Deliberate intentional, planned, conscious Workshop Overview - - PDF document

deliberate intentional planned conscious
SMART_READER_LITE
LIVE PREVIEW

Deliberate intentional, planned, conscious Workshop Overview - - PDF document

5/28/2014 The Ethics of Self-Disclosure: Bringing Nuance to Content and Process Andy Bernstein, PhD, CPRP Zurs Taxonomy of Self-Disclosures: What is Addressed in This Workshop Involuntary client-obtained information Accidental


slide-1
SLIDE 1

5/28/2014 1

The Ethics of Self-Disclosure: Bringing Nuance to Content and Process

Andy Bernstein, PhD, CPRP

Zur’s Taxonomy of Self-Disclosures: What is Addressed in This Workshop

  • Involuntary—client-obtained information
  • Accidental—unplanned encounters and

utterances

  • Unavoidable—appearance, speech, etc.
  • Deliberate—intentional,

planned, conscious

Workshop Overview

  • What has been our collective experience

around self-disclosure—training vs. real life?

  • What has changed in this area of practice?
  • What is the difference between content and

process disclosures? Are there other types?

  • What are the benefits and possible harms of

disclosing within each of those domains?

  • What--if anything--does PRA’s Code of Ethics

say about self-disclosure?

slide-2
SLIDE 2

5/28/2014 2

What’s In Your Training? c

What do you actually do

regarding self-disclosure?

Evolution of Helping

  • Before professionals

– Mutual Help – Experiential Knowledge (Thomasina Borkman)

  • Industrial Revolution and Class System

– Formal training and purported expertise – Professional Knowledge – Accountability to third parties

  • society (educators, discipline certifiers, geographic entities)
  • payors (insurers)
  • professions (guild system)

Evolution of Helping, p.2

  • Industrial Revolution and Class System (cont’d)

– techniques and the standardization of helping – objectification of helpees, and helpers – commodification of helping industry

  • Consumer Empowerment

– naturopathic, alternatives to traditional Western medicine – whole person – self-help movement – “nothing about us without us” – questioning big pharm and big psych – recovery and psychiatric rehabilitation – consumer-providers, peer workforce

  • Integrated Health Care
slide-3
SLIDE 3

5/28/2014 3

How has this evolution affected the ways in which deliberate self-disclosure is viewed in the field?

Three Types of Disclosure

  • Content—facts about us or about

experience we’ve had in our lives

  • Process—how we are thinking at the

moment

  • Hybrid—how we think generally; our

beliefs or values (attitudinal) Content Examples

  • This is my first year working in this setting.
  • I’m a student, and this is part of my training.
  • I’ve received mental health services in the past.
  • I’m in recovery myself from…
  • I, too, have been the parent of adolescents.
  • No, I’m not actually a parent.
  • I’ve had serious trauma in my own past.
  • No, I’ve never been divorced.
  • I once lived in __________ , also.
  • I grew up in a family in which ….
slide-4
SLIDE 4

5/28/2014 4 Process Examples

  • I’m thinking that we could go in a couple of different

directions at this point...

  • I’m thinking about asking you some questions about

your family.

  • When you smile like that it makes me think that ….
  • At this point I usually ask about prior relationships, but

I’m not sure that’s a good idea right now.

  • I’m trying to figure out how you really feel about that.
  • I’m having trouble remembering how you ended up in

that situation.

Attitudinal Examples

  • I usually think that when people are sitting here,

there are forces acting upon them which they’re trying to understand.

  • Yes, I do believe in God.
  • I think it’s important for clients to have some

sense of control over what happens here.

  • I generally believe that people do things for

reasons that make sense to them at the time.

  • I’m not opposed to medication; I just think that it

is only one tool among many which can be used.

Why Self-Disclose?

  • Credibility
  • Connection
  • Authenticity
  • Transparency
  • Humanness
  • Others?
  • Role-Modeling
  • Perspective
  • Collaboration
  • Sharing Power
  • Demystification
slide-5
SLIDE 5

5/28/2014 5

Additional Reasons to Self-Disclose Why NOT Disclose?

  • It might work against building the kind of relationship

you’re trying to create.

  • It might make YOU uncomfortable and thus feel

compromised in your ability to work well.

  • It might be coming out of YOUR need to share and not

the needs of the person with whom you’re working.

  • It might be forbidden in the setting in which you work.
  • It might not be consistent with the way in which you

work.

