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ETHICAL CLIMATE

Presented by: Arcangel, Ana Patricia C. Dumlao, Clarissa Jane D. Mendoza, Jellian C. Olarte, Sarah Jennifer M. Ranin, Adrianne R.

ORGANIZATIONAL CULTURE


Counseling occurs within the context of an organization or institution.

The use of cultural perspective can help counselors realize the organizations complexity and the interaction between the characteristics of a setting as they influenced decision making.

This includes a need to understand the unique aspects of group or team experiences.

Culture


a) b)

c)

Counselors must fully examine the potential influence of their worldview upon their counseling practice. Counselors must strive to understand how a developed worldview may influence: The decision making of members of any culture Any individual who interacts with members of the culture The effects of the interaction between an insider and the outsider.

Counselors worldviews are shaped partially by their participation is a specific organizational culture. This may affect their decision making.  The culture is what the group learns over a period of time in regard to problem solving. This type of learning is manifested as observable behaviors-ways of thinking about the world and ways of feeling.



a) b) c)

d)

e) f)

Culture can be define as: A pattern of basic assumptions. Invented, discovered or developed by a given group As it learns to cope with its problems of external adaptation and internal integration That has worked well enough to be considered valid and therefore Is to be taught to new members as the Correct way to perceive, think and feel in relation to those problems

Any definable group with a shared history can have a culture within an organization. Therefore, an organization can have many subcultures.

Ethics and Organizational culture




Hospital-based practice is a specific type of organizational culture that generally manifests a model of practice reflected by a definable paradigm. the hospital practice model, typically known as medical model. This model is becoming increasingly prevalent in the behavioral health practices of counselors due to the influence of managed care on all mental health disciplines. Professional roles are constructed in response to institutional expectations and professional practices. Such roles also incorporate virtues obligations. Roles encompass social expectations as well as standard and ideals.

Political and moral and ethical problems will arise and persist as long as some professionals make the decisions and order their implementation by others who have not participated in the decision making. These conflicts are avoidable but must be anticipated and prevented by establishing practices that honor open and collaborative decision making. Obligations of fidelity must be made clear: open routes to collegial dialogue must be valued. Decision making that involves complexity and conflict can be broken down into manageable tasks that help facilitate collaborative discussion among rightful parties.

ORGANIZATIONAL CLIMATE
Organizational climate is how people characterize a systems practices and procedures, such as the sense of safety or fear of retribution that a counselor may feel when faced with big or small decisions. An ethical climate, one facet of an organizational climate, describes the shared perception that colleagues hold concerning ethical procedures and practices within an organization. It upholds or erodes virtues such as compassion, discernment, truthfulness, and integrity.

 a) b)

The individual and organizational variables that contribute to the ethicality of the climate are complex and multilayered. The decision maker is faced with individual, client, team and organizationally contingent factors that must be considered. A basic understanding of some of the identified variables , both for the individual and for the team is essential to intentional ethical counseling within an organizational setting. Two basic individual skills have been identified as essential to the collaborative process: The ability to assert ones thoughts and ideas The ability to clarify the content of others contribution to the decision making process.

It is essential that a working team established a due process in a particular form fir its decision making practices. The mechanism of such due process must be sensitive to multiple disciplinary perspectives and cultural gender differences and must be able to facilitate the production of a group decision.

Accountability to the organization




Ethical standards mandate that counselors are accountable to both their clients and to the organizations in which they work. It is the organizations ethical obligation to fully disclose all relevant information about its mission and practices, including its provision. Counselors who accept a position with an organization enter into a tacit agreement to honor its values and standards of practice. at the same time they have the obligation to honor their professional code of ethics.

Climate factors and ethical decisions




 a) b) c) d) e) f)

Factors in the work environment that influence the ethical decision-making climate of service organizations include the organizations socialization practices, interpersonal relationships with significant others in the workplace (peers and superior), role perceptions and individual levels of development of the service providers. Factors influence on ethical behavior of employees: Structure Ethical climate Task dimensions Influence of significant others in the environment Role perceptions and Levels of personal development of the individual service provider

Clearly an ethical climate is a product of the interaction among institution, the individual counselor, and numerous contributing influence. It is the responsibility of the individual counselor to address some of the influences before making a working covenant with the institution.

