Contemporary Field Education Issues

Learning Objectives

• To understand ways to limit the potential for ethical violations
• To understand the importance of ethical issues in field education
• To understand the importance of personal safety and ways to ensure it
  

As agency field supervisors, you have the responsibility of dealing with a variety of issues related to ethics, boundaries, impairment due to temporary or chronic concerns (ie: health-related, mental health, personal crisis, chemical dependency,etc) with your field student. Most students will do just fine and not present any of the above-outlined issues over the course of the field placement. Others may present challenges. It is important to remember that your role is that of "teacher" as well as supervisor and that you may be called upon to determine if an issue is more developmental in nature versus true impairment or incompetence. After all, these are "students", not seasoned social workers. We need to be realistic with our expectations while not ignoring potential "red flags" such as serious mental health issues or other areas that might pose a risk of harm to clients in the future. It is important that you talk with the faculty liaison or field coordinator if you have concerns, early in the field placement. While issues may need to be dealt with differently than in an employment situation, the NASW Code of Ethics still applies.

Student safety is another issue which should warrant your attention. A personal safety risk assessment should be completed on each case/project. Appropriate protective measures should be taken, when needed.

Please consider the following as you provide supervision to your field students:

As social workers, we are bound by the NASW Code of Ethics. Although the Code offers guidance in making difficult decisions, it does not provide specific answers. Field supervisors are responsible for modeling ethical practice when working with students. They are also responsible for the actions of their students. In order to minimize the potential for ethical violations, Dettlaff (2003) provides the following suggestions for supervisors:

• Meet regularly with students in order to review all significant client contacts.
• Regularly review and approve all significant case decisions.
• Thoroughly document all supervisory conferences and decisions resulting from these conferences.
• Review all written documentation completed by your student and ensure any necessary corrections are made.
• Continually assess your student's performance to ensure that tasks and assignments are appropriate for the student's skill level.
• Arrange for appropriate supervisory coverage when you are away, and advise your student regarding whom to contact if you are not available.
• Provide written documentation regarding agency policies and procedures for handling situation involving clients at risk of harming themselves or others.
• Thoroughly review agency policies regarding disclosures of confidential information and reporting requirements.
• Ensure all clients are informed of your student's status and provide your name and contact information to clients.
• Regularly discuss with your student potential ethical dilemmas and value conflicts that may arise in client relationships.

Confidentiality: Issues surrounding confidentiality are likely to arise in the field placement. According to the Code of Ethics, a social worker must protect a client's right to confidentiality whenever possible. It is important to be aware of local, state, and federal laws that require the breach of confidentiality, such as mandated reporting and duty to warn.

Physical Contact: Although it is clear that any sexual contact or relationship with a client is unethical, other forms of contact are rarely addressed. While hugging a client may be appropriate in some social work settings, it is not in all. This goes for other forms of contact as well. It is important to discuss expected behavior, boundaries and agency rules with students. Developing clear and appropriate boundaries with clients is critical in the early stages of the relationship.

Unethical behavior of Colleagues: As social workers, we are required to report unethical behavior by colleagues. Students may be unwilling to address these issues for fear of repercussions. By supporting the student and creating an environment of accountability, a supervisor can alleviate some of this anxiety. By holding individuals accountable for their unethical practice, the profession of social work can be strengthened.

Sexual Harassment: Sexual harassment can be defined as any unwanted behavior or remark that creates an intimating, hostile environment and impairs performance. It is a violation of power and trust, that must be addressed. Most agencies have policies in affect to address the issue of sexual harassment. Please be aware of your agency's policy. Employers are ultimately responsible for creating a healthy working environment, free of harassment.

Impaired Practice: Impairment, stemming from extreme mental or physical health issues, distress, or substance abuse, is not uncommon in the field of social work. It is a social worker's ethical responsibility to provide the best quality of service. Impairment demises this potential and can lead to unethical behavior. The Code of Ethics includes four standards related to impaired practice of colleagues, which are:

2.09 Impairment of Colleagues
(a) Social workers who have direct knowledge of a social work colleague's impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action.

(b) Social workers who believe that a social work colleague's impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.

2.10 Incompetence of Colleagues

(a) Social workers who have direct knowledge of a social work colleague's incompetence should consult with that colleague when feasible and assist the colleague in taking remedial action.

(b) Social workers who believe that a social work colleague is incompetent and has not taken adequate steps to address the incompetence should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.

Safety: Social workers must consider their personal safety in all situations. It is not uncommon to be subjected to some form of violence in the field placement, either verbal or physical. Supervisors must make students aware of the potential risks and ways to minimize the potential for harm. Berg-Weger and Birkenmaier (2000), offer the following suggestions:

Evaluations of MSW Field Students

For field placements during the academic year, the faculty liaison visits the agency at least three times. The first of these visits is to go over the student's learning contract early in the field placement (within the first 6 weeks). The second is to conduct a mid-year evaluation and the third is for the final evaluation.

These formal evaluations are critical in determining whether a student is ready to proceed to their next field placement or into independent social work practice, for those completing their Field II placement. Supervisors are obligated to provide feedback to students with respect to their progress, as well as any concerns they may have pertaining to their social work practice. If supervisors have concerns they are uncomfortable sharing with a student, they should be sure to contact the faculty field liaison for consultation.

Health Insurance Portability & Accountability Act (HIPAA)

Field agencies are responsible for providing training on HIPPA for field students, appropriate to the role of HIPAA in you agency. "The federal HIPAA law was passed by Congress in 1996, presenting the single largest change in the health care business environment since the advent of Medicare and Medicaid in 1965. HIPAA is not a state or federal program, but an industry-wide effort to enhance consumer control of insurance coverage, create health care industry standards to improve administration; and protect and secure personal health information."(MN DHS)

The Minnesota Department of Human Services has a comprehensive HIPAA web site that may provide additional information for you and your field student. They also have an on-line HIPPA training available.

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