Ethics - Wisconsin Nursing Home Social Workers Association

Technology, Social Media, and
Professional Ethics
Presented by
Nicholas P. Smiar, PhD, ACSW, CISW
Professor Emeritus of Social Work
University of Wisconsin – Eau Claire
In memory and in honor of Dr. Leonard Gibbs,
Esteemed colleague and friend
Scenario 1
The director of a small, non-profit health care agency in
a rural setting requires his staff to receive messages
about clients on their personal voicemail systems, as a
cost saving measure.
Scenario 2
Jim, a social worker in a county child protective service
unit, has had a particularly bad day at work, dealing with
both administration and clients. He goes home and uses
his Facebook page to describe the terrible day he had at
work and to complain about the county human services
department. He does not name any clients, but he does
provide data about his day.
Scenario 3
ABC agency, which serves a Medicaid population, is so
proud of its new computerized intake system which
permits clients to register and be screened on line. The
new system saves money and provides greater efficiency
of operation.
Scenario 4
Mary works in a managed care system which handles
hundreds of cases each day. Her job is to draw private
health care information (PHI) from a database and send
that information to either a service provider or the
billing agency. She does this by attaching the document
to e-mail and sending it to the other agency.
Scenario 5
As part of his clinical practice, Jason starts a Facebook
page where he posts information about his practice, for
potential clients. He has linked his private Facebook to
the professional one and regularly receives “friend”
requests from clients. He has accepted some of his
clients who are “better put together.”
Scenario 6
In her clinical group
therapy practice, Luanne
decides to start a therapy
group on-line, as a
convenience for patients
and as a cost-efficient way
to offer services. The
group will meet in an online chat room, on a
secure website, with
password protection.
Scenario 7
A young man is admitted through the emergency
room of a hospital for an apparent overdose that
was a possible suicide attempt. The admitting
physician requests the social worker’s help in
locating information about the patient who was
brought in by ambulance after being found
unconscious in a public place. The suggestion is to
search for the individual on Facebook and Twitter,
to locate any statements about suicide attempts or
any information that would facilitate patient care.

[adapted from Chernack, K.B. (2012). The ethics corner: Beyond the
friend request. Update, (Summer), p. 9]
Scenario 8

After Fred does an initial assessment, gathering
information from the client, and after the client has left,
he goes onto the Web and searches out all of the
information he can find about the client, including any
Facebook or other social networking site, and places the
information in the client’s file, as part of the assessment.
Oh, the possibilities!
 e-mail, cell phone, texting, fax, voicemail, Twitter, blogging

social networking: Facebook MySpace, YouTube, Bebo, Friendster,
LinkedIn [see:
http://en.wikipedia.org/wiki/List_of_social_networking_websites]
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
chat rooms, videoconferencing
Tele-health – provision of on-line therapeutic services
◦ Iondividual and group psychotherapy
◦ Psychoeducational program software

at agency level:
◦ LAN services, shared servers, contracted servers
◦ case management programs
 generating reports
 assisting service planning and delivery
◦ automated billing
◦ human resources management software
◦ budget construction and monitoring
Objectives of this workshop:
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to maintain and improve the quality of technologyrelated services provided by professionals;
to serve as a guide to professionals incorporating
technology into their services;
to help professionals monitor and evaluate the ways
technology is used in their services;
to inform clients, government regulatory bodies,
insurance carriers, and others about the professional
standards for the use of technology in the provision of
professional services.
(adapted from: NASW & ASWB. (2005). NASW & ASWB Standards for Technology
and Social Work Practice. Washington, DC: NASW Press & ASWB.)
Some definitions: Technology

“A set of prescribed events that are embedded in
hardware, software, or telecommunications and that
direct activities, decisions, or choices. Sometimes
technology is divided into hard technologies, such as
switches and electronics, and soft technology, such as
the processes and procedures associated with accounting
or risk assessment.”
◦ NASW & ASWB. (2005) , NASW & ASWB Standards for
Technology and Social Work Practice, Glossary of Terms
Some definitions….
Ethics – standards regarding the “rightness” or
“wrongness” of an action; may be personal,
professional, organizational. Based on core
values, connected to standards of action.
 Code of Ethics – a formal and codified statement
of core values of a profession, connected to
standards of action, as a guide for evaluation of
one’s own actions first, and then of the actions of
other professionals; a hallmark of a profession and
part of the agreement between a profession and
society: “reasonable expectations by the public.”