IMPAIRED PROFESSIONALS

Disability vs. Impairment

Disability is an identifiable condition that may be stable and whose functional limitations, when manifested, are recognized and often overcome with appropriate changes, assistance or accommodations. Impairment is often a gradually recognized condition that manifests when an individual attempts to perform some activity. Impairments may be manifested on a continuum by varying degrees of loss of optimal function and can have many causes.

A person with disability may also become impaired. (e.g. a counselor). Impairment may be the result of having a headache or the flu. The more dysfunctional and pervasive impairments that can disrupt professional performance typically include unrecognized or untreated chronic physical illness, substance abuse, and emotional and psychological factors such as burnout and sexual acting-out behaviours.

Definition of Impairment (Lamb, Cochran, and Jackson,1991)

It can applied to psychology interns in the following ways: An interference in professional functioning that reflected in one or more of the following ways:

An inability or unwillingness to acquire and integrate professional standards into ones repertoire of professional behaviour. An inability to acquire professional skills and reach an accepted level.

Ethically, professional impairment is a matter of concern when it leads to a decreased level of professional competence. The term can be applied to people in various professional roles, including those of student, counselor, intern, supervisee and supervisor. Findings indicated the three most common problem were: suicidal behavior, marital problem, and work problems.

The three of the more common issues related to the development of specific professional impairments are: a) burnout and job stress, b)violation of professional boundaries and c)substance abuse. A counselor who continue to provide professional service while impaired may be violated of their ethical code. A counselor is aware that a colleague or student is providing unethical service but fails to intervene may also be behaving unethically due to failure to address this issue.

Awareness that includes a working knowledge of practice standards and sensitivity to violation of these standards is the key to ethical behaviour. The impaired professional often provides clues over time that a pattern of problem behaviour exists. Typically, the unethical behaviour of an impaired colleague is not an isolated occurrence.

BURNOUT AND JOB STRESS

Burnout
Burnout is an emotional exhaustion in which the professional no longer has positive feelings, sympathy or respect for clients. It is often associated with fatigue, frustration and apathy that result from prolonged stress and overwork.

Three distinct factors (Maslach & Jackson,1986)


Emotional exhaustion including feeling emotionally overextended with work. Depersonalization, including having unfeeling or impersonal reactions to client. Lack of personal accomplishment or feeling incompetent at your work.

Counseling and work done in the helping and mental health professions are significantly stressful by their nature. All counselors at some time experience some degree of the signs of burnout. Studies reviewed by Welfare (2002) have shown that about 1-5% of those sampled suffer from a full syndrome of burnout, but approximately one-third of the counselors scored high in emotional exhaustion in a number of these studies.

Burnout should be differentiated from job stress. Stadler (1990) noted that impaired counselors have lost the ability to transcend stressful events. Not all stress is negative or rises to level that is seriously affects the function of the individual experiencing it. In fact, stress can be positive and, in its most basic sense, is the individuals reaction to challenges and changes.

There are quite a number of resources that counselors can use to enhance their personal and professional well-being in dealing with job stress and preventing burnout.

Professional Self-care skills


Continuing education Consultation and supervision Networking Stress management strategies

Personal Self-care skills


Healthy personal habits Attention to relationships Recreational activities Relaxation and centeredness Self-exploration and awareness

Studies suggest that certain client factors may contribute to therapist burnout. Among these are the number of contact hours with clients and the number of clients in a caseload that present with pervasive stressful behaviour, such as aggression or limit testing. Interestingly, therapist who work in agency settings were more prone to burnout that those working in private settings.

These data indicate the importance of climate conditions on an individual. Implications for ethical practice may include: a)setting limits on the size of a caseload, b)acknowledging duty to understand the process of burnout and prevention techniques, c)conducting research to determine how work settings can affect counselors, and d)mediating untoward effects of workplace stress on the work of counselors.

