Introduction
Social works represent a unique sphere based on strict ethical and moral principles and values. Working as a residential counselor in a mental health agency, I understand that social workers are faced with different ethical dilemmas and conflicts, which are difficult to resolve and avoid. Thus, professional knowledge and skills help social workers to reduce tension and support all patients and people in need. As social work gradually and painfully evolved into a profession, many individual and group efforts have been made to define overarching professional purposes. Social workers, being human and having individual and group interests, seek to support these interests just as do other groups in society seek to support theirs. In a sense, the very choice of knowledge used, or unit of attention addressed, or methodology applied in the construction of practice models is political and determined by value commitments to some degree.
Problem identification a Value Conflict
The paper is based on a value conflict that occurred between a social worker and his mentally ill patient. The conflict is caused by religious diversity and different value systems which prevent a client from therapeutic treatment. At the beginning of the 21st century, America is inhabited by different nations and ethnic groups that shared different religious and ethical practices. The value conflict under analysis is connected with religious diversity and the impossibility to deliver quality service to ethically diverse patients. In other words, the value system of social work practice differs greatly from Asian national values and religious practices. According to ot the Code of Ethics: “Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers’ social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice” (NASW Code of Ethics 2008). Some Asian patients refuse to follow prescribed treatment and be involved in psychological therapy. They explain that these practices contradict their religious values and principles (Adams, 2001).
This situation suggests that every practice model is exclusive in fact if not by design; every model “values” some kinds of clients as contrasted with others. To the extent that psychosocial therapy emphasizes cognitive procedures which rely upon reflective capacity, face-to-face communication through the verbal exchange in interviews most typically held in private offices, and is associated with voluntary services, there may be an unintended “ideal client” who is cognitively and verbally sophisticated and who has both the motivation for and the access to, help-seeking in the voluntary sector (Walsh, 2006). Social support theory repeatedly emphasizes the interplay of multiple factors; however, person and situation emanate from separate and unequal theoretical perspectives and most phases of diagnostic assessment address personality factors. Without a systematic way to assess interaction, it is therefore difficult to maintain the dual focus sought in the person-situation configuration. Although Hollis repeatedly emphasizes the importance of defining personality strengths as well as weaknesses, the psychoanalytic knowledge base tends to weigh problem definition in the direction of pathology, excess, and disorder. The moral dilemma of social workers is to choose between their professional duties and responsibilities and the religious values of their clients (Walsh, 2006).
The Important of this Dilemma for a Social Worker
Social workers operate in a complex environment influenced by cultural changes and religious diversity. This situation is crucial for a social worker because he can choose between alternatives and find the best possible solution for his clients. Accepting this view of ethics, it is probably correct to say that the concept ‘ethical decision’, as it is used colloquially in health care contexts, refers to a type of decision that is guided by certain prescriptive and proscriptive moral principles of conduct or other moral considerations (rather than by punitive legal laws) and a desire to achieve a given moral end. While it is not the only means toward change, a positive therapeutic relationship is essential to all practices as it allows honest communication to take place, allows trust to develop, and enables the client to accept and use the worker’s help (Walsh, 2006). The relationship requires the worker’s acceptance, warmth, goodwill, and positive regard for the client, as well as confidence in his or her skills and the casework process; the client must be able to trust the worker. The relationship is developed and modified through these attitudes as well as through specific treatment procedures. There are also special therapeutic uses of elements within the client-worker relationship (Hepworth et al 2002).
Persons and systems Affected by the Dilemma
It is possible to identify the three groups of people affected by this value conflict: a client and his family, the social worker, and the social agency. Then, when multiple groups express their multiple group interests, confusion, contradictions, and conflicts over theoretical turf become prevalent. The main problem for a social agency is that a social worker has to violate or neglect the main principles of counseling and the Code of ethics. According to the Code of Ethics: “Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients’ socially responsible self-determination. Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs” (NASW Code of Ethics 2008). That is why it is usually best, in the interests of higher professional (self-) interests, for these separate group interests to seek common purposes (Walsh, 2006). However, method by method and approach by approach, it is not possible through additive means to achieve a unifying professional purpose; a linkage between method and purpose needs to be established. medical ethics (taken here as ethics from the distinctive role differentiated perspective of medical practice) is a subcategory of bioethics, a form of moral philosophy. It is conceptually incorrect and misleading then to treat medical ethics as being synonymous with health care ethics or bioethics. It is also conceptually incorrect and misleading to treat social work ethics as a subcategory of medical ethics given the quite distinct realms of inquiry, practice, and theoretical perspectives to which these respective fields relate. If social work ethics is to be regarded as a subcategory of anything (and it is far from clear that it is), it is more likely to be that of bioethics in much the same way that medical ethics is (Hepworth et al 2002).
The problem for a client and his family is a lack of trust and social support needed for a mentally ill patient. This rejection is caused by religious values and dental medical treatment methods (Walsh, 2006). It is impossible to take into account their unique values and religious preferences. In pattern-dynamic and developmental reflection, relationship phenomena can also be used as one source of increasing the client’s self-understanding (although with less intensity and intra0psychic depth than in psychoanalysis, since the nature of the transference is different). By focusing on ego-dystonic preconscious elements in the transference and irrational components affected by experiences later than infancy and early childhood, the client is helped to understand dynamically his or her unrealistic responses to the worker and the ways they repeat earlier reactions to parents and closely related people. The client can use this awareness to correct similar distortions and responses to other people in his or her current life (Payne 2005).
