Ethics UpdateFor School Counselors

Presented by:

Gary R. Schoener, M.Eq., Licensed Psychologist Director of Consultation & Training

SCHOOL DISTRICT 27926 APRIL 2013

• School or Agency rules & policies• Ethics codes• Codes of conduct (licensure board)• Laws & rules• Standard of care: what a reasonable &

prudent practitioner would do in the same or similar circumstances (failure = malpractice)

Standards for Conduct

Roles & Responsibilities• The school & professional as fiduciaries –

position of trust – explicit vs. implicit warranties – we set the rules• Supervisory role – the supervisor is

responsible for actions of the supervisee done within scope of employment – vicarious liability (respondeat superiori) vs. negligent supervision• Consultation -- is there such a thing as

negligent consultation?

Ethical Standards [ASCA Code, 2010]

• Responsibilities to students• Confidentiality• Dual Relationships• Appropriate Referrals• Standards related to group work• Danger to self or others• Student records• Evaluation, Assessment & Interpretation• Technology

Decision-making recommended by ASCA

•Define the problem emotionally & intellectually•Apply the ASCA standards & the law•Consider the student’s age &

develop-mental level•Consider the setting, child’s rights,

parent’s rights

Decision-making (continued)

•Apply moral principles•Determine your potential course of

action and their consequences• Evaluate the selected action•Consult• Implement the course of action

•Beneficence – doing good; helping•Non-maleficence – avoiding harm•Autonomy – client’s input and role• Fidelity – consistent with what

promised• Justice -- welfare of client vs. others;

fair use of resources – having a basis to proportion them

Ethical Framework

Ethical Decision-Making•Not what is ethical vs. unethical, but

the comparative ethicality of the options•Weigh which principles are best

dealt with through each option• Likely positive vs. negative outcomes

of choosing a given course of action?

 

Positive Outcomes Negative Outcomes

 Option A ______________ _________________  ______________ _________________  ______________ _________________ Option B ______________ _________________

______________ _________________ ______________ _________________

  

Decision table or chart

Professional boundaries•Confidentiality•Parent-child issues• School vs. individual•Dual relationships – limit risk, avoid• Potential exploitation• Conflict of interest• Sexual/romantic involvement

Dual relationships [ASCA Code, 2010]

Avoid dual relationships that might impair their objectivity and increase the risk of harm to students (e.g. counseling family members or children of close friends or associates). If a dual relationship is unavoidable, the school counselor is responsible for taking action to eliminate or reduce the potential for harm to the student through use of safeguards, which might include informed consent, consult-ation, supervision, & documentation.

Confidentiality• IEP Meeting & similar challenges – (a)

group discussion of confidentiality; (b) private meetings with colleagues from other fields to work out understandings.• Specific issues – who needs to know?:• Girl is pregnant • Boy involved in gang activity • Drug or alcohol abuse • Girl is sexually assaulted

Boundaries challenges

•Contact w/ students not on caseload•Children/relatives of colleagues•Gifts from parents or students• Social encounters•Recovery groups•Attending funeral, graduation, etc. –

issue of how visible to be

Ethical & Practice Challenges

• Suicide intervention – related challenges:• Keeping up to date -- assessment• Having consultative resources• Safety plans• Intervening w/ dangerousness:•What do we know about assessment?• Talk, writings, posts & what they mean• Duty to warn or protect

Caution regarding internet posts

• Some suicides and violent acts against others follow angry posts on websites or blogs;• The problem is that we have no good data on

what constitutes a warning we should heed• In the wake of tragedies, over-reaction to

writings & statements can bring about harsh treatment. A 17 year old high school student was suspended after she wrote a poem in her personal notebook including: “I understand the killings in Connecticut; I understand why he pulled the trigger” (referring to Adam Lanza)

Challenges of private knowledge• CASE 1: You have a case with severe

abuse. You visit your sister and notice the family lives next door, and her kids are going over to play in the abuse house. What actions do you take if any? • CASE 2: Your brother brags to you how he

fooled child protection into closing a case, by threatening his wife and kids to deny the complaint. What action options are there? What if any should you take?

