ETHICAL CHALLENGES AND MANAGING RISK IN SOCIAL WORK PRACTICE 2019 Chicago Social Work Conference September 13, 2019 Oak Brook, Illinois Joseph T. Monahan, M.S.W., A.C.S.W., J.D. Monahan Law Group, LLC, Chicago [email protected] 2 Introduction Joseph T. Monahan, MSW, ACSW, JD Numerous laws affect social workers: Confidentiality Civil commitment/outpatient treatment Child abuse and neglect reporting Juvenile court School student records FERPA

Domestic violence acts Americans with Disabilities Act NASW Code of ethics Professional licensing acts Employment laws Criminal statutes Social Security Act HIPAA Individuals with Disabilities Education Act Workers Compensation Act 3 Involvement in Legal Proceedings Why do social workers get sued?

Malpractice Civil Actions Theories of liability Substantive risk areas Elements Duty Breach Proximate/legal cause Injury Know the law, embrace the law! Risk management tips:

Records management Consultation Identify difficult cases early Listen to client complaints Qualifications/credentials Malpractice insurance Confidentiality Understand expectation of privacy Avoid inappropriate boundaries 4 What to do if You are Sued In the courtroom: Do not ignore court papers Contact supervisor/attorney Relationship with attorney Knowledgeable in practice area Do not speak with opposing parties Or opposing counsel

Maintain practice normal course of Know the actors Know your role Direct examination Cross examination Tips for trial participants Answer the question that is asked Do not go farther than what you know as a witness E.g. do not change record-keeping practices

5 Client Suicide Big Picture Statistics Major public health concern 2nd leading cause of death among individuals 10-34 Risk Management Policy Training Crisis response protocol Documentation Risk factors

Behavioral health issues Personal characteristics Adverse life circumstances Risky behaviors Family characteristics Environmental factors Warning signs 6 Client Suicide Professional Liability Concerns Survivors are searching for answers Protecting yourself Professional liability insurance Potentially multiple defendants Records and confidentiality Just say no! Secure the record Requests for records Speaking with family members

Self-care Tips for talking about suicide: Give accurate information Address blaming and scapegoating Do not focus on the method Address anger Address feelings of responsibility Promote help-seeking 7 Confidentiality Reasons for and importance: Privacy Foundation of the therapist-client relationship Confidentiality is complex Involves legal and ethical

knowledge and judgment General rule: All records and communications are confidential and shall not be disclosed except as provided by law What records must be maintained? With consent Without consent Subpoenas: Do not be intimidated Just say no! Who is asking, on what authority? Consultation, notification, documentation Always retain control of the original file

8 Boundary Issues & Dual Relationships Boundary violations vs. boundary crossings Identification Assessment Risk management Conceptual framework Intimate relationships Personal benefit Emotional and dependency needs Altruistic gestures Unanticipated circumstances NASW Code of Ethics 1.05 Cultural Competence and Social Diversity

1.06 Conflicts of Interest 1.09 Sexual Relationships 1.10 Physical Contact 1.11 Sexual Harassment 1.13 Payment for Services Risk management strategy to avoid boundary violations 9 Clinical Supervision & Consultation Professional supervision The relationship between supervisor and supervisee in which the responsibility and accountability for the development of competence, demeanor, and ethical practice take place. Common liabilities in the supervision context: Inadequate and improper supervision or social work guidance Sexual improprieties Outside supervision v. supervision in the workplace Formal supervision agreement or memorandum of understanding 10

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