PROFESSIONAL BOUNDARIES

PROFESSIONAL BOUNDARIES
Professionals who transgress boundaries with clients, students, or participants in research may be violating clearly stated ethical standards related to detrimental counselor-client relationships. Schoener (1995) described the types of individuals who may become boundary violators and might be more likely be involved in such relationships.

PROFESSIONAL BOUNDARIES


Psychotic Individuals These professionals have difficulties with boundaries due to delusional thoughts. Antisocial, Narcissistic, and Borderline traits These individuals may appear high functioning on the surface but have the need for control and manipulation in relationships. These individuals may engage in exploitive behavior in relationships.

PROFESSIONAL BOUNDARIES


Chronic neurotic or character-disordered individuals These individuals are susceptible to lovesickness. These are socially isolated individuals who have significant emotional needs that are met through relationships with clients. Individuals experiencing life crises This can include individuals at midlife or late life and new clinicians. This can include life illness in the clinician as well.

PROFESSIONAL BOUNDARIES


Individuals experiencing life changes Life transitions, including retirement or job change (promotions/loss) can make a clinician susceptible to boundary violations.

PROFESSIONAL BOUNDARIES
Treatment Boundaries are defined and established by the professional to promote a trusting relationship and facilitate an effective therapeutic working alliance. Professional Boundaries may include limitations about such relationships factors as: establishing fee structure for services, time and session length, personal disclosure, limits of touch, and the general tone of the professional relationship.

PROFESSIONAL BOUNDARIES
Counselors should evaluate whether their current situations place them at risk for a boundary violation and keep these factors in mind as they proceed in professional practice. The most common misconception in the area of boundary violation is It couldnt happen to me. (Norris et al., 2003)

PROFESSIONAL BOUNDARIES
It is natural for counselors to be attracted to clients or to like their company sometimes. This reaction is not unusual in professionals who are highly interested in people and are motivated to help them. Counselors should try to adopt the following practices, which will provide client-centered care and maintain professionalism.

PROFESSIONAL BOUNDARIES


Provide individual care Show compassion, meet the clients needs, and show interest in the client but do not promote or encourage a relationship that leads to dependence. Be mindful of cultural ethnic characteristics. Use good communication skills Watch the level of disclosure (remember who is giving and who is receiving the therapy) ask colleagues for feedback, and seek feedback from an objective party.

PROFESSIONAL BOUNDARIES


Monitor physical boundaries Watch clothing selection, watch type of touch (therapeutic touch versus sexual touch) and avoid potentially detrimental relationships. Maintain emotional psychological boundaries Avoid enmeshment power/control issues and affection. Solve problems with the patient, not for the patient.

PROFESSIONAL BOUNDARIES


Remember your code of ethics Above all, keep in mind that you are professional who provides a professional service, and keep the focus of therapy as such.

PROFESSIONAL BOUNDARIES
Agencies can assist counselors in maintaining appropriate boundaries by developing an appropriate organizational climate through policy development. Policies that reinforce appropriate professional boundaries through proactive actions in hiring, the development of personal policies, staff performance review, and staff education are important in setting the right climate. (Sheets, 2001)

PROFESSIONAL BOUNDARIES
Personal policies should include new employee review and sign off on relevant codes of ethics prior to beginning service within the agency. The agency should have in place specific and well-outlined processes for review of unprofessional conduct complaints. These policies should address confidentiality of information and due process. Staff performance reviews should address issues of professional accountability as well as boundary issues.

PROFESSIONAL BOUNDARIES
Staff education should include new employee orientation with direct attention paid to reviewing relevant codes of ethics and a frank discussion of professional boundary issues. Ongoing employee education should consider professional boundaries as an annual topic at the minimum. Special education sessions may be held supervisory staff following an incident of professional misconduct to assist the staff in learning from the experience. (Sheets, 2001)

SUBSTANCE ABUSE

SUBSTANCE ABUSE
SUBSTANCE ABUSE Although the etiology of substance dependence and abuse is varied preexisting faulty coping mechanisms and certain predictive behaviors seem to precede professional impairment. Knowledge of risk factors related to chemical dependency can aid in early recognition and intervention.

