● Understand that meaning or value of medical treatment, health care, and health education varies in clients. ● Understand that beliefs and concepts of emotional well- being vary from culture to culture. ● Understand that mental health and emotional disability are culturally based and that responses to these conditions are influenced by culture as well. ● Recognize that folk and religious beliefs may influence a family’s reaction and approach to a child born with a disability or later diagnosed with physical/emotional disability or special health care needs. ● Understand that traditional approaches to disciplining children are influenced by culture.
● Understand that families from different cultures will have different expectations of their children for acquiring toileting, dressing, feeding, and other self-help skills. ● Accept and respect that customs and beliefs about food, its value, preparation, and use are different from culture to culture. ● Before providing in-home mental health services, seek information on acceptable behaviors, courtesies, customs and expectations that are unique to families of specific cultures and ethnic groups served by you. ● Acquire information during intake and/or assessment about natural helpers that may assist you, with informed consent, in providing services. The issue of informed consent should include both prescribing the need to inform clients of potential or actual conflicts and taking reasonable steps to resolve any conflict in a way that protects the client’s needs and interests. take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. Recognizing that there are many contexts within which mental health work is practiced, dual relationships are not always entirely banned by different professional association ethical codes. The word “should” in sections where dual or multiple roles are outlined within various codes of ethics implies that there is room for exceptions. However, what they are usually distinguishing is that dual relationships are not permitted when there is risk of exploitation or harm . Not banning all dual relationships puts the burden on each worker both of determining and, if needed, proving that the relationship was not harmful to the client. Five conceptual categories with regard to boundary violations generally occur around five central themes: 1. Intimate relationships : These relationships include physical contact, sexual relations, and gestures such as gift giving, friendship, and affectionate communication. For example : Amanda didn’t think much about a client’s thank-you bouquet, until a week later, at their session, he confessed his strong romantic affection for her. 2. Pursuit of personal benefit : The various forms this may take include monetary gain and receiving goods and services or useful information. For example: Lawrence was surprised to learn that one of his colleagues was receiving stock tips from one of his clients, who ran a very successful brokerage firm. 3. Emotional and dependency needs : The continuum of boundary violations ranges from subtle to glaring and arises from social workers’ need to satisfy their emotional needs. For example: Jeff thought of himself as a father figure to his clients, and encouraged them to contact him at any hour of the day, including during his vacations. 4. Altruistically motivated gestures : These arise out of a mental health practitioner’s desire to be helpful. For example: Sandra felt compelled to give a newly sober client a small loan after the client cried that she didn’t have enough money to feed her children. After Sandra gave her the cash, the client purchased alcohol and got drunk.
CONFLICTS OF INTEREST
One of the most difficult areas of responsibility to clients is conflict of interest. Workers need to avoid conflicts of interest
that interfere with the exercise of: ● Professional discretion, and ● Impartial judgment.
Dual or multiple relationships Dual or multiple relationships occur when mental health professionals relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively. Dual or multiple relationships with current or former clients should be avoided whenever possible, and the exploitation of clients for personal, religious, political, or business interests should never occur. Further, workers should not engage in dual or multiple relationships with clients or former clients where there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, workers should unprofessional behavior, such as “boundary violations,” a term that more specifically identifies harmful dual relationships. Most mental health professionals can easily recognize and identify common boundary issues presented by their clients. Likewise, most can identify examples of boundary violations around professional behavior – for example, sexual misconduct. While not exclusive to the clinical role, there are certain situations that are more challenging than others, especially for workers vulnerable to committing boundary violations. Boundary violations Conflicts of interest relate closely to other types of Boundary issues involve circumstances in which there are actual or potential conflicts between workers’ professional duties and their social, sexual, religious, or business relationships. These are some of the most challenging issues faced in the mental health profession and typically involve conflicts of interest that occur when a worker assumes a second role with one or more clients. Such conflicts of interest may involve relationships with: ● Current clients. ● Former clients. ● Colleagues. ● Supervisees and students. With that in mind, the following would be examples of inappropriate boundary violations, and thus unethical, in that workers are involved in a dual relationship that is exploitative, manipulative, deceptive, or coercive in nature: ● Buying property from a disaster client at far below its market level. ● Falsely testifying to support fraudulent actions of clients. ● Imposing religious beliefs on a client. ● Suggesting that a hospice client make you executor of his/ her will. ● Referring a client to your brother-in-law, the stockbroker. ● Friendship with the spouse of a client you are treating for marital issues.
Page 73
Book Code: SWUS1524
EliteLearning.com/Social-Work
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