Ethics Are Not Just for Practitioners — Thoughts for Supervisors and Managers
Most licensing boards similar to the Ohio Counselor, Social Worker, & Marriage and Family Therapist Board discipline only individual practitioners. While some of these professionals are in solo private practice, many of them work in agency and large, multiprofessional practice settings. Any ethical lapses may be theirs alone or the result of working in an environment that is conducive to cutting corners.
The agency and its practices have a significant impact on licensees. While individual licensees must practice within the constraints of prevailing ethical and legal codes, agency practices have a role to play in ensuring they are not fostering unethical activity. Agency practices that create an environment that supports ethical practice (and we assume the vast majority of agency and practice leaders want this) include many of the following steps:
• Create and maintain strong human resources policies. Be prepared to address employee performance issues. A quick internet search can yield an abundance of excellent examples of human resource policies that can be shaped to meet the circumstances of an agency or practice. It is critical that agencies establish and maintain high expectations for employees with respect to basic employment practices. It is easy, in a busy practice and when working with professionals, to allow other priorities to get in the way of effective supervision. Staffers who are not managed will manage themselves. Agencies and supervisors need to be aware of organizational practices that may not meet best practice standards. Ultimately, each individual licensee is responsible to maintain practice standards, but if employees raise concerns about agency practices or policies that may violate professional ethics, carefully look at those practices and ensure they meet state licensing requirements and national codes of ethics.
• Regular training is essential. All staff must be trained regularly in ethics. This includes those clinicians in direct practice as well as administrators. While ethical practice standards may seem obvious, everyone needs reminders. The questions and comments that occur as a result of training may also highlight other areas for improvement.
• Update handbooks and staff resources regularly. Maintaining such resources electronically can help facilitate the updating process. New sources of continuing education may become available to your employees; state requirements or standards may change over time. Do not let your standards become stale. Sign up for any updates from the appropriate licensure boards to ensure you are getting current information on law and rule changes. Have strong quality control and assurance policies and procedures. This is imperative to ensure your reputation as an agency, as supervisors, and to the clients or public that come into contact with you professionally. Regularly monitor records for accurate, timely documentation, and monitor billing practices. Too many times an agency finds it cannot be reimbursed for services that have been billed when the documentation is not adequate.
• Familiarize yourself with the laws and rules of professionally credentialed employees. Be prepared to report employees who violate the laws and rules. If you terminate an employee who may have committed a violation of licensure laws and rules, remember to report to the appropriate licensing board. While it may seem penalty enough to terminate an employee, possible legal and ethical lapses should be properly investigated to ensure a problem is not transferred to another workplace.
• Spend now to avoid spending later by retaining legal counsel and consulting that counsel as necessary. One possible project for legal counsel is to review policies and procedures. For example, are your informed consent and confidentiality practices and forms up to date and in conformity with current legal standards?
• Participate in the profession by joining associations, attending in-person trainings, and acting as a practicum and internship site. Internship and practicum students offer your employees a way to help others new to the professions, thereby reinforcing good practice in them. Through teaching we learn.
• Do not rely solely on your own judgment. Do not let your experience or your title (e.g., executive director or clinical director) get in the way of good judgment. Remember you are not only a supervisor or manager, but also a leader. At all levels you have to be vigilant regarding the tendency to rely solely on your own experience. Consultation with others, even when you are in a supervisory role, is always a best practice standard. Develop a team of professionals to refer to as needed.
• Make it a practice to assess whether agency practices may unintentionally influence workers to participate in unethical behavior. Assessments can be proactive, particularly when anticipating a change in policy or procedure. For example, if the agency expects higher than usual caseloads, it may wish to monitor the change closely to ensure no staff are tempted to submit fraudulent documentation to keep up with caseload expectations. Reactive assessment following the resolution of an ethical issue can also provide insights that can help avoid future issues. Such assessments need be neither complex nor difficult. Asking questions and imagining yourself in the position of your workers will give you important feedback.
No one policy, procedure, or step ensures a workplace free of problems. Nonetheless, by remaining alert and diligent, and following the steps above, a supervisor or manager in an agency or practice setting can be more confident that their direct reports work within the appropriate laws and rules.
— Brian Carnahan is executive director of the State of Ohio Counselor, Social Worker, & Marriage and Family Therapist Board.— Tracey Hosom is an investigator with the State of Ohio Counselor, Social Worker, & Marriage and Family Therapist Board.