Law and Ethics


MPSW 20 Code of Conduct – regulation, attached to Chapter 457,
applicable to Licensed Marriage and Family Therapists, Licensed
Professional Counselors, and Licensed and Certified Social
Workers; set of prohibitions of professional misconduct; not an allinclusive list; makes reference to “standards of practice.” Oriented
to enforcement.
Professional code of ethics: accepted standards of practice;
reasonable expectations of the public, on the basis of professed core
values. Oriented to voluntary compliance.
◦ NASW Code (1999): http://www.socialworkers.org/pubs/code/code.asp
◦ NBCC (2005): http://www.nbcc.org/Assets/Ethics/nbcc-codeofethics.pdf
◦ ACA Code: (2005):
http://www.counseling.org/Resources/CodeOfEthics/TP/Home/CT2.aspx
◦ AAMFT Code (2001):
http://www.aamft.org/iMIS15/Content/Legal_Ethics/Code_of_Ethics.aspx
◦ APA Code (2010): http://www.apa.org/ethics/code/index.aspx
Other applicable standards…


NASW and ASWB Standards for Technology and Social
Work Practice, at URL:
http://www.aswb.org/pdfs/TechnologySWPractice.pdf
NBCC Standards for Web Counseling, at URL:
http://nbcc.org/AssetManagerFiles/ethics/internetCouns
eling.pdf
Technology in the codes…
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NASW 1.07
NASW & ASWB Standards for Technology and Social
Work Practice
ACA Code (2005) A. 12. Technical applications
NBCC Code (2005) B. 6, 12-15.
AAMFT – no specific sections
Further thoughts…
Think of the Code of Ethics as
the reasonable expectations
by the public of behavior of the
professional, based on the
professional’s profession of core
values to the public…
 …and so, the Code of Ethics is
not a set of externally derived
and applied rules (prohibitions)
but an internally developed
guideline which forms the
agreement between the
profession/professional and
society and to which each
professional explicitly
subscribes.

Ethics and Law

Ethics – social justice: what is
right or fair.
◦
◦
◦
◦
NASW Code of Ethics
NBCC Code of Ethics
ACA Code of Ethics
ACA Ethical Standards for
Internet On-Line Counseling
◦ AAMFT Code of Ethics
◦ APA Code of Ethics

Law – legal justice: following
the rules of the court
◦
◦
◦
◦
◦
Chapter 457 [law]
MPSW 20 [regulation]
Chapter 455 – Psychologists
Psy 5 Code of Conduct
HIPAA/HITECH
Applicability of Codes of Ethics

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
Rule of the court: In legal
matters regarding ethical
practice, the code of ethics of
the largest professional
organization in the field shall
apply, as accepted standards of
practice.
In social work: NASW
(150,000 members).
In counseling, the NBCC and
the ACA
In marriage and family therapy,
the AAMFT
Ethics and Regulation
MPSW 20 Code of Conduct
MPSW 20 Code of Conduct




Part of MPSW, the set
of regulations attached
to Chapter 457.
Applies to Social
Workers, Marriage and
Family Therapists, and
Professional Counselors
As regulation, has the
force of law.
Is not an exclusive list
of prohibited activities
but refers to “accepted
standard of practice.”
Let’s Review MPSW 20

Note:
◦ MPSW 20 addresses principally the obligations to
clients.
◦ MPSW 20 is phrased in negative terms, i.e., what
the professional should not do.
◦ Almost all of what is contained in MPSW 20
appears also in the professional codes of ethics,
with a few exceptions:
 violation of the law in matters related to professional
practice - MPSW 20.02 (2)
 determination of end of the professional relationship –
MPSW 20.02 (11)
MPSW 20 Conduct
“20.02 Unprofessional
conduct…includes, but is
not limited to, engaging in,
attempting to engage in, or
aiding and abetting the
following conduct…..”
 The accepted standard of
practice to which MPSW
20.02 refers is the code of
ethics of the profession. And
it will be used in the
definition of unprofessional
conduct.