SUBSTANCE ABUSE
The following etiologic factors have been consistently cited: Genetic predisposition Poor coping skills Lack of education and impairment Absence of effective prevention strategies Drug and alcohol availability The context of permissive environment Denial

      

SUBSTANCE ABUSE
The work place is often the last area to be affected, professional competence is affected adversely. Barriers to early recognition of the chemical dependency of colleague include: Lack of training in recognition of early signs of abuse The insidious and confusing effect of the diseases progression on daily function that leads to signs that are easily rationalized away The subsequent denial of both the impaired professional and the individuals colleagues

 

SUBSTANCE ABUSE
The task of differentiating impairment from problematic behaviors is difficult. Acting on the conclusion that impairment is even more difficult. Relatively few counselors have received training in this area. The literature (Skorina, DeSoto & Bissell, 1990) suggests that counselors tend to underestimate or fail to recognize impairment in colleagues recovery may be delayed. Suggestions for dealing intentionally with potential impairment among ones peers include primary, secondary, and tertiary levels of intervention based on the timing and need of the situation.

SUBSTANCE ABUSE
Primary intervention Include involvement in educational programs (e.g., graduate education or in service programs) These educational programs provide: Values clarification Regarding impairment and the individual conditions that often cause the impairment (e.g., adopting an attitude of assistance and compassion versus one of blame) Knowledge of potential signs of impending impairment (both individually and institutionally)

 

SUBSTANCE ABUSE
Secondary intervention Include the establishment and knowledge of sound practice standards. These standards include steps to obtain due process for both the individual who may be impaired as well as the individuals colleagues. Tertiary intervention Involves understanding and involving the necessary resources to make a direct intervention with an impaired colleague.

MOBBING

year 1960s the first use of this term occurred as applied to human behavior by Konrad Lorenz-an Australian ethnologist, he described human behavior as being similar to the behavior that animals show in scaring away an enemy.

Heinesmann (1972) -a Swedish physician, researched similar behavior among children that has subsequently been labeled bullying. Leymann (1996) -used the term mobbing to describe similar violence among adults in the workplace. -he found that work cultures created circumstances wherein marked individuals were labeled as difficult and pushed to the margins of the workgroup culture.

Davenport, Distler Schwartz, and Pursell Elliott (1999) -described mobbing as workplace expulsion through emotional abuse. -the term was derived from its root word, mob, meaning a disorderly crowd engaged in lawless violence. Davenport et al. (1999) Mobbing -is an emotional assault that targets an individual via two types of hurtful conduct from work colleagues. -one type of misconduct is overt and is considered to active aggression. -the other involves passive tactics that are more covert and often disguised between acts of occasional kindness.

Leymann(1996) Mobbing -is a process that happens insidiously over time. -distinguished five phases in this process: Conflict, aggressive acts, management involvement, branding (as difficult or mentally ill), and expulsion. Keashly (1998) -other terms have been used for these phenomena: bullying, workplace trauma, harassment, and emotional abuse in the workplace.

Davenport et al. (1999) -mobbing is the process of an emotional assault that often begins with passive, insidious marking of an individual as a threat to the norms of the organizational culture. Jones et al. (1984) -the mobbing process is like the process of marking among people with disabilities. *A distinguishable characteristic of mobbing is the organizational collusion that typically supports this insidious process.

Davenport et al. (1992) -identified organizational elements that make a working environment vulnerable to participation to in mobbing: bad management (e.g. excessive bottom-line orientation at the expense of human resources) stress-intensive workplace monotony disbelief or denial by managers unethical activities flat organizations downsizing merging.

-within this vulnerable organizational context, he suggested that the complex dynamic that results in mobbing is the outcome of an interaction among five elements: The psychology and the circumstances of the mobbers The organizational culture and structure The psychology of the mobbees personality The circumstances of the mobbee A triggering event, a conflict, and factors outside the organization

WHISTLE-BLOWING

Whistle-blower (McDonald & Ahern, 2000. p. 314) -one who identifies as an incompetent, unethical, or illegal situation in the workplace and reports it to someone who may have the power to stop the wrong. *Counselors are mandated by their codes of ethics and by state licensure guidelines to report questionable or unethical behavior, yet many are hesitant to become whistle-blowers.

