, Koch, and Seaberg, 2017). Individuals may need to surrender privacy in the case of contact tracing or the tracking of movements through cell phone locations. An extremely distressing dilemma arises through the necessity for triage, in which choices need to be made concerning who will get available treatment when there is not enough to go around. The COVID-19 crisis forced the Office for Civil Rights (2020), an arm of the U.S. Department of Health and Human Services, to issue guidance concerning the disclosure of confidential health information in certain circumstances. For example, the individual’s HIPAA authorization is not needed when disclosure is necessary: ● To provide treatment.
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 (2020a) offers ethics-related suggestions for getting through an especially difficult time: ● In order to avoid burnout and compassion fatigue, self-care remains important. ● In keeping with NASW Standard 1.15, Interruption of Services, social workers need to have a plan in place to provide continuity of services. Social workers should be able to provide remote services if need be, and they should have an emergency backup person or system in place, and have communicated the plan or policy and acquired the necessary valid consents. ● Social workers need to communicate, although this can be challenging in a new and ever-changing situation. It is important to be aware of and coordinate with local, state, and federal resources. Social workers need to keep communications secure, to the extent possible, and avoid breaching privacy and confidentiality. ● In keeping with NASW Standard 1.04(d), Competence, social workers need to be competent in the technology to provide appropriate telehealth services, if necessary. ● In keeping with Standard 1.07, Privacy and Confidentiality, it is important to ensure the privacy and confidentiality of electronic communications in every way. ● In keeping with Standard, 1.03(e), Informed Consent, social workers need to discuss their policies involving the use of technology with their clients.
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Book Code: SWTX1524
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