Evans, Arthur L.

Sherr, Michael E.

English

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Cedarville UniversityDigitalCommons@CedarvilleSocial Work Faculty Publications Department of Social Work2006Navigating Through Dual Relationships: Applyingan Ethical Continuum in a Rural Field PlacementArthur L. EvansMichael E. SherrCedarville University, msherr@cedarville.eduFollow this and additional works at: http://digitalcommons.cedarville.edu/social_work_publicationsPart of the Social Work CommonsThis Article is brought to you for free and open access byDigitalCommons@Cedarville, a service of the Centennial Library. It hasbeen accepted for inclusion in Social Work Faculty Publications by anauthorized administrator of DigitalCommons@Cedarville. For moreinformation, please contact digitalcommons@cedarville.edu.Recommended CitationEvans, Arthur L. and Sherr, Michael E., "Navigating Through Dual Relationships: Applying an Ethical Continuum in a Rural FieldPlacement" (2006). Social Work Faculty Publications. 46.http://digitalcommons.cedarville.edu/social_work_publications/46     The New Social Worker     Winter 006Ethics & Field Placement At age 55, returning to school to pursue my (Arthur’s) MSW represented both an opportunity for a second career and a progression in how I live out my spiritual beliefs. For 30 years, I worked as an ordained pastor in the Assemblies of God church where I served on staff at churches in rural areas in Idaho, Colo-rado, and Oregon. Being a pastor in the Assemblies of God church, I was trained to see a person’s relationship with God as the key to understanding and address-ing social problems. During my last few years as a pastor, I started seeing more and more people in my congregation coming to me for help with challeng-ing problems. Although I tried offering moral guidance, I realized that many people needed more than prayer and di-rection from biblical texts. I began to feel trapped and conflicted between wanting to offer more help and staying within the parameters of my role as a pastor. I reached a point at which I thought to myself, “I am tired of ministering to people, I want to minister with people.”  As a second-year graduate student in the MSW program at Northwest Naza-rene University (a CSWE-accredited program), I have found the right balance of acquiring the knowledge, values, and skills to work with people, while also growing and reflecting upon my rela-tionship with God. As I complete my concentration field placement, however, I have learned that when it comes to providing direct services, being a former pastor of a local church in a rural area makes balancing dual relationships with clients unavoidable. Arthur’s Dilemma: To Serve or Not to Serve My concentration field placement is at a behavioral health clinic where I am learning to provide individual, group, and family counseling. Located in a rural community, the clinic is the only agency in the county that provides counseling services. The clinic uses a treatment philosophy that combines cognitive-be-Navigating Through Dual Relationships: Applying an Ethical Continuum in a Rural Field Placementby Arthur L. Evans and Michael E. Sherr, Ph.D., LCSWhavioral therapy with solution-focused treatment. Early in the semester, I spent most of my time observing sessions and role-playing client scenarios with my field instructor. Then I began seeing cli-ents on my own with clinical supervision with my field instructor twice a week.  Within the first week of seeing my own clients, I received two referrals from Pastor Harris, who is on staff at the church where I used to preach. First, he referred April Zonger, who he said was having “anger outbursts.” On the phone, Pastor Harris shared, “I wanted to make sure April would be seen by someone she trusts and who has a strong faith.” The first thing I thought to myself was, “I was her youth pastor. I’ve known April since she was 12 years old! I’m still friends with her parents.” I wanted to be helpful, but I wasn’t sure it would be ethical for me to see her. At the same time, I might be the only social worker April would even consider for counsel-ing. Moreover, I thought to myself, “Where else could she go?”  Pastor Harris also referred Walter and Kathy Laurens for family counsel-ing. According to Pastor Harris, Kathy Laurens was contemplating whether to leave her husband after 16 years of marriage. Apparently, Walter’s mother had been living with them for two years and Kathy couldn’t take it any longer. The Laurens have been attending Pastor Harris’s church for the last three years. I think I remember meeting them when they started going to church; but since I stopped preaching, I have been attend-ing a different congregation, so I don’t really know them. Again, my spiritual beliefs were the main reason Pastor Har-ris referred the Laurens to the clinic. An Ethical Continuum As I thought about what to do about the referrals from Pastor Harris, I realized that I was friends with many of the clergy in my county. I began feeling overwhelmed and thought to myself, “What am I going to do when I begin receiving referrals from other pastors?” I decided to talk with one of my professors for some guidance. My professor helped me conceptual-ize and apply an ethical continuum to help me decide each individual referral from my former pastoral colleagues. First, we reviewed the standard for dual relationships in the NASW Code of Eth-ics. In relation to social workers’ ethical responsibilities to clients, Section 1.06(c) particularly addresses dual relationships. Section 1.06 (c) states:  Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relation-ships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries.  Dual relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively. We developed a two-tiered ethi-cal continuum based on social work literature. The first continuum consisted of determining the degree to which I wanted to take a rule-based versus cultur-ally sensitive approach to interpreting Section 1.06(c). A rule-based approach is a strict adherence to the ethical mandate in which every effort should be made When it comes to providing direct services, being a former pastor of a local church in a rural area makes balancing dual relationships with clients unavoidable.The New Social Worker     Winter 006    to avoid dual relationships. Moreover, social workers should take safeguards to avert the possibility of developing a secondary relationship with clients. A culturally sensitive approach tends to fa-vor a tempered adherence to the ethical mandate that is sensitive to the unique characteristics of the rural environment (Gumpert & Black, 2005).  