Jane Warren Amanuel Haile Asfaw Avis Garcia University of Wyoming Professional Studies Department

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Learning from the Past to Enhance the Future: Ethics Issues and Training Needs of Rural Counseling Practitioners. Jane Warren Amanuel Haile Asfaw Avis Garcia University of Wyoming Professional Studies Department Counselor Education Program. Research Team. - PowerPoint PPT Presentation

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Wellness Articles

Learning from the Past to Enhance the Future: Ethics Issues and Training Needs of Rural Counseling Practitioners

Jane WarrenAmanuel Haile AsfawAvis GarciaUniversity of Wyoming

Professional Studies DepartmentCounselor Education Program

1Research TeamJane Warren-University of Wyoming-Department of Professional Studies - Counseling programAmanuel Haile Asfaw- University of Wyoming-Department of Professional Studies - Counseling programCarrie Ahls - University of Wyoming-Department of Professional Studies -Counseling programJohnna Carlene Nunez -University of Wyoming-Department of Social Work programJennifer Weatherford -University of Wyoming-Department of Professional Studies-Educational Research program Noor Syamilah Zakaria - University of Wyoming-Department of Professional Studies - Counseling program

OutlineIce breaker-Your most difficult ethical challenge this last year Ethics in counselingEthics challenges in rural settings Our researchRelevance of our researchApply to your own wellnessApply to your ethical challengeDialogue The Best of Times-The Worst of TimesImagine for a few minutes your most difficult ethical challenge you had this yearWhat made it difficult?What did you do?

The Best of Times-The Worst of TimesShare your insights with someone next to youBrief discussion

Ethics in Counseling

Professionalto profess to do (Ponton & Duba, 2009)Ethics make a profession, a profession

Ethics in Counseling

Counseling defined (ACA)Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals...a basic framework and that each participating organization is welcome to add a statement that fleshes out the particular specialty or area of focus.

Ethics in CounselingEthical PracticeACA Codes-APGA-1961-Ist codes5 revisions since 1961 ( every 7-10 years)March 2014 most recent changesWhy???

Ethics in CounselingACA 2014 Code of Ethics: Nine SectionsSection A: The Counseling RelationshipSection B: Confidentiality and PrivacySection C: Professional ResponsibilitySection D: Relationships With Other ProfessionalsSection E: Evaluation, Assessment, and InterpretationSection F: Supervision, Training, and TeachingSection G: Research and PublicationSection H: Distance Counseling, Technology, andSocial MediaSection I: Resolving Ethical Issues

Ethics in CounselingSix Functions of 2014 Codes1. Sets forth the ethical obligations of ACA members and provides guidance intended to inform the ethical practice of professional counselors. 2. Identifies ethical considerations relevant to professional counselors and counselors-in-training.3. Enables the association to clarify for current and prospective members, and for those served by members, the nature of the ethical responsibilities held in common by its members. 4. Serves as an ethical guide designed to assist members in constructing a course of action that best serves those utilizing counseling services and establishes expectations of conduct with a primary emphasis on the role of the professional counselor. 5. Helps to support the mission of ACA. 6. The standards contained serve as the basis for processing inquiries and ethics complaints concerning ACA members

Ethics in CounselingProfessional Values-2014 PreambleProfessional values are an important way of living out an ethical commitment. The following are core professional values of the counseling profession:1. enhancing human development throughout the life span;2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts;3. promoting social justice;4. safeguarding the integrity of the counselorclient relationship; and5. practicing in a competent and ethical manner.