  • It might be harmful to the person you’re working with
  • It might be the wrong time to do so.
  • Others??

Additional Reasons NOT to Self-Disclose

slide-6
SLIDE 6

5/28/2014 6 What does PRA’s Code of Ethics Say About Disclosure?

NOTHING DIRECTLY

But let’s drill down into them a bit…

Principles, Standards, and Guidelines of Ethical Practice

From PRA Practitioner Code of Ethics (9/28/12)

  • Fundamental Principles (21/5)
  • Fundamental Standards (24/4)
  • Guidelines for Principles and

Standards (43/10)

Principles (21)

  • The fundamental principles are aspirational in

nature—a framework for guidance in practice.

  • A. Ethical Behavior (2)
  • B. Integrity (5)
  • C. Freedom of Choice (3)
  • D. Justice (4)
  • E. Respect for Diversity and Culture (7)
slide-7
SLIDE 7

5/28/2014 7

Standards (24)

  • The fundamental standards are descriptive

ideals–how to implement the foundational principles; grouped into 4 sections indicating important areas for ethical practice:

  • A. Competence (7)
  • B. Informed Consent (6)
  • C. Advocacy (7)
  • D. Propriety (4)

Guidelines (43) for Principles and Standards

  • The guidelines are prescriptive statements

recommending practitioner tasks that are essential to ethical practice; grouped into 10 categories that represent areas where ethical practice may create a special challenge for practitioners:

  • A. Promoting Ethical Behavior F. Multiple Roles and Relationships
  • B. Practice Responsibilities (3) G. Supervision (7)
  • C. Confidentiality (5)
  • H. Termination (3)
  • D. Rights Protection (3)
  • I. Service Coordination (3)
  • E. Individualization (2)
  • J. Collegial Relationships (7)

Guidelines Caveat

  • Practitioners should be aware that these

guidelines do not cover every possible circumstance where ethical dilemmas may arise.

  • Should an ethical dilemma arise, practitioner

should be able to justify their decisions and actions, including explaining how the Code of Ethics was considered and applied.

slide-8
SLIDE 8

5/28/2014 8 Principles Which Might Be Related to Self-Disclosure

  • A. Ethical Behavior

– A1. Practitioners uphold and advance the mission, principles, and ethics of the profession.

  • B. Integrity

– B1. Practitioners act in accordance with the highest standards of professional integrity and impartiality. – B3. Practitioners are continually cognizant of their own needs, values, and of their potentially influential position, in relationship to persons receiving services. – B4. Practitioners foster the trust of persons receiving services and do not exploit them for personal gain or benefit. – B5. Practitioners act fairly and honestly in professional relationships and business practices, and do not exploit them for personal gain or benefit.

Principles Which Might Be Related to Self-Disclosure p.2

  • D. Justice

– D3. Practitioners provide information about their professional qualifications to deliver services to people using those services.

  • E. Respect for Diversity and Culture

– E3. Practitioners study, understand, accept, and appreciate their

  • wn culture as a basis for relating to the cultures of others.

Where differences influence the practitioner’s work, the practitioner shall seek training and/or consultation. – E5. Practitioners demonstrate respect towards the cultural identities and preferences of persons using their services, and respect the right of others to hold opinions, beliefs, and values different from their own.

Guidelines Which Might Be Related to Self-Disclosure

  • J. Collegial Relationships

– 2. Practitioners are transparent in defining their ongoing professional relationship with those colleagues whom they employ, supervise, or mentor, especially when those relationships change.

  • G. Supervision

– 5. Supervisors model and engage supervisees in objective and balanced self-assessment. – 6. Supervisors inform supervisees about performance expectations, including competencies required, standards for acceptable completion of job duties, and any rules, policies, and procedures that relate to general practice. – 7. Supervisors refrain from entering into multiple roles and relationships with supervisees. When multiple roles and relationships are unavoidable, it is the responsibility of the supervisor to conduct himself/herself in a way that does not jeopardize the integrity of the supervising relationship.

slide-9
SLIDE 9

5/28/2014 9

Looking Ahead

Is there anything with respect to personal disclosure which you think you might do or think about differently in the future, one way

  • r another?

Andy Bernstein, PhD, CPRP

Psychologist in Independent Practice Clinical Director, UA Health and Wellness Center (Camp Wellness) Tucson, Arizona 520-396-4956

adbpsy@gmail.com andybernstein@email.arizona.edu