MPSW 20: Unprofessional conduct
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Unqualified practice
Violation of the law
Incompetent practice
Fraud or deception in
application
False advertising
Fraudulent billing
Making false statements
Discrimination
Practice while impaired
Violating confidentiality

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Sexual contact, conduct, etc.
Failure of notice
Harmful dual relationship
Failure to conduct assessment,
evaluation, or diagnosis
Claiming secret knowledge
False research practices
Failure to notify regarding
financial conflicts of interest
MPSW 20: Unprofessional conduct


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Failure to maintain adequate
records
Violating any provisions of
Chap. 457
Failure to notify the Social
Work Board of status of license
or certification

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
Failure to notify regarding
interruption or termination of
service
Gross negligence
Having license or certification
which has been revoked,
suspended, etc., without notice
to the Social Work Board
MPSW 20.02
Professional Misconduct
(1) Performing or offering to perform services for which the credential holder is
not qualified by education, training or experience.
(4) Using fraud or deception in the application for a credential.
(5) Using false, fraudulent, misleading or deceptive advertising,
or maintaining a professional relationship with one engaging
in such advertising.
(6) Engaging in false, fraudulent, deceptive or misleading
billing practices.
(7) Reporting distorted, false, or misleading information or
making false statements in practice.
(10) Revealing facts, data, information, records or communication received. from
a client in a professional capacity
(13) Failing to avoid dual relationships or relationships that
may impair the credentialed person’s objectivity or create a conflict
of interest.
(18) Failing to maintain adequate records relating to services
provided a client in the course of a professional relationship.
Ethical issues may arise in regard to …


Boundaries and the use of social media – NASW 1.09-1.11; 2.072.08; MPSW 20.02 (13)
Electronic communications and records – NASW 1.08, 3.04;
MPSW 20.02 (18); N&A 7
◦ E-mail – the ethics of e-mail
◦ Data storage and access
◦ Data transmissions

Electronic provision of services - telehealth
◦ Identification and verification of clients
◦ Regulatory competence: Practicing only where licensed or certified N&A 5

Access by professionals and by clients – the “digital divide” NASW
3.08, 6.0; N&A 2
Ethical issues may arise in regard
to…

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
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Technical and professional competence in the use of technologies
and continuing education NASW 3.08, 4.01 (b); N&A 4, 10
Risk management - NASW 1.02, 1.03 esp. (e), 1.16 (f), 3.06; N&A
8
Cultural competence and vulnerable populations NASW 1.05;
N&A 3
Practice competencies
◦ Supervision N&A 9-6
◦ Advocacy N&A 9-1
◦ Community practice N&A 9-2
◦ Administrative practice N&A 9-3
◦ Research N&A 9-5
Competency
“Social workers shall be
responsible for becoming
proficient in the
technological skills and
tools required for
competent and ethical
practice…
 and for seeking appropriate
training and consultation to
stay current with emerging
technologies.”
◦ connection to continuing
education, professional
development, and
supervision
(NASW/ASWB, 4)
Legal and Regulatory Competencies

The professional abides by all laws and regulations in
the professional’s jurisdiction and in the jurisdiction in
which the client is receiving services
◦ knowledge of law and regulation in regard to practice
but also in regard to technologies, e.g., HIPAA,
HITECH, etc.;
◦ no practice in other jurisdictions unless qualified there
by state licensure or certification. [crossing state or
jurisdictional lines while offering services]
(NASW/ASWB, 5; ACA, A. 12. e; NBCC Web 13)
Access

“Social workers shall have
access to technology and
appropriate support systems to
ensure competent practice and
shall take action to ensure client
access to technology.”
(NASW/ASWB, 2.)

Ethical obligations in regard to:
advocacy
digital divide
“Counselors provide reasonable
access to computer applications
when providing technologyassisted distance counseling
services.” (ACA, A. 12. d)
THE USE OF SOCIAL MEDIA
What are the “social media”?