TWO TYPES OF WHISTLE-BLOWIN Nathaniel (2002) INTERNAL WHISTLE-BLOWING-which is often called reporting Hunt (1995) EXTERNAL WHISTLE-BLOWING-including public disclosure by a person with inside information about a specific situation. *Whistle-blowing can be beneficial and override the negative risk by a) Providing a climate that supports the protection of current and future clients as well as coworkers b) Facilitating communication among colleagues c) Encouraging constructive problem solving

*Counselors are obligated to their employers as well as to their clients, making the decisions concerning disclosure ethically complex. *The actual experience of becoming a whistleblower can be a life-changing event if the situation is serious enough. At times, the counselors maybe receive sufficient support and the process maybe difficult, but gratifying.

*Ethical codes for counseling disciplines do provide codified standards of behavior for addressing concerns regarding unethical behavior of a colleague. *The APA and the ACA codes of ethics provide standards for informal resolution of ethical violations and for reporting ethical violations. They direct the professional first to attempt to resolve the situation by discussing it directly and informally with the other therapist, providing that confidentiality rights of the client are not violated in the process.

LEGAL ISSUES

Civil Rights Act of 1967. Title VII. Unlawful for an employer to discriminate or to fire an individual based on race, color, religion, sex or national origin

Subsequently, federal and state legislation extended this protection; for example: The Age discrimination Act in Employment Act of 1967 The Vocational Rehabilitation Act of 1973 The Americans Act of 1990

The Age discrimination Act in Employment Act of 1967


The ADEA includes a broad ban against age discrimination and also specifically prohibits: Discrimination in hiring, promotions, wages, or termination of employment and layoffs. Statements or specifications in job notices or advertisements of age preference and limitations. Denial of benefits to older employees. An employer may reduce benefits based on age only if the cost of providing the reduced benefits to older workers is the same as the cost of providing full benefits to younger workers. Since 1978 it has prohibited mandatory retirement in most sectors, with phased elimination of mandatory retirement for tenured workers, such as college professors, in 1993. Mandatory retirement based on age is permitted for: Executives over age 65 in high policy-making positions who are entitled to a pension over a minimum yearly amount.

The Vocational Rehabilitation Act of 1973


In the context of the Vocational Rehabilitation Act, the term "disabled individual" means "any person who: (1) has a physical or mental impairment which substantially limits one or more of such person's major life activities; (2) has a record of such impairment, or ; (3) is regarded as having such an impairment. This definition is closely related to the definition provided by the Americans with Disabilities Act.

The Americans Act of 1990


ADA is a wide-ranging civil rights law that prohibits, under certain circumstances, discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964, which made discrimination based on race, religion, sex, national origin, and other characteristics illegal.

US legislation has attempted to extend compensatory relief to individuals who have suffered significant mental injury as a result of hostile working environment. Arizona, California, Iowa, Wisconsin and Wyoming legally acknowledged that mental injury can result from excessive stress on job calling it mental health injury.

Levi Strauss & Co. and Saturn Corporation lead the way in establishing company philosophies that support an individuals right to a work environment that is free from mobbing. * Davenport et al. (1999) offered a list of twelve components that can create this type of culture.

Ways to Reduce Mobbing


by Davenport et al. (1999)
1.

2.

3.

4.

Mission statement includes the organizational objectives on how employees are treated; vision and value statements align all employees. Organizational structure includes clear reporting levels. Job descriptions are defined in terms of duties and responsibilities Personnel policies are comprehensive, consistent, legal, and simple including expected behaviors and standards of ethics.

5. Disciplinary issues are dealt with consistently, fairly, and expeditiously. 6. Employees buy into the goals and objectives of the organization. They have been educated regarding their role in the achievement of these goals 7. New employees are selected not only based on their technical qualification but also on the basis of their emotional intelligence , such as their capacity if dealing with diversity, working in self-directed teams and managing conflict.

