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Week 4: Intersectionality of Bias in Organizations Report

Angela DeWitt

University of Phoenix

SWRK/401

Dr. Billy Bible

November 11, 2024

Ethical Dilemma 1: Factors Involved

A client at ABC Therapy Services in a small rural town stated they had intentions to harm

himself. The client is a 45-year-old male (yom). He is American Indian male who lives on a

local reservation and an enrolled member of the DEF Band of Ojibwe. He has been married for

20 years and they have 2 teenage sons. He was injured on the job about 6 months ago that left

him disabled and unable to return to work. He has been a client at ABC Therapy Services for

approximately 3 months for depression and anger issues. The client stated that he is angry that

he cannot do things that he used to do. He is in constant pain from his injury. He is also

depressed and angry he cannot provide for his family. They must rely on social service

programs for food. They cannot afford phones or internet. He stated he feels helpless. He stated

that it would be better if he was dead. He then shared the plan he had made to follow through on

committing suicide. Areas to think about for bias, power, and privilege would be low income,

race discrimination, and lack of services provided to the families on the reservation to name a

few.

Ethical Dilemma 5: Factors Involved

A co-worker at ABC Social Services was discovered engaging in inappropriate

interactions with clients on social media. ABC Social Services is in a rural small town where

everyone knows everyone. This co-worker is a Caucasian 23-year-old female from the area right

out of college. She earned a BSW, and this is her first professional social work job out of

college. She did well in all her classes. She attended the UMD Social Work Program in Duluth,

MN. She was able to go on a scholarship and her parents covered her living expenses, so she did

not work while attending college. She has a big presence on multiple social media sites per her

resume. It was discovered that she had added some clients to her social media accounts, and
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engaging with them. When asked about it, she admitted she had added clients to her personal

social media to keep in contact with them. Areas to think about for bias, power, and privilege

would be wealth, race privilege, and a sense of entitlement to name a few.

Ethical Approach

When a social worker becomes aware of a client’s intention to harm themselves or others,

they must balance their duty to warn with maintaining confidentiality (NASW, 2024). The 45

yom was given informed consent at the initial appointment. It was provided in writing and was

read aloud. He stated that he understood what was in the document and signed it. He had a plan

to harm himself with a firearm. The client was reminded of the informed consent he was

provided initially. The client stated he remembered and understood. After speaking with the

client about why he felt like the only choice was to harm himself, he agreed to go to a mental

health facility to be evaluated for his depression and possible medication options. There were

releases of information signed by the client for the social worker to make referrals to an inpatient

crisis mental health facility and other programs that can help provide support when he is

released. The client was willing to be admitted right from the therapy session. He gave

permission to contact his spouse to let them know what was going on. The client was asked if he

gave permission to contact Tribal Police to reach out to his spouse along with a phone call from

the social worker. The client did give permission. If the client would not have given permission,

a phone call to the local ambulance would have been made for a suicidal male that needed to be

transported to the hospital. Tribal Police would have been contacted also. Only the information

needed to provide care would be released in order to keep the client’s information as confidential

as possible.
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Under the NASW Code of Conduct 2.10, social workers should take adequate measures

to correct colleagues’ unethical behavior. During the conversation, the co-worker stated that

they did not realize that the interaction on Facebook was considered unethical since they were

not talking about services being provided. They were told they are required to keep client

information confidential which would include their professional relationship. It was stated that

boundaries can be easily blurred in a small town when you know everyone. It was suggested the

co-worker seek out training to help them learn how to gain knowledge on how to set appropriate

boundaries. Part of the discussion included that clients are not friends and cannot be treated as

such by adding them to social media accounts. Suggestions on how to fix the situation were

discussed. The co-worker was thankful for the conversation and started to make corrections

immediately to their social media accounts. The co-worker was also told that if they ever had

any questions about what would be ethical or unethical, they could ask for feedback from co-

workers before going ahead with it.

Address and Advocate

ABC Therapy Services should make sure the client receives the help he needs to address

his suicidal ideations. The supervisor should also reach out to the social worker to make sure

they are doing ok. Having to admit someone to a crisis unit might not be an easy decision for

them. They may struggle emotionally with the decision. The spouse should be warned so any

firearms in the home can be removed or safely locked up with no way for the client to be able to

get to them. This would include releasing some confidential information but only the

information necessary, not all the client’s information.

Most social workers know that confidentiality ends when a client indicates an intention to

act violently toward an identifiable victim (Johnstone, 2010). However, it is not always clear cut
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when the intent to act violently or to harm someone is not a physical weapon. For example, if

someone has an STD and refuses to take precautions or to warn their partners. According to

Johnstone, 2010, this kind of situation is not so clear if social workers have a duty to warn.

Social workers need clearer legal guidelines on where confidentiality ends and the duty to warn

third parties begins (Johnstone, 2010). According to Johnstone, 2010, there are seven criteria

proposed that should be considered when determining whether a breach of confidentiality is

appropriate. These factors are: (1) the gravity of the harm; (2) the probability of the harm; (3)

the identifiability of potential victims of the harm; (4) the imminence of the harm; (5) the

probability that an intervention can mitigate the harm; (6) the degree to which means other than

breach of confidentiality have been exhausted; and (7) whether the patient himself is the agent of

the harm. In this dilemma, it would be good to advocate for clearer laws with the legislators

and clearer policies at the agency level.

The ABC Social Services employee that confronted their co-worker for inappropriately

engaging with clients in social media did the right thing by respectfully discussing the behavior

and talking about solutions. Colleagues have an ethical obligation to correct colleagues’

unethical behavior (NASW, 2024). The agency should address this with a required staff meeting

for all staff to go over current policy or develop policy to give direction about social media so

this does not happen in the future.

Social Media is still relatively new and the implementation of policy and training

regarding social media use is not yet comprehensive (Diamond, E. L., & Whalen, A., 2019),

Social media allows for personal information to leak in to professional lives and can influence

professional abilities (Diamond, E. L., & Whalen, A., 2019). Greater clarity and guidance is

needed for social work leaders, managers, and practitioners to help them navigate their way
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through this digital mine field (Cooner et al., 2020). The profession needs to protect service

users from unthinking, unethical, and potentially illegal social media use, while opening up

discussion around the use of social media as a possible resource (Cooner et al., 2020).

According to Cooner et al., 2020, it is recommended to engage with a spectrum of stakeholders

in a full discussion to develop guidelines and approaches to staff support, professional

development, and practice that are relevant to social work in a fast changing digitally networked

society.
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References
Code of Ethics of the National Association of Social Workers. (2021). NASW.

Cooner, T. S., Beddoe, L., Ferguson, H., & Joy, E. (2020). The use of Facebook in social work

practice with children and families: exploring complexity in an emerging practice.

Journal of Technology in Human Services, 38(2), 137–158.

https://doi.org/10.1080/15228835.2019.1680335

Diamond, E. L., & Whalen, A. (2019). Ethics and Social Media: Professional Considerations for

the School Psychologist. Contemporary School Psychology, 23(4), 351-356.

https://doi.org/10.1007/s40688-017-0170-x

Johnstone, G. L. (2010). A Social Worker’s Dilemma When a Client Has a Sexually Transmitted

Disease: The Conflict between the Duty of Confidentiality and the Duty to Warn Sexual

Partners. University of Louisville Law Review, 49(1), 111–132.the information with your

reference entry. You can use the Reference and Citation Examples (Center for Writing

Excellence > Reference and Citation Examples) to help format your source information

into a reference entry.