From Wikipedia:
Social media includes web-based and mobile
technologies used to turn communication into
interactive dialogue. Andreas Kaplan and
Michael Haenlein define social media as “a
group of Internet-based applications that build
on the ideological and technological foundations
of Web 2.0, and that allow the creation and
exchange of user-generated content.”
◦
Kaplan, Andreas M.; Michael Haenlein (2010). "Users of the world, unite! The challenges and
opportunities of Social Media". Business Horizons 53 (1): 59–68. doi:10.1016/j.bushor.2009.09.003
The social media…

Social networking now accounts for 22% of all time
spent online in the US.
[http://blog.nielsen.com/nielsenwire/global/social-media-accounts-for-22-percent-oftime-online]

A total of 234 million people age 13 and older in the
U.S. used mobile devices in December 2009.
[http://digital.venturebeat.com/2010/02/10/54-of-us-internet-users-on-facebook-27on-myspace/trackback]

If Facebook were a country it would be the world's 4th
largest between the US and Indonesia.
[http://digital.venturebeat.com/2010/02/10/54-of-us-internet-users-on-facebook-27on-myspace/trackback]
Social media sites…

Social networking: Facebook, MySpace, Twitter,
Flixster, Hi5, Last.fm
◦ Mobile sites: Dodgeball, Friendstribe, Groovr, Gypsii, Loopt,
◦ International sites: Badoo, Migente, Orkut, Studivz, Mozes,
Peepsnation, Socialight, Wattpad,

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Social News: Digg, Propeller, Reddit
Social photo and video sharing: YouTube, Flikr
Wikis: Wikipedia, Wiki, Wetpaint, PBWiki, Wikispaces,
Wikidot, Central Desktop, SocialText, Stikipad,
EditThis. Info, Seedwiki
What are the risks?
Boundary crossings and violations (NASW 1.06)
◦ Link between professional page and personal
page – unintentional and intentional selfdisclosure?
◦ “Friending” a client – boundary violation?
◦ Acquaintances in common – boundary
crossing?
 Breach of privacy or confidentiality (NASW 1.07)
 Using social media to deliver services – We’ll
discuss this later, in regard to telehealth

Facebook Disclaimer:

“Risks inherent in sharing information. Although we allow you
to set privacy options that limit access to your information, please
be aware that no security measures are perfect or impenetrable. We
cannot control the actions of other users with whom you share your
information. We cannot guarantee that only authorized persons will
view your information. We cannot ensure that information you share
on Facebook will not become publicly available. We are not
responsible for third party circumvention of any privacy settings or
security measures on Facebook. You can reduce these risks by using
common sense security practices such as choosing a strong
password, using different passwords for different services, and
using up to date antivirus software.”
To use Facebook or not…?

What is on the Facebook profile?
o Facebook Page: professional use, one-way
o Facebook Profile: personal content, photos, etc.

Are privacy controls set?
o Digital “natives”
o Digital “immigrants”
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What is the context of therapy? (e.g., client age, culture, clinical
setting, therapeutic approach, size of community)
Who is the client? (e.g., clinical issues, boundary instincts)
Why did the client post the request?
Will this set a challenging precedent for other clients?
What are the HIPAA and documentation implications?
Will “Friending” a client create complex boundary issues?
[from The Zur Institute]
ELECTRONIC
COMMUNICATIONS –
E-MAIL
The ethics
of e-mail
E-mail
From:
http://www.chacocanyon.com/pointlookout/050406.shtml


