free parfessionals' prevention ethics course. copyright © 2015 parfessionals, llc., all rights...

Free PARfessionals' Prevention Ethics Course. Copyright © 2015 PARfessionals, LLC., All Rights Reserved. www.parfessionals.com

Prevention Ethics In A Multicultural World

Significance to Behavioral Health Care

http://www.parfessionals.com/


Welcome

• Introductions

• Course Outline

• Overview of prevention in behavioral health systems of care

• Overview of ethics and ethical principles

• Assumptions used for creating prevention ethics

• Applying ethical principles to multiple layers of prevention activities

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Course Assumptions

• Prevention is a collaborative process seen through a behavioral health lens, integrated throughout all levels of treatment.

• Prevention specialists provide evidence-based programs and engage in evidence-based practice.

• Effective prevention programs and skilled prevention specialists are culturally competent.

• Prevention programs are obliged to funding sources, expected to be cost-effective and capable of positive results.

• Prevention programs are held accountable for the impact they have on individuals and communities.

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Overview of Prevention in Behavioral Health Care

Behavioral health - state of mental/emotional being and choices as well as actions that affect wellness

Prevention - interventions that are intended to hinder or reduce the risk of developing a behavioral health problem, such as underage alcohol use, prescription drug misuse, and illicit drug use.

Direct Focus

• reducing risk factors

• increasing protective factors

(SAMHSA, 2014)

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Why Do We Need Prevention?

• By 2020, mental and substance use disorders will surpass all physical diseases as a major cause of disability worldwide.

• The annual total of the estimated societal cost of substance abuse in the United States is $510.8 billion.

• The estimated total of 23.5 million Americans aged 12 and older will be needing treatment for substance use.

• Each year, approximately 5,000 youth under the age of 21 die due to underage drinking.

• More than 34,000 Americans die every year as a result of suicide, with approximately one occurring every 15 minutes.

• Half of all lifetime cases of mental health issues and substance use disorders begin by age 14 and three-fourths by age

24.

• In 2008, an estimated 9.8 million adults in the U.S. had a serious mental illness.

(SAMHSA, 2014)

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Continuum of Care

SAMHSA. A Behavioral Health Lens for Prevention. (2014) Retrieved from:http://

captus.samhsa.gov/prevention-practice/prevention-and-behavioral-health/behavioral-health-lens-prevention/3

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http://captus.samhsa.gov/prevention-practice/prevention-and-behavioral-health/behavioral-health-lens-prevention/3




Levels of Interventions

Indicated

• immediate risk

• Immediate environment

Selective

• Subgroups of the larger population

• Biopsychosocial risk factors that apply to that group

• community

Universal

• Broad approach to general public

• Large community systems

• Social justice

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(SAMHSA, 2014)



Ethical Standards

The Development of " Professional Ethical Identity “

The Clarification of the Meaning of Competent Practice

The Definition of Professional Behavior

The Establishment of Standards for Accountability

The Clear Distinctions Regarding Responsibilities and Limitations of the Profession

The Validation of the Profession in the Eyes of the Public

The Creation of a System of Accountability Which Changes as the Profession Changes, Thereby Ensuring the Needs of Those Served are Met.

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(Herlihy & Corey, 2014)



Two Categories of Ethics

Mandatory

• Minimum standards

• Violations result in consequences

Aspirational

• Highest possible standards

• Understanding of values

Herlihy, B., & Corey, G. (2014). ACA Ethical Standards Casebook (7th ed.). Alexandria, VA: American Counseling Association.

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Ethical Values

Stewardship: use resources judiciously

Honesty and candor: tell the truth

Fidelity: don't break promises

Loyalty: don't abandon

Diligence: work hard

Discretion: respect confidentiality and privacy

Self-improvement: be the best you can be

Non- maleficence: do no harm

Restitution: make amends to persons injured

Self-interest: protect yourself

Autonomy: enhance freedom of personal destiny

Obedience: obey legal and ethically permissible

directives

Conscientious refusal: disobey legal or unethical

directives

Beneficence: help others

Gratitude: pass good along to others

Competence: be knowledgeable and skilled

Justice: be fair, distribute by merit

(White & Popovits, 2001)

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Prevention Professional as Agent of Change

Prevention Professional Constituents

• Indicated/Individuals

• Selective/groups &

communities

• Universal/general public

• Systems – healthcare, social

programs, government, etc.

• Funding sources

• Policy makers & decision makers

Change Agent

Top down prevention

Top down preventionBottom up prevention

Bottom up prevention

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Ethical Concepts

• Competence

• Professionalism

• Accountability & Public Trust

12



Application of Cultural Competence

Ethnic Minorities

• Each group has specific issues even with a longer presence or high growth within the U.S.