At the same time, the second continuum consisted of distinguishing between boundary crossings and bound-ary violations. Boundary crossings are associations outside the “boundaries” of the standard client-social worker relation-ship that can be used to benefit the cli-ent. Boundary violations are associations outside the “boundaries” that violate and exploit the client (Lazarus, 2003). My professor encouraged me to consider both continuums in an inverse manner. The closer I adhere to applying a rule-based approach, the more likely I am to ethically cross boundaries to ben-efit my clients. The more I lean toward applying a culturally sensitive approach, the more likely I am (even unintention-ally) to violate the boundaries and risk putting my clients in awkward positions. By applying the two inverse continuums, I can assess the benefits and risks of each referral on a case-by-case basis.  Applying the Ethical Continuum  As I considered the referrals from Pastor Harris, I eventually came to differ-ent conclusions. Given my past relation-ship with April Zonger as her youth pastor and my current relationship with her parents, I decided to apply more of a literal interpretation of Section 1.06(c). Nevertheless, I also recognized that April needed to see someone and that her options were limited. I decided to cross boundaries by calling April to share my concerns about working with her in a client-social worker relationship and to let her know that I was scheduling an ap-pointment for her with someone else at the clinic who shares her spiritual beliefs.  In contrast, I decided working with the Laurens would be appropriate. Although I had some experience with them in a different capacity, I didn’t have a current relationship with them and would not likely see them afterward. Just as important, I believe my understanding of the Laurens’ spiritual beliefs and pres-sures, combined with my professional social work skills, enables me to apply a culturally sensitive approach to working with them. The Ethical Continuum Beyond Direct Practice in Rural Settings: Arthur’s Professor Responds In a rural area, distinguishing between culturally sensitive practice and practice that breaches the NASW Code of Ethics is an everyday occurrence. As an advanced social work intern at a behavioral health clinic, Arthur experi-enced the dilemma in a very specific and limited way. Ultimately, his decisions between culturally sensitive practice and a rule-based approach narrowed down to a decision of whether or not to see a particular client for direct counseling. As students train to practice social work in rural settings, it is important to realize that every relationship a student has with family, friends, pastors, teachers, principals, and neighbors is a potential dual relationship. On one hand, who students are in terms of last name and history in the rural setting gives them ac-cess to building trusting relationships and networking to become effective builders and linkers of services to the community. On the other hand, students have to be critically aware of their responsibilities to take precautionary measures to protect the privacy and confidentiality of people and to be sure people are not exploited (even unintentionally).  Applying the inverse two-tiered ethical continuum provides students and social work practitioners a concep-tual framework to be effective in rural settings and, at the same time, hold themselves accountable. Nevertheless, what students and practitioners in rural settings must realize is that they have to learn to apply the continuum all of the time and in every relationship.  For example, a number of my stu-dents are the only social workers in their towns or counties. When they want to create a new program, make the commu-nity aware of a growing drug problem, or conduct a child abuse investigation, they are likely to speak or work with people they will see in their own Sunday school class, friends of their families, or someone whose parents went to school or grew up with their parents.  Friends and family members are likely to feel entitled to information about what is going on, will be talking about it at the local diner or at the dinner table, or have a sincere interest because they want to “pray for” or “help” a fam-ily that is struggling. If social workers in rural settings are not consciously aware of distinguishing between culturally sensitive and unethical practice, they will unknowingly practice in ways that haphazardly jeopardize the well-being of the people they are serving.  ReferencesGumpert, J., & Black, P. N. (2005). Walking the tightrope between cultural competence and ethical practice: The dilemma of the rural practitioner. In L. H. Ginsberg (Ed.), Social work in rural communities (4th ed., pp. 157-174). Alexandria, VA: Council on Social Work Education.  Lazarus, A. (2003). Boundary crossings vs. boundary violations. Annals of the National Psychotherapy Association, 6(1), 24-26.Arthur L. Evans is an MSW candidate at Northwest Nazarene University. He served in pastoral ministries with the Assemblies of God Church for 31 years, and currently works as an advanced social work intern at the Behavioral Health Clinic for Advocates for Inclusion, where he is also a case manager. Michael E. Sherr, Ph.D., LCSW, is an assistant professor in the social work department at Northwest Nazarene University. He is a nationally recognized scholar and serves as Assistant Editor of Social Work and Christianity: An International Journal.Additional Rural Social Work ResourcesCarlton-LaNey, I. B., Edwards, R. L., & Reid, P. N. (Eds.). (1999). Preserving and strengthening small towns and rural communities. Washington, DC: National Association of Social Work-ers. Ginsberg, L. H. (Ed.). (2005). Social work in rural communities (4th ed.). Alexandria, VA: Council on Social Work Education. Martinez-Brawley, E. E. (1990). Perspectives on the small community. Washington, DC: Na-tional Association of Social Workers. Rural Social Work Caucus—http://www.uncp.edu/home/marson/ruralRural Social Work ( Journal)—http://www.latrobe.edu.au/socialwork/rsw.html

Navigating Through Dual Relationships: Applying an Ethical Continuum in a Rural Field Placement

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Navigating Through Dual Relationships: Applying an Ethical Continuum in a Rural Field Placement

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