Whatever is unethical in
life and practice is
unethical in e-mail also.
Unethical:
◦ denial
◦ disclosing e-mail to harm
someone
◦ abusive omission
◦ misidentifying oneself
◦ faking a mishap
◦ dragging your feet
◦
◦
◦
◦
◦
silence
misrepresenting a quote
pleading false confusion
intentional ambiguity
wandering eyes (like
postcards in the mail)
◦ forgery, e.g., editing the
headers
◦ masquerade – misusing
another’s e-mail account
E-mail, texting, etc.
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Do I or does my agency have a policy about e-mail use and has the
policy been shared with clients verbally and in written form?
[NASW 1.07]
Am I using the e-mail for general/administrative purposes or for
therapeutic purposes? [see standards for on-line clinical work]
Is the e-mail providing access outside of regular hours, or is it a
primary mode?
Does this e-mail communication fall under HIPAA/HITECH
because it contains PHI? [see standards re documentation and
records]
Should this e-mail communication be documented as part of the
client’s record? [see standards re documentation]
How accessible is this e-mail or the e-mail system to outsiders?
Compromise of privacy and confidentiality? [see standards re
privacy and confidentiality]
Remember: If it is in writing, electronic or otherwise, it is and
ought to be part of the record.
[from The Zur Institute]
To Google or not to Google?

The professional googles
the client…with consent,
without consent
◦ Level 1: Curiosity (Google
Light)
◦ Level 2: Due diligence:
thorough search
◦ Level 3: intrusive search to
Listservs
◦ Level 4: Deceitful –
Facebook, chat rooms
◦ Level 5: Illegal search –
cyber-stalking
(from The Zur Institute)
To Google or not to google?
Why are you googling?
What is the
connection to the
service?
 Is the client aware of
this practice?
(Informed consent)
 What are you doing
with the information?
Into the file, shared
with others?

Services offered electronically
Terms used…
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Internet-supported Intervention
Web-based therapy
E-interventions
Computer-mediated interventions
Online therapy
Online counseling
Technology assisted distance counseling (TADC)
E-therapy/e-counseling
Cybertherapy/cybercounseling
E-health
Psycho-technology
Tele-Health
Internet counseling
Therap-E-Mail
 From: Fredric Reamer, Ethical Issues Related to Social Workers’ Use of Social Media and Online
Services, Power Point presentation. Copyright 2012, NASW. Reprinted with permission from NASW
Lunchtime Series Webinars 2012
Forms of electronic services
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E-therapy chat (live)
Moderated forum
Web-based psychoeducation
Self-guided Web-based interventions with automated feedback (e.g., anxiety, phobia, selfesteem, anger, weight loss)
◦
◦
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Human support
No human support
Video conferencing
Telephone therapy
Avatar therapy
Expert systems
Email exchanges
Text messages
Client Blogs
Client Twitter

From Fredric Reamer, Ethical Issues Related to Social Workers’ Use of Social Media and Online Services, Power Point
presentation. Copyright 2012, NASW. Reprinted with permission from NASW Lunchtime Series Webinars 2012
A Taxonomy of Technology-Assisted
Distance Counseling

Telecounseling [synchronous]
◦ Telephone-based individual, couple, and group
counseling

Internet Counseling [synchronous or
asynchronous]
◦ E-mail-based individual counseling
◦ Chat-based individual and group counseling
◦ Video-based individual, couple, and group
counseling
 NBCC, Practice of internet counseling
Why do on-line services?
 Less expensive means of service delivery for
the professional
 Convenience for client and professional
 Reduces or eliminates the effects of
geographical distance and physical barriers.
 Non-face-to-face interaction may be safer for
shy or anxious clients.
 Permits more flexible scheduling
49
Why not do on-line services?
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You do not have the
practice context to support
it.
It may open you to 24
hr/day availability.
You may not have the
regulatory competence.
You must ensure that your
assessment connects with
the choice of service.
On-Line Clinical Work
Done only through secure websites or through e-mail systems
which use encryption (ACA, 12.g.,6)
 Only general, non-confidential information is offered via
non-secure websites, e.g., information of interest to users of
the website; referral information; contact information; links
to related sites (licensure board, professional association, etc.)
 The website is constantly monitored and updated.
 The website provides notice of

◦
◦
◦
◦
◦
limitations confidentiality of information transmitted over the Web
security of the website itself
whether encryption will be used
whether special software is needed to receive encrypted messages.
supervision of the services
Risk management


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“…ensuring high-quality
practices and procedures
…that are legally sound
and ethical
…to protect clients and
safeguard against
litigation.” (NASW/ASWB 8).
◦ assessment of risks
◦ policies and procedures
to reduce or eliminate
risks
Risks in on-line clinical work