For a social worker, the danger is to deprive trust and faith of his mentally ill clients and violate his professional duties and principles. “Social workers’ primary responsibility is to promote the well-being of clients. In general, clients’ interests are primary. However, social workers’ responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be so advised” (NASW Code of Ethics 2008). The challenge to social workers working with Asian clients is to demonstrate that competence and empathy are not unique to members of a particular group (Walsh, 2006). For example, a competent white social worker can be as “black” as any of the clients in his or her organization. Blackness is more than a condition of the skin; it is thinking black, behaving black, and accepting black. Just as some black people admit that there are white people who have “soul,” there are many white people who acknowledge that some black people have “culture.” Skin color may be a help or a hindrance in establishing rapport. The major determining factor is the quality of interaction among people (Payne 2005).
The Course of Actions
The proposed course of action is to change treatment methods and social support practices in order to meet clients’ expectations and religious bias (Walsh, 2006). The following plan will help to overcome negative attitudes and stereotypes:
- Sustainment. This category includes procedures designed to lessen the client’s anxiety, build belief and faith in the worker’s goodwill and knowledge. Much sustainment occurs through nonverbal and paraverbal communication.
- Direct influence. Procedures designed to promote or discourage a specific action or kind of behavior on the client’s part constitute direct influence. They form a continuum from mild to extreme forms.
- Exploration-description-ventilation. Such procedures are designed to draw out facts and feelings associated with them.
- Person-situation reflection. This category includes procedures designed to promote discussion of the current or recent situation, client responses to it, and their interaction. This type of reflection is further subdivided into the type of change in the client’s perception, awareness, or understanding sought by the communication. One is extra reflective, involving the situation; three are retroreflective, involving the client’s own behavior; one lies midway between.
- Pattern-dynamic reflection. Procedures in this category are designed to promote reflective consideration of psychological patterns involved in behavior and the underlying dynamics. Such reflection further extends (deepens) intrareflection.
- Developmental reflection. Included here are procedures designed to promote reflective consideration of developmental factors contributing to dysfunctional psychological patterns. Developmental reflection further extends (deepens) intrareflection back through time (Payne 2005).
While the worker helps the client think about the nature of the person-situation configuration–augmented by sustaining attitudes and direct influence–the differences between the client’s expectations and the worker’s actual responses in their discussion may counteract earlier negative parental effects (Walsh, 2006). Thus, there may be greater acceptance and freedom for clients who experienced restrictive, hostile, or controlling parents; greater ego control for clients whose earlier experiences lacked realistic restraints; improved self-image for all clients, as the worker’s attitudes and therapeutic optimism foster the client’s own confidence. In a related way, the client’s tendency to identify with a worker with whom there is a positive relationship can foster an imitative kind of learning, similar to a child’s learning from a parent with whom he or she identifies (Payne 2005).
In order to avoid violation of ethics and moral principles, a social worker should report the problem and possible outcomes to his agency. The first step in establishing rapport with minority workers is to help them relax (Walsh, 2006). To do so, the administrator must be relaxed. If a social worker is worried about being verbally or physically attacked or sued, it will show. Besides, clients may also be anxious about the encounter. They may wonder about the supervisor’s hidden agenda. For some clients, regardless of their race or ethnicity, conferences with supervisors produce feelings of great discomfort. It is typical for people to bring their community-related anxieties with them to the workplace (Walsh, 2006). As an example, fear of police brutality is not easily left in the community outside the workplace. The spread effect can cause some clients to fear all authority figures. During the initial encounter, organization problems or conversations about community problems exacerbate feelings. A few minutes of “small talk” can often reduce stress. Effective administrators know when to slow the pace and talk about non-threatening subjects. However, not even the most tactful administrators always succeed in establishing trust (Walsh, 2006). By providing a lens through which to view the relation of parts to one another and to the whole, a practice perspective suggests what and how to see; it does not prescribe what to do. By providing a slice of practice life, a practice model perceives phenomena in a certain way and it further presents a means for action. It has been suggested that the ethical perspective can encompass diverse practice models used to carry out professional purposes. In this regard, there is a subtle but significant difference between incorporating a model to fit within another perspective and selectively utilizing particular practice roles or interventions of a model within that perspective (Payne 2005).
Conclusion
The ethical dilemma suggests that the ethical code provides the social worker with specific processes, procedures, and principles for helping individuals, as well as a framework for differential interventions; this technology can be utilized differentially by professionals who choose to perceive practice phenomena from an eco-systems perspective or from any other perspective. As suggested in the preceding analysis, the ethical code also reflects a particular theoretical and philosophical view of human functioning which emanates largely from psychoanalytic understanding and which thereby frames the way problems are defined and procedures are emphasized. While the model is committed to integrating multiple variables, the relative salience of variables becomes settled by such factors as the relative power of its knowledge base. The ethical code has its own perspective on social functioning and social work practice, and the integrity of the model ought not to be disrupted by trying to adjust it to fit another perspective from another time. To do so would be to create a different model of practice and ethical values of a social worker.
References
Adams, R. (2001). Social Work 2nd ed: Themes, Issues and Critical Debates. Palgrave Macmillan.
Hepworth, D.H., Rooney, R.,& Larson, J., (2002), Direct Social Work Practice: Theory & Skills (6thed). Belmont, CA: Brooks/Cole.
Payne, M. (2005). Modern Social Work Theory. Palgrave Macmillan; 3Rev Ed edition.
Walsh, J., (2006), Theories for Direct Social Work Practice, Belmont, CA: Brooks/Cole.
NASW Code of Ethics, (2008). Web.