8. Training and staff development- rightly valued for all employees. The system meets the needs of the changing organization. Training includes issues of human relations in addition to technical knowledge. 9. Communications are open, honest, effective, and timely. 10. Participation, teamwork, creativity, decisionmaking, trust, and empowerment are structures that allow for the highest possible degree of employees personal involvement in achieving the companys goals.

11. Conflict resolution/mediation is a mechanism for resolving conflict at all levels. There is a follow-up to ensure that the conflict has really been resolved. 12. EAP (employee Assistance Programs) or a comparable program includes behavioral risk assessment and management.

Counseling mental health, rehabilitation, and other helping organizations that employ professionals who work directly with clients should take seriously the need to establish a nonthreatening, positive environment. Mobbing and Whistle-blowing often begin with the presence of the unresolved conflict and the admirable attempt of an individual to resolve the situation

Guidelines for Whistle-blowing


1. 2. 3. 4. 5. 6.

Confirm the issue. Check your perceptions with peers. Involve others in an action plan Set deadlines Document details of your discussion. If needed, take the problem upstairs.

DECISION MAKING IN CONTEXT

Situation:
Supervisor of counselors- who experienced turmoil during his own divorce several years ago Group of counselors- approached the supervisor because theyre concerned to their colleague due to the recent marital and emotional difficulties she has been experiencing Counselor X- not been documenting her session and the level of documentation is not in the line with agency policy. Fraudulent billing goes against agency standards

Tarvydas Integrative Model of Ethical Decision Making


Stage I - Interpreting the Situation Through Awareness and Fact Finding) implies that counselors closely examine the situation and be aware of what types of situations constitute an ethical dilemma.

Stage II (Formulating an Ethical Decision)- Consult with administrator of the agency (direct supervisor) to determine what course of action to follow and are pleased to experience support for compassionate but direct intervention to address counselors issue. Possibilities include: Suspension Mandated counseling Correction of billing erors Reporting of unethical behavior to licensure board

Stage III (Selecting an Action by Weighing Competing Non-moral Values) implies analyzing the course of action from the perspective of personal competing values and contextual values. * Supervisor wondered whether she have a personal blind spot affecting your judgment because you feel personally close to this counselor and you yourself experienced turmoil during her own divorce several years ago.

Stage IV (Planning and Executing the Selected Course of Action)- the counselors determine the concrete actions that need to be taken, with consideration given to the potential obstacles to taking that course of action. * Finally, supervisor is pleased to think that a positive by-product of this intervention will further reinforce the value placed on ethics in the agency climate overall for all staff.

Social Constructivist Model


The Social Constructivist Model would also emphasize the issues in this dilemma that are art of the ethical climate from standpoint of the social relationships that constitute the climate (e.g: relationship between counselor and clients, counselor and colleagues, supervisor and clients..etc.)

Through reviewing the Tarvydas Model, it would seem that most of the viewpoints of this situation would involve a non-adversarial consensus that the counselors behavior does not meet the their shared rules of conduct for professional behavior. The more interesting issue facing the supervisor in this models process is whether or nit the counselor will disagree with this interpretation and consensus that is share by her supervisor and administration and consistent with team beliefs.

The counselor might remind the supervisor of her long-term and positive relationship with both the supervisor and team to present an alternative objective truth regarding the situation. The counselor might negotiate to the supervisor for an alternative solution for her. Counselor Supervisor

Counselor Supervisor Administrator Administrator asks an office manager from another office of the agency to step in to see if he can arbitrate an agreement regarding how to handle the situation. Counselor Supervisor Administrator Office manager of the agency If all the parties agreed to the arbitrator to abide the decision, they may implement it such as obtaining a psychological evaluation and have a mental health intervention

The supervision would include assisting her in reviewing and correcting her billing and clinical records. After considerable thought, the counselor , supervisor, and administrator agree to this arbitrated solution to the ethical dilemma.

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