Traditional Boundaries with regard to Information Access• Client has access to information about

the professional based on published biography or revelations, news items

• Professional only has access to information about client from disclosures or access granted through signed releases

Self-disclosure by professional• Are you obligated to answer all of the

student or parent’s questions?• There are not clear rules on this, and

there is great variability in the field•What helpful or expected?•What is risky or ill-advised?• In general, problematic if too often, too

much, too personal – Most complaint letters begin with list of alleged self-disclosures

Realities of a small community• You & client belong to same church, same

social club, same athletic club• Client lives in same building as a friend of

yours – what are the issues?• Client interacts with member of your

family, with or without knowing the connection;• Former client interacts with you or a

friend or family

Traditional Communication• Communication by traditional mail (now

called “snail mail”);• Communication by phone during limited

business hours; • Leave messages on answering machines

for later response;• Phone calls private, although a message

left might be saved;• Quick response not expected or promised

Communication in today’s world

• Expectation of being able to connect at all hours, even when professional is away from office, via cell phones, texting, etc.• Same is true for emails;• Emails and text messages create a record;• Emails can be misdirected or examined by

others – need to warn people about employer access to work computers

Technology [Section A.10. in ASCA Code]

• Promote benefits of and clarify limitations of technological applications• Advocate for equal access to technology• Take reasonable measures for maintain-

ing confidentiality of student info.• Understand the intent of FERPA and its

impact on sharing electronic records• Consider the extent to which cyberbully- ing is interfering with student’s educa- tional progress.

Text Messaging• A growing number of people do texting

instead of (or in addition to) emailing;• This is an abbreviated type of message

with less information;• This the only way to quickly reach people;• Unlike a phone call, it is silent, so people

can receive and view a text without the ring of a phone

Text Messaging (continued)

• Veterans Crisis Line (800) 273-8255 or text to 838255 http://veteranscrisisline.net • Crisis Connection has a program for

texting in 7 counties in northeast Minn. – they are receiving more texts from young people in a day than they previously received as phone calls in a month. • Some use for follow-up or crisis contacts

Smartphones & Tablets & Apps• The Therapist May See You Anytime,

Anywhere (NY Times, 2/13/12)• Cognitive bias modification (CBM) using

an app for social anxiety which directs attention away from hostile faces• Nader Amir at San Diego State –

30”/week for anxiety disorder• Daniel Pine at NIMH – 40 children with

chronic anxiety

More apps• Hazelden’s Field Guide to Life• iMedicalApps -- examines new apps•Mobilyze – “a therapist in your pocket”• Can be a source of reference information

or assist the practitioner• Can enable a client to log in personal data

and keep focused on goals• In future may use sensors

More apps

•Mood 24/7 https://www.mood247.com get to know yourself• PTSD Coach Mobile App downloaded

45,000 times in 58 countries www.americantelemed.org/i4a/pges/index.cfm?pageid=3969• Defense Dept: T-2 Mood Tracker identify

& track stress; Breathe2Relax release stress; Tactical Breather manage stress

Social Networking Sites

•Facebook -- >845 million users•50% log in on any given day; •Linkedin – 175 million members;•200 million are on Twitter •Posts can be from you, friend, relative, including children

Networking for support

• Pro-Ana blogs: social support, ways to cope, self-expression – but risk of exposure & question about whether it encourages (“pro-ana” on Wikipedia)• Bipolar: www.dbsalliance.org • Victims of abuse: rape and sexual assault

victim bulletin boards• Do an internet search about any

condition or problem to see what is there

Limiting access to sites

• On Jan. 23, 2013, US Court of Appeals for 7th Circuit ruled in Doe v. Marion County Prosecutor, striking down Indiana law that imposed broad social media restrictions on sex offenders, • The law prevented most registered sex

offenders from using social networking websites, instant messaging services, & chat rooms.

More visibility issues• If you use a family photograph on

Facebook, even with the highest privacy settings people see that photo;• Even if you don’t show your family to the

world, friends or family may show your photo or a family activity;• 90% of US physicians are on Facebook or

Linked in or some social media.

Twitter – constantly being in touch

• Twitter involves sending “tweets” – short messages sent rapidly all over• People end up engaging in something

akin to a conversation• For anyone impulsive, this is dangerous• A French court [1/24/13] told Twitter to

identify people who posted anti-Semitic & racist entries [lawsuit claims people broke French law against racist speech]

Hazards Never Imagined (for staff or even clients)• Happy slapping – assaulting someone while

others film it (usually on cell phone)• Sexting – sending racy photos of yourself or

someone else • Filming and/or broadcasting a party, or other

event• Live broadcast using cell phone or camera

(privacy invasion case – Tyler Clementi suicide at Rutgers – Dharun Ravi, age 19, convicted in Feb. 2012.)

Hazards Never Imagined (cont.)• Fake profiles• Internet harassment – which can lead to

great distress the same as any type of bullying (1/3 to 1/2 of adolescents?);• Fake emails & chat screen names – so one

can harass secretly;•Massive Defriending – being shut-out by

groups of friends or classmates on a social networking site such as Facebook

Undressing your Friends (or enemies)

• FalseFlesh.com, billed as “adult image editing software” allows you to paste someone’s face onto a nude body• “Easily make any picture a

nude picture in minutes”

Cases to lose sleep over

• Draker v. Schreiber (2006, 2008) two students created My Space site with fake photos trashing Asst. Principal – Anna Draker sued them and their parents without success;•Megan Meier, driven to suicide by “Josh,”

created by the mother of a girl she was having a dispute with;

Cases (cont.)