Potential treatment of minors
without appropriate consent
(NBCC, Practice, 2; ACA
12.h.5).
Limitations to and inadvertent
compromises to
confidentiality (NBCC,
Practice, 10-12; cf.
HIPAA/HITECH regulations);
Unknown cultural differences
of the client (NBCC, Practice,
9);
Inability to respond to crisis
or emergency situations
(NBCC, Practice, 6);
Risks in 0n-line clinical work
Equality or inequality of
telehealth and face-to-face
treatment modalities;
 Licensing issues – treating
clients across state lines
outside of one’s
jurisdiction (NBCC, B. 13.; ACA,

A. 12. e.; NASW & ASWB, 5).

Possible technical
disruptions and failures
(NBCC, Ethical Practice,
4).
◦ Risks from: Scheetz, K., &
Barnett, J. (2010).
Behavioral telehealth:
Ethics, law, and effective
clinical practice. APA
Risks in on-line clinical work:

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inappropriateness of individuals or their treatment issues
for telehealth modalities (ACA, 12.c).;
adequacy of assessment and diagnosis of individuals via
telehealth;
loss of important non-verbal information, including
body language, eye contact, appearance, posture, and
grooming;
inability to assess the accuracy and consistency of the
client’s identity online, as well as the client’s inability to
adequately assess the clinician’s qualifications;
Recommendations for Risk Management

Secure informed consent so that the client is fully informed
regarding the work (see ACA, 12.g., and NBCC, Practice, 112)., The informed consent should include information about:
◦ maintaining confidentiality and possible breaches of
confidentiality;
◦ The entering of, storage of, access to, maintenance of, and
destruction of records;
◦ the use of encryption for communications ;
◦ emergency procedures, such as calling 911 or a local crisis
hotline, when the professional is not available ;
◦ factors which may affect service delivery, such as time
zone differences, local customs, and cultural or language
differences;
Recommendations for Risk Management

Informed consent (continued):
◦ method for establishing client identity;
◦ accommodations for persons with various challenges;
◦ links to ethical and legal codes and professional
associations, esp. on the topic of internet clinical work.
◦ all colleagues, supervisors, and employees, such as
Informational Technology (IT) administrators, who might
have authorized or unauthorized access to electronic
transmissions.
◦ all authorized or unauthorized users including family
members and fellow employees who have access to any
technology clients may use in the counseling process.
Recommendations for Risk Management
Use of a password for access; changed regularly
 Watch what you put on line:

◦ Be aware that anything which you have posted on line can be read
by clients.
◦ Clients have access to your website, blogs, chat rooms, bulletin
boards, list serves, etc.
◦ Want to know what your clients can find out? Google your name.
◦ You can remove private or incorrect information. Go to:
www.ReputationDefender.com, or any similar website.
Provide only services which you are qualified to provide and
not as adjunct to your regular services and not as your only
service.
 Do on-line consultation with colleagues only when you have
written consent from the client.

Identification and verification


The professional…
represents himself or
herself to the public
accurately
◦ in advertising, esp. on
the Web
…makes an effort to
verify client identity and
contact information.
◦ in transactions with
client electronically
Documentation

“Social workers shall
protect client privacy
when using technology in
their practice and
document all services,
taking special safeguards
to protect client
information in the
electronic record.”
(NASW/ASWB, 7).
Electronic Records

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
Recording, storing, maintaining, using, and transmitting
electronic data, esp. private and confidential information,
according to ethical and legal/regulatory requirements.
Use of appropriate procedures: encryption systems, on-site
file servers with fire walls, creating regular back-ups,
password protection, and audit trails.
Information given to clients regarding electronic records:
access, informed consent, limitations, length of time records
are held, and procedure for destruction of data.
Records must be accurate and must describe the standard of
care provided.
Documentation of client’s informed consent for release of
information or notice to the client when a record is released
without client consent.
(NASW 1.07, n; NASW/ASWB, 7; NBCC, B, 6; HIPAA/HITECH
compliance)
Records (cont.)

