ETH2228 - Using Best Practice Ethical Decision Making Models and the Code of Ethics: A Guide for Mental Health Clinicians presents

Using Best Practice Ethical Decision Making Models and the Code of Ethics: A Guide for Mental Health Clinicians

This workshop was developed by:

Sally Sutton, MA, MSSW

Sally Sutton, MA, MSSW, is a Senior Policy Analyst at the Institute for Health Policy, Muskie School of Public Service, University of Southern Maine. Ms. Sutton completed her graduate work in social work and public policy and administration at the University of Wisconsin-Madison. In addition to over 25 years work as a social justice advocate, managing nonprofits and being involved in the debate on many public policy issues impacting social workers and their clients, Ms. Sutton has taught graduate level courses in legal and ethical issues in social work, provided continuing education workshops on the same topics, and currently serves as an officer on the board of the Maine state chapter of NASW, as well as on that group’s ethics committee.

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The objective of this course is to increase participants’ skills in identifying ethical issues and in applying both their codes of ethics and the best practice ethical decision making models in addressing complex ethical dilemmas. This training will use a number of scenarios to highlight some of the complex ethical dilemmas that mental health clinicians are likely to face. When the trainee completes this course, he or she will:

1) Know the background and basis for the NASW Code of Ethics, the American Counseling Association Code of Ethics and the American Association for Marriage and Family Therapy Code of Ethics
2) Understand common ethical dilemmas and legal issues affecting social work and counseling practice
3) Grasp the most important models for addressing and resolving ethical dilemmas, and factors that may impact those approaches
4) Comprehend the writings and teachings of the experts in the area of ethics, values, dual relationships and cultural competency

This course is primarily designed for clinicians in the early to intermediate stages of their career, or for clinicians seeking review of the subject area.


Section I: Introduction

Section II: Introduction to the Codes of Ethics

Section III: Common Code Violations and Legal Issues in Social Work and Counseling Practice

Section IV: Gaining Familiarity with the NASW, ACA and AAMFT Codes of Ethics: Finding the Ethical Issue

Section V: Key Influences on Any Ethical Decision Making Process

Section VI: Best Practice Models of Ethical Decision Making (PART 1)

Section VI: Best Practice Models of Ethical Decision Making (PART 2)

Section VII: Applications of an Ethical Decision Making Model

References and Test



Section I: Introduction

Please note the following three paragraphs from the preamble to the codes of ethics for, respectively, social workers, counselors and marriage and family therapists:

NASW code: This code offers a set of values, principles, and standards to guide decision making and conduct when ethical issues arise. It does not provide a set of rules that prescribe how social workers should act in all situations. Specific applications of the code must take into account the context in which it is being considered and the possibility of conflicts among the code’s values, principles, and standards. Ethical responsibilities flow from all human relationships, from the personal and familial to the social and professional.

ACA Code: When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decision-making process. Reasonable differences of opinion can and do exist among counselors with respect to the ways in which values, ethical principles and ethical standards would be applied when they conflict. While there is no ethical decision-making model that is most effective, counselors are expected to be familiar with a credible model of decision making that can bear public scrutiny and its application.

AAMFT code: The absence of an explicit reference to a specific behavior or situation in the Code does not mean that the behavior is ethical or unethical. The standards are not exhaustive. Marriage and family therapists who are uncertain about the ethics of a particular course of action are encouraged to seek counsel from consultants, attorneys, supervisors, colleagues, or other appropriate authorities.

Each of these statements speaks to the complex relationship between the codes of ethics and responsible ethical decision making. Mental health clinicians in each of the three major counseling disciplines are expected to thoroughly understand their code of ethics and use their code as a starting point for guiding their decision making in situations of ethical conflict.

However, each code states, in essence, that the code - by itself - is insufficient to resolve all ethical dilemmas. The responsible mental health clinician must also understand some other things.

Based on these two understandings, there are several key purposes of this introductory course on ethical decision making. As our first key purpose, we have prepared this course to enhance the understanding of the background, basis and purposes for the codes of ethics that guide the work of mental health professionals. This will allow course participants to have a better understanding of their professional responsibilities to their clients, colleagues, employers, as well as to their profession - as defined by the codes for their professions.

As you may have already inferred, the three main codes we will be examining will consist of the NASW Code of Ethics, the American Counseling Association Code of Ethics and the American Association for Marriage and Family Therapy Code of Ethics. These three codes of ethics have many similarities in how they are written and in the areas that they cover. They also have some subtle differences that are reflective of the slightly different traditions and core values of the three professions.

The codes of ethics, as the encapsulation of the core values and principles of the respective professions, have been designed to act as a foundation for the making of complex ethical decisions. In order to operate ethically, mental health clinicians are expected to be thoroughly familiar with their professional code of ethics, and to use the code as a starting point for ethical practice.

For our second key purpose, we wish to ensure that each clinician is aware of the common ethical dilemmas and legal issues that a person may encounter in their day-to-day practice - so that steps can be taken either to avoid or to handle those violations or dilemmas. Accordingly, we will provide some information about the most frequent types of ethical violations and some of the challenges that practitioners face, and the ways in which the codes of ethics inform decisions about how to resolve these challenges.

However, being familiar with the code of ethics and the most common types of violations is still not sufficient. In order to practice ethically, each mental health clinician ultimately must develop their ethical understanding to the point where good ethical decision making is almost second nature, incorporating key elements of the codes, as well as other important knowledge of ethical decision making processes, into a systematic and thorough approach to identifying ethical violations and resolving dilemmas.

To help the trainee to expand their knowledge of ethical decision making, as our third key purpose this course will present a number of best practice models or approaches that can be used for resolving ethical dilemmas. A social worker, therapist or counselor can pick the approach that best fits their style and type of practice.

To take this knowledge one step further, the course will also present a discussion of some factors that will influence the successful application of any decision making model, such as the need to be culturally competent or aware of your own values, or how to be an ethics advocate.

In line with our final key purpose, the course will provide some practice scenarios that highlight some complex ethical dilemmas. This will serve to bring the knowledge from this course closer to actual practice. We will provide a detailed analysis of the scenarios, highlighting the areas of the professional codes and the best practice ethical decision making models that are relevant to an understanding of the best course of action to resolve the ethical dilemma.