Human Relations And Privacy And Confidentiality Social Work Essay

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23 Mar 2015

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("Professional Ethics", n.d., para. 1) states, "Ethics are rules and values used in a professional setting. Professional ethics concerns the moral issues that arise because of the specialist knowledge that professionals attain, and how the use of this knowledge should be governed when providing a service to the public". ("Professional Ethics", n.d., para. 1) further states "the professional carries additional moral responsibilities to those held by the population in general. This is because professionals are capable of making and acting on an informed decision in situations that the general public cannot, because they have not received the relevant training".

Most professions use professional ethics, which, are encoded in their code of ethics to internally regulate themselves and preserve the integrity of the profession as well as preventing the exploitation of clients. The codes of ethics are broad guidelines that members are required to convert to the appropriate professional behaviour. Herlihy and Corey (as cited in Corey, Corey and Callanan 2007) suggests that "a code of ethics has the following objectives:

Educate the professional about sound ethical conduct

Provide a mechanism for professional accountability

Serve as a catalyst for improving practice"

Engels, Pope and Vasquez cited in Corey, Corey and Callanan (2007) highlighted that despite these code of ethics the professional will face limitations and problems in striving to be ethically responsible. Limitations cited included:

Ethic codes may lack clarity and precision which make assessment of ethical applications difficult

A practitioner's personal values may conflict with a specific standard within an ethics code

The codes may not align with state laws or regulations regarding reporting requirements

Ethics codes should be understood and applied within the specific cultural framework)

Professional ethics can be subdivided into two levels, namely mandatory ethics and aspirational ethics. Mandatory ethics represents basic ethics, which comply with the minimal standards, while aspirational ethics are the highest standards of thinking and conduct to be sought by the professional (Corey, Corey and Callanan, 2007, p.13). Corey, Corey and Callanan (2007) states "Aspiration ethics means that the professional will seek to go further and reflect on the effects their interventions may have on the welfare of their clients". Aspirational ethics have been captured by the American Psychological Association (APA) in the general principles of its codes of ethics. (APA General Guidelines , n.d., par 1) states that "compliance with these guidelines are not mandatory or enforceable however they are intended to guide and inspire psychologists toward the very highest ethical ideals of the profession". The principles stated in the APA Ethical Principles Code of Conduct include the following:

Beneficence and Non-maleficence - This requires the psychologist to strive to benefit those with whom they work and take care to ensure they do no harm. In addition, they are to seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons.

Fidelity and Responsibility - Psychologists are expected to establish relationships of trust with those with whom they work. They should be aware of their professional and scientific responsibilities to society and to the specific communities in which they work. They should uphold professional standards of conduct, clarify their professional roles and obligations, accept appropriate responsibility for their behavior, and seek to manage conflicts of interest that could lead to exploitation or harm.

Integrity-Psychologists should seek to promote accuracy, honesty and truthfulness in the science, teaching and practice of psychology. In these activities psychologists should not steal, cheat, or engage in fraud, subterfuge, or intentional misrepresentation of fact.

Justice -Psychologists should recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists.

Respect for people rights and dignity-Psychologists should respect the dignity and worth of all people and the rights of individuals to privacy, confidentiality and self-determination. Psychologists should be are aware that special safeguards may be necessary to protect the rights and welfare of persons or communities whose vulnerabilities impair autonomous decision-making.

The other component of the APA Ethical Principles and Code of Conduct for psychologist is the Code of Conduct/ Ethical Standards, which are enforceable standards that should guide the actions of the psychologist in their professional lives. The APA has 10 ethical standards and, for the purpose of our discussion, we will focus on three of these namely, competence, human relations and privacy and confidentiality. The three standards cover a broad spectrum of issues, which will be discussed at a summary level.

The APA Ethical Principles and Code of Conduct competence standard requires the Counseling and Consulting Psychologist to "only provide services, teach or conduct research only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study or professional experience". Additionally they are expected to continuously undertake efforts to maintain and improve their competence. Finally, they should exercise self-awareness that will reduce the likelihood that they will undertake an activity, which their personal problems could prevent them from performing in a competent manner. Possessing the relevant competencies, maintaining and improving these competences and taking steps to ensure that personal conflicts or problems do not prevent them from properly executing their job is tied into the general principle of beneficence and non maleficence which are aimed at doing what is best for the client. Seeking to prevent personal conflicts and problems affecting the working relationship is consistent with the recommendation that Counseling and Consulting Psychologist maintain notes of their feelings resulting from interactions with clients. The counseling psychologist in the therapeutic relationship would maintain process notes, which among other things includes the therapist thoughts, feelings and reactions to clients. The consulting psychologist should keep notes, such as a diary, which details feelings and reactions to members of the client organization system. This self-monitoring should help the psychologist to identify problems during the therapeutic/consultative process that can negatively affect the relationship and therefore take the requisite steps such as getting counseling or terminating to prevent harm to the client.