• There are recommended prevention strategies that target their needs and concerns

• Identified groups are African Americans; Latino Americans; Native Americans; Asian Americans

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Recent Immigrants

• New and/or different places of origin

• More research and familiarity is important

LGBT Community

• Needs strong legal advocacy

• Stigma and discrimination

• Less state legislation for workplace environment



Global Competence

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• Working definition(s) have been researched and highly discussed

• Different skills are needed for successful global competence

• Values and competencies are related but applied in its own way



Competence

Top Down

Knowledge acquisition & continuing

education• Emerging trends• Evidence based practices• Ability to read, interpret and

compile empirically supported research

Supervision & consultationCertification & licensing maintenanceSkills

• Communication• Networking• Advocacy• Mediation• Negotiation• Empowerment of others• Strategy & planning

Bottom Up

Present as an expert• Present & communicate

knowledge effectively• Pursue knowledge

Model behavior

• Self-awarenessIntegrityCongruenceFidelityKnowledge of barriersSkills

Cultural Competence• Understanding risk and protective

factors• Multiple sources of information• Involving community influencers• Awareness of values

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Professionalism

Cultural Competence• Understanding risk and protective

factors• Multiple sources of information• Involving community influencers• Awareness of values

Top Down

• Fidelity of program implementation

• Truth in research

• Partnerships with comprehensive care

providers and treatment teams

• Collaborative attitude

• Scope of services

• Professional boundaries

• Confidentiality

Bottom Up

• Truth in research

• Accurate, honest

communication

• Community collaboration

• Scope of services

• Professional boundaries

• Confidentiality

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Accountability & Public Trust

Individual liberty vs. public good Consideration of iatrogenic effects

Top Down

• Affiliation with funding sources

• Transparency

• Accuracy of outcome data

• Standards of proper use for public

funds

• Program fidelity

Bottom Up

• Proactive advocacy

• Accuracy of empirical needs

assessment

• Objectivity

• Student of the community

• Self-determination

Cultural Competence• Understand social exclusion• Recognize the impact of cultural

trauma• Collusion• Barriers • Systemic disadvantages• Stewardship

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Large Group Discussion

You are at a school district event where a number of prevention programs are showcasing what they do in the hopes of signing up their teenagers for participation. You overhear one of your colleagues talking with a volunteer about partying and feeling hung over within earshot of potential participants.

• Which ethical concepts apply to this situation?

• What immediate actions would you take?

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You run an after school program at a local high school and a 15 year old girl discloses to you that her mother’s live-in boyfriend has been touching her inappropriately after he and her mom partied all night. This young girl has a tone of determination when she says that she’s been keeping a large knife in her room and if he comes at her again, she will kill him.



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As a result of reporting the abuse of a 15 year old girl, you learn that reporting sexual assault to the police is discouraged in this community. You are told that the police are “all white” and don’t care about the African American population. They aren’t to be trusted and inactive. You are also told that victims have been put through terrible interrogations when they’ve reported. Not only does the community distrust the police, but for those who were lucky enough to see their abusers arrested, the court system made the victim into the “bad guy” and no justice was done. As a result, the abortion rate for young girls is high as is the use of alcohol and marijuana. You also learn that many of the young people coming into your program are young women who have been repeatedly sexually assaulted.


• What actions would you take?

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Your supervisor asks you to put together a grant proposal for a program targeting Hmong families in the community. You know nothing about the population and are unable to find research to support the need for a program. When you tell the supervisor the circumstances, she tells you to make something up because the organization needs the money to keep other programs going too.



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Small Group Discussion

Option 1

Invite participants to explore one or both of the following websites:

Behavioral Health Solutions of South Texashttp://rgvcouncil.org/stagging/

Wisdom of the Elders, Inchttp://rgvcouncil.org/stagging/

Discussion questions

1. In what ways are these programs culturally competent?

2. Invite participants to comment on what ethical values and concepts they see illustrated.

Option 2

Invite members of small group to discuss ethical situations they have encountered and include how they were

handled.

Get feedback from other group members.

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http://rgvcouncil.org/stagging/





Conclusion

• Prevention is about people

• Aspire to the highest ethics standards available

• Engage people of influence as an agent of change

• Advocate for social justice

• Get to know the communities you serve

• Never stop learning

• Consultation can be repeated and continuous

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Please fill out the Evaluation.

Thank You!Trudi A. Griffin, MS, LPC-I Julie R. Cotton, MSW, MLIS Jorea Kelley-Hardison, CIT

PARfessionals’ Team of Stars


free parfessionals' prevention ethics course. copyright © 2015 parfessionals, llc., all rights...

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