Electronic transfer of client
records:
◦ only when both sending and
receiving entities have secure
transfer and acceptance
capabilities [e.g., encryption];
◦ the recipient is able to
effectively protect the
transferred information
[HIPAA/HITECH
compliance];
◦ the informed consent of the
client is in place prior to the
transfer.
◦ (ACA, B, 3, e)
Practice Competencies and
Technology
•Supervision
•Advocacy
•Community Practice
•Administrative Practice
•Research
Practice Competencies: Supervision
Following applicable laws regarding supervision
and the use of technology for licensure.
 “Persons receiving supervision have a
responsibility to become familiar with these
definitions and meet the requirements” – law,
regulation, third-party payers, and professional
entities. ( NASW & ASWB, 9-6
 Use of supervision by use of technology for
regular supervision:

◦ Adequacy
◦ Suitability
Practice competencies: Advocacy

“Social workers shall use technology to inform and
mobilize communities about policies that will benefit
individuals and groups and seek to provide tools,
opportunities, and information so that clients are able to
advocate directly for their own interests.” (NASW/ASWB, 9)
[empowerment; case and cause advocacy]

Ethical obligation regarding advocacy: “Social workers
should promote the general welfare of society, from local to
global levels, and the development of people, their
communities, and their environments. Social workers should
advocate for living conditions conducive to the fulfillment of
basic human needs and should promote social, economic,
political, and cultural values and institutions that are
compatible with the realization of social justice.” (NASW , 6.01).
Community Practice

“The social worker shall advocate for the adoption and
use of relevant technologies that will enhance the wellbeing of communities.” [advocacy]. (NASW/ASWB Standard 9.2)
Cultural competence and vulnerable
populations



NBCC, Practice, 9: “Internet counselors are aware that some
clients may communicate in different languages, live in different
time zones, and have unique cultural perspectives. Internet
counselors are also aware that local conditions and events may
impact the client.”
NASW & ASWB, Standard 3: “Social workers shall select and
develop appropriate online methods, skills, and techniques that
are attuned to their clients’ cultural, bicultural, or marginalized
experiences in their environments. In striving for cultural
competence, social workers shall have the skills to work with a
wide range of people who are culturally different or who may be
considered a member of a vulnerable population, such as people
with disabilities and racial, ethnic, and sexual minority status, and
those whose primary language may not be English.”
NASW Code of Ethics, 6.04 Social and Political Action: “(b)
Social workers should act to expand choice and opportunity for all
people, with special regard for vulnerable, disadvantaged,
oppressed, and exploited people and groups.”
Administrative Practice:

“Social workers shall keep themselves informed about
technology that will advance quality program operations
and service delivery, invest in and maintain such
systems, and establish policies to ensure access,
appropriate security, and privacy in agency information
systems.” (NASW & ASWB, 9-3).
◦ ensuring availability and access
◦ training for those using the technology
◦ attention to information security and risk management
Practice Competencies: Research:

“Social workers
conducting, evaluating,
disseminating, or
implementing research
using technological
approaches shall do so in
a manner that ensures
ethical credibility and
ensures the informed
consent of the
participant.” (NASW/ASWB,
9-5; see also: NBCC, Section E, 1-6).
Research

Research
◦ ensuring the informed
consent of the subjects
◦ evaluating the
credibility and
limitations of the
research
◦ protection of data in
the electronic record
DECISION MAKING IN
ETHICS
Factors in the decision making:







One’s own personal value set and impact of the
decision on oneself
Agency philosophy, policies, procedures
Regulatory agencies and codes
Legal aspects and issues
Circumstances which affect the decision
Professional ethics
External verification (not subjective judgment)
How are these supposed to fit within the
decision making process?
Priority of professional ethics.
Ethical Rules Screen
Examine the Code of Ethics to determine if any of
the standards of the Code are applicable. These
standards take precedence over the worker’s
personal value system.
 If one or more standards apply, follow these.
 If the Code does not address itself to the specific
problem, or if several standards of the Code
provide conflicting guidance, use the Ethical
Principles Screen