Ethics Challenges in Rural Settings

Research has identified:dual relationships, multiple roles, unique community standards, isolation, lack of access to training and supervision,given cases for which they are not prepared,role conflicts,inconsistencies,idiosyncratic choices in such ethical practices as confidentiality and informed consent,burnout/self-impairment. Ethics Challenges: Errors Happen Strom-Gottfried (2003) Social Workers (NASW)--Of 267 adjudicated cases, 107 involved sexual activity, 77 involved dual relationships, 70 involved other boundary violations, 55 involved failure to seek supervision, 41 involved failure to use accepted practice skills, 34 involved fraudulent behavior, and 33 involved premature termination. Trigg and Robinson (2013) found the most frequent ethical violations were practicing outside of the scope of ones training and experience and practicing while impaired due to substance use or mental health matters (p. 28), violations of professional boundaries (both nonsexual and sexual), and breaches of confidentiality. 13The Research QuestionsIf there are ethical challenges in rural settings and research shows ethical errors occur, what might be the ethical challenges as reported by counseling practitioners in one rural state? What would counseling practitioners in one rural state want for ethics training?

Lets ask the practitioners!

Our Research Through an exploratory survey in 2012 of a representative sample (n=316) of licensed and certified counseling and social work mental health professionals (N=1,324) in Wyoming ethical issues and training needs were identified by the providers. The intended goal was to obtain direct feedback about ethical issues and ethical training needs from practitioners themselves who work in rural settings. Our Research-The SurveyA brief demographic questionnaire Two questions:The most difficult professional ethical dilemma or situation I have encountered in the last two years has been:______Two primary ethical trainings I would find to be most helpful in my practice are: self-care, boundaries, rules and regulations, malpractice, supervision, professional competency, risk management, end of life, suicide, duty to warn, confidentiality, diagnosis, spirituality, multicultural topics, and other.`

Results 316 (27%) responded to the survey**our distribution results of the survey sample (see Table 1-oour results) closely approximated the (12/29/ 2011distribution of licensing and certification in the state)CAPA- 23CAP- 623% (3%)PAT- 13 LAT- 134-7% (3%)CSW- 89PCSW- 109 LCSW- 49330% (29%)PMFT- 16 LMFT- 935% (4%)PPC- 168LPC- 75646% (47%)CMHW- 18.09%

1974 in total

Our Research FindingsEthical Issues Three primary ethical issues: Dual relationships (19%)Confidentiality (19%)Competence (17% )Two additional findings regarding ethical dilemmas encountered were professional silence and supervision representing 10% and 9%, respectively. Our Research FindingsEthical Training Needs Three primary ethical training needs: Boundaries (12%) State Rules and Regulations (12%)Supervision (10%)One respondent stated, I think in our state it is more difficult to maintain professional boundaries because of the closeness of our communities. For instance, in my neighborhood I am surrounded by former clients as neighbors. Summary The Two AreasEthical issues:Dual relationships (19%)Confidentiality (19%)Competence (17% )TrainingBoundaries (12%) State Rules and Regulations (12%)Supervision (10%)

Relevance of Our ResearchFits with the ACA 2014 Ethics Codes

Counseling relationship (A. 5. Prohibited Non Counseling Roles and Relationships-Managing Boundaries )Virtual relationshipsConfidentiality CompetenceImpairmentMonitor effectivenessConsult on ethical concernsContinued EducationObtain ethical supervision (online and in person)Relevance of Our Researchfor Counseling Ethics Education

Educate about rules and changes in codesProvide more training for supervisors and supervisionIncrease boundary education on all levelsIdentify the many challenges, choices, and requirements in confidentiality Understand the ethical issues faced by rural practitioners may be different than urbanand design programs accordingly. Relevance of Our ResearchFor Our Profession Promote dialogue among practitioners about ethical challenges and actionsEncourage compassion for practitioners Promote wellness for all counseling practitioners Relevance of Our Research for Existing Ethics EducationInform Licensing BoardsMake Continuing Education Relevant Listen to PractitionersMissing: Multicultural needs (last item mentioned for training)

Apply to Your Ethical Challenge

What have you learned and what might you do now differently, if anything?Dialogue

Questions/Discoveries

ReferencesHarrison, R. L., & Westwood, M. J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy Theory, Research, Practice, Training, 46, 203-219. doi: 10.1037/a0016081Maltzman, S. (2011). An organizational self-care model: Practical suggestions for development and implementation. Counseling Psychologist, 39, 303-319. doi: 10.1177/0011000010381790.