• Ryan Hallingan, middle school student with a learning disorder was the focus of bullying & suggestions he was gay. He hanged himself after a girl who claimed to be his friend told him publicly he was a “loser” and that she had been pretending to be just like him so she could post their conversations on line and humiliate him.

Cases (cont.)

• Ghyslain Raza, the “Star Wars Kid,” a Canadian adolescent made a video in 2002 pretending to fight with a light saber as a school project. Another student posted it, adding music, and 900 million saw it on the web. Raza was taunted repeatedly and dropped out of school. After treatment for depression he got support, some from the internet, graduated law school, and heads a foundation for preservation.

Cases (cont.)

• Jesse Logan, Ohio teenager, sent nude pictures of herself to her boyfriend. After they broke up he sent them to other girls who circulated them on line. She was called a slut & ridiculed and started skipping school. Jesse went public with her story via a TV interview in May 2008, but two months later hanged herself. A classic example of the dangers of sexting.

Cases (cont.)

• 4/21/11 Buffalo, NY. Police invade home with assault rifles; throw man on floor; call him a “pervert” and “pedophile” and confiscate all computers and cell phones in the house including those of his wife and daughter. He did not have a passcode on his wireless router and it was utilized by someone nearby to download pornography. This can be done by neighbor, or from a car.

Other networking issues

• Caring Bridge – sites related to illness: counselor’s illness?; posting on client’s bridge?;• Blogs -- posting responses;• Sites focused on special interests: • Client alerts you to site• You encounter client on a site• Former client alerts you to site

Google & Net Research • Should you “Google” a client?• Emergency Situation – identity issue;• Client denies suicide history but has

prior attempts;• Reality check on claims by client;• Checking on criminal justice history;• Screening for sex offenders

Google & Net Research (cont.)•What if the client googles you? • Intern entering therapy googles her

therapist and then wonders if she’s “blown it” by doing this.•What if they tell you? What if you

suspect?• Sites that evaluate professionals –

YELP has >25 million hits a month

Some thoughts• The internet creates a “small town” or

ethnic subgroup for all of us;•With some areas of work such as criminal

justice, there may be greater challenges – clientele, role of security;• Health care rating sites are likely to grow

and include more therapists – healthgrades.com, vitals.com

Self protection• Be aware of your web-presence • “Google” yourself• If there is false information, contact site

administrator to get things changed• Should you control on-line presence by

expanding it? Should you post your own www.google/com/profile?• Collegial discussion – develop standards

On line reviews• It’s hard to know what they mean – they

are not systematic;• The data about your work or practice may

be in error or outdates;•Many times there are only a few who do

a review so there can be a heavy influence of just a few ratings• Consumers focus on manner – civility,

perceived warmth, etc.

Consent and Disclosure•What ground rules will you have for a

given school or program for googling?• If you do “Google” someone, will you

disclose this to them?•What rules if any will you ask clients to

follow as regards the internet?• Will you ask them to maintain any

privacy or respect any boundaries?

Communications & Social Media Policy (examples)• Email: Email only to arrange or modify

appointments. Do not email content or important things we should discuss face to face…..• Rating or review sites: Info. on them is

questionable; I cannot respond to them and do not need positive ratings; ask me about any concerns you have about my services.

Communications & Social Media Policy (continued)• Text messaging: please do not use to

contact me – leave phone message for time changes, etc.; email not as good but at …. • Internet interaction: do not use wall

postings or other means of communication on the internet – none are private• Blog or Twitter: I do not follow you on

either – if there are things you want to share, bring them to a session

Communications & Social Media Policy (continued)• Friending: It is my practice to not accept

contact or “friend” requests from clients on social networking sites such as Facebook or Linkedin. They can compromise privacy and also complicate our helping relationship.•Website or Facebook Page: If you have

questions, bring them in a session. Please don’t interact on the internet.

Communications & Social Media Policy (continued)• Search Engines: I do not research my

clients on Google or other search engines. There may be occasions where you will direct me to look up something related to your life or experience, and if so we can discuss it at a future meeting. If you choose to check me out on the web I would note that not all information is accurate, and would suggest that we discuss anything which you find troubling.

Communications & Social Media Policy (continued)• Recording: Unless we have specifically

discussed it, there will be no recording of our meetings or any phone conversation. All of our discussions are private.• Records: I will maintain the records of our

work together as confidential although some billing-related information may be communicated securely. Please remember that any notes you make can compromise your privacy if not carefully protected.

Gary R. Schoener, Licensed Psychologist, M.Eq.Director of Consultation and Training

2421 Chicago Avenue SouthMinneapolis, MN 55404

(612) 870-0565 Ext. 107grschoener@walkin.org

www.WalkIn.org

CONSULTATION & TRAINING INSTITUTE