The APA ethical standard on human relations encompasses the avoidance of unfair discrimination of clients, avoiding harm, multiple relationships, use of informed consent, and managing conflict of interest among others. Discussions in this paper will be on avoiding harm, multiple relationships and informed consent. The standard requires the counseling and consulting psychologist to "take reasonable steps to avoid harm to clients, organisational client, supervisees and others with whom they work and to minimize harm where it is foreseeable and unavoidable". Seeking to minimize harm where it is foreseeable and unavoidable bears significance for the consulting psychologist as their interventions and the resulting changes may have an impact on persons unknown. This results from the nature of the consulting relationship, which usually involve three parties, the consultant, the consultee/client system and the client groups served by the consultee (Lowan, 2002, p. 733). Additionally, the APA standard states the Counseling and Consulting psychologist should "avoid multiple relationships with clients directly or thorough a person closely associated with or related to the client". Lowman, (2002) defines multiple relationships as "those situations in which the psychologist functions in more than one professional relationship, as well as those in which the psychologist functions in a professional role and another definitive and intended role". Specific risks associated with such relationships outlined in the code of ethics include loss of objectivity and exploitation of the client by the psychologist (Lowman, 2002, p. 739). The consulting psychologist needs to be aware of the potential harm that can result from their failing to effectively manage relationships within the organization and that it can affect not only those in the dual relationship but also others in the organization (Lowman, 2002, p. 740). The challenges facing consulting psychologists in this regard are special, as in most instances a dual relationship will exist. Dual relationships in and of themselves are not always bad and they can be considered inevitable however, they need to be managed carefully. If the consultant is hired based on a referral from a member of the consultee system with whom the consultant has a previous social or professional relationship, this can present several issues. These issues includes how the consultant's perspective may be affected by information received from this person, expectations that the persons may have in terms of access to or influence on the consultant, how the dual relationship is perceived by other in the organization and is resultant impact on these persons interaction with the consultant.(Lowman, 2002, p.741). The presence of dual or multiple relationships in the therapeutic relationship can create situations in which the client feels they cannot be assertive or take care of themselves. This arises primarily due to the existence or previous existence of a therapeutic relationship that creates and uneven balance of power between the therapist and the client. These multiple relationships can include romantic involvement with a previous client after the 2 years stipulated by the standards or the therapist involvement in a business relationship with the client. The avoidance of these dual relationships are advocated for family member and close friends as the increased intimacy can reduce the therapist effectiveness as a professional. The psychologist objectivity and maintenance of professional distance is usually impaired if dual relationships are established.

Informed Consent is a particularly important area covered by this ethical standard. Freeman (cited in Lowan 2002) defined informed consent in terms of four essential elements "(1) the competence of participants to make rational decisions regarding whether or not to participate; (2) the voluntary nature of participation; (3) access to full information regarding the purposes, potential risks and benefits, and the likely outcomes of participation; and (4) the ability to comprehend relevant information". The Consulting psychologist faces peculiar challenges in obtaining informed consent, as the client is more difficult to identify. The consulting psychologist will rightly identify the organization as the client but the organization is made up of groups of individuals organized in a hierarchical structure that intrinsically carries power differentials. While the consulting psychologist can say that the organization is represented by whom ever contracted them, and these persons may be supportive of the consultation, can the same be said of others in the lower levels of the organization. The organization hierarchical structure makes one question whether participation is truly voluntary (Lowman, 2002, p.737). Additionally, contrary to group therapy where all the individuals sign an informed consent, this may not be practical for all the persons that may be involved with the consultative process. A dilemma exists even if the contracting person (organisational representative) signs an informed consent, can it be said to be truly be on behalf of all the persons in the organization? In my opinion, the matter of persons having full information regarding the purposes, potential risks and benefits of the process can also be questioned. Again, full information may be available to top management, but not to all members of the organization.

The counseling psychologist is expected to obtaining informed consent from the individuals, families, couples or groups members in the early stages of establishing the therapeutic relationship. Corey, Corey and Callanan state, "The main purpose of the informed consent is to increase the chances that the client will become involved, educated and a willing participant in therapy". Informed consent involves providing the client with sufficient information to make informed choices about entering into, and continuing the client/therapist relationship. Providing the client with information, is a way of protecting the client's rights and teaching them about their rights, which encourages the developments of a healthy sense of self and personal power (Corey, Corey & Callanan, 2007, p.154). It is important, as it outlines the basis of the relationship and is one of the means of establishing boundaries within the relationship.

The APA Privacy and Confidentiality ethical standard states "Psychologists have a primary obligation to take reasonable precautions to protect confidential information obtained through or stored in any medium". The importance of confidentiality is emphasized by Bersoff (cited in Lowan 2002) who states "except for the ultimate percept -above all, do no harm - there is probably no ethical value in psychology that is more inculcated than confidentiality". The psychologist is required to protect the information and to disclose the limitation on that confidentiality as dictated by legal or other requirements. Confidentiality in the organizational setting, poses challenges, such as the number of persons who have legitimate access to the data collected, for example management personnel or committees (Lowman, 2002, p. 738). The consulting psychologist will have to address these limitations openly and seek to establish a collective responsibility with members of the consultee system, which will promote a collective approach to the handling of such matters (Lowman, 2002, p. 738). Unlike the counseling psychologist, who deals with clients one to one, by their choice or acts on behalf of a third party, in which case the client is informed and can chose what information to divulge. The consulting psychologist has to work to overcome the perception of possible victimization that less powerful persons within an organization may feel if they disclose certain information. This can prevent the psychologist from obtaining important information, and if it is received, he/she may be faced with an ethical dilemma of how to use the information, taking into consideration how it can affect the individual or the organization.

Based on the fore going discussions it is seen that the professional code of ethics is vital for the counseling and consulting psychologist. Professional ethics are a requirement for the profession of psychologist, just as a society cannot exist with rules and laws so psychological profession cannot exist without ethics. The counseling and consulting psychologist needs to know and practice these ethical requirements in their professional practice, failing which, they could be barred from the profession or face legal action. Compliance is required for the profession and for the individual to be economically viable, as the service provided must be of a quality that can be trusted. Professions are built on the trust that the public places in it and if that trust is eroded, it is doomed. Additionally, professional ethics protect the consumers of the service by the establishment of standards and removing some of the personal values or morals, which could be harmful. It has its limitations, as it does not provide ready-made answers for everything, only provide broad guidelines.



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