[From:
Loewenberg, F. M., & Dolgoff, R. (1992). Ethical decisions
for social work practice. Itasca, IL: F. E. Peacock Publishers.
Chapter 3: Guidelines for ethical decision making, p. 59]
Ethical Principles Screen
Protection of Life
 Equality and inequality
 Autonomy and freedom
 Least Harm
 Quality of Life
 Privacy and confidentiality
 Truthfulness and full disclosure

[From:
Loewenberg, F. M., & Dolgoff, R. (1992). Ethical decisions for
social work practice. Itasca, IL: F. E. Peacock Publishers.
Chapter 3: Guidelines for ethical decision making, p. 60]
Ethical Decision Making








Determine: an ethical issue or an ethical dilemma? [conflicts of
values, rights, responsibilities].
Identify key values and principles; rank them. [Go deep into the
Code]
Identify key persons, groups, organizations with a stake in the
issue/dilemma
Identify all possible courses of action
Examine reasons for & against each action
Consult with colleagues, supervisor, ethics board; do not do
this alone.
Select the strategy, implement it, document it.
Reflect on outcomes: Monitor, evaluate, document
[From:
Reamer, Frederic G. (2001). Ethics education in social work.
Alexandria, VA: Council on Social Work Education, pp. 106-112].
Instructions for the Exercises:
Read the scenario carefully.
 Are you concerned about anything here?
 If so, what?
 Is this an ethical issue or an ethical
dilemma? What is the issue or dilemma?
 “Tag” it into the Code and MPSW 20.
 Follow the rest of the model for decision
making.

Sources
Corey, G., & Corey, M.S. (Eds.) (2011). Codes of ethics for the helping
professions. Belmont, CA: Brooks Cole/Cengage Learning.
Deardorf, W. W. (2012). Internet-based treatment: A comprehensive
review [Ethics and risk management]. BehavioralHealthCE. An online course, at URL:
http://www.behavioralhealthce.com/index.php/component/courses/?task
=view&cid=69
Finn, Jerry. (2006). An exploratory study of email use by direct service
social workers. Journal of Technology in Human Services, 24(4), 1-20.
Foxhall, K. (2000). How will the rules on telehealth be written? Monitor
on Psychology, 31(4), 38.
Gelman, Sheldon R.; Pollack, Daniel; & Weiner, Adele. Confidentiality of
social work records in the computer age.
Jurgens, Kristin, & Gregoire, Jocelyn. (Eds.). (2012). Counseling Ethics:
Philosophical and Professional Foundations. New York: Springer.
Maheu, M.M., & Gordon, B.L. (2000). Counseling and therapy on the
Internet. Professional Psychology: Research and Practice, 31(5), 484489.
Sources (continued)
Marson, S. M., & Brackin, S. (2000). Ethical interaction in cyberspace for
social work practice. Advances in Social Work, 1 (1), 27-42.
Marson, S. M., & Brackin, S. (1996). Therapy on the Internet:
Confidentiality as a misnomer, Part II. North Carolina Social Worker
Newsletter, 21 (6), 2, 6-7.
NASW & ASWB. (2005). NASW & ASWB Standards for Technology and
Social Work Practice. Washington, DC: NASW Press & ASWB.
National Board of Certified Counselors (NBCC). (2005) . Code of Ethics
Reamer, F.G. (2009, Nov. 13). Eye on ethics: Novel boundary challenges:
Social networking. Social Work Today, on line at URL:
http://www.socialworktoday.com/news/eoe_111309.shtml
Remley, T.P., & Herlihy, B. (2001). Ethical, legal, and professional issues
in counseling. Upper Saddle River, NJ: Merrill/Prentice-Hall
Sources (continued)



Marson, S. M. (2000). Internet ethics. The New Social Worker, 7 (3),
19-20.
Scheetz, K., & Barnett, J. (2010). Behavioral telehealth: Ethics, law,
and effective clinical practice. APA.
Zur Institute. (n.d.). Digital ethics: Internet and therapy. On line at
URL: http://www.zurinstitute.com/articles.html#boundariesemail