| February 2003 |
Ethics in EAP Practice Cheryl Caron, New England Medical Center “We have a unique role in terms of providing service, because we serve two clients: the employer and the employee. And doesn’t that, many times, put us in a position of choices to be made, and pose dilemmas about what to do in terms of situations we hear about from our clients? Over the past five years I’ve been studying ethics in employee assistance and conducting extensive literature reviews trying to find out what’s been written on the topic. Although there have been some articles written on ethics and EAPs, the literature really comes from people’s perspectives and opinions and also some anecdotal information. But very little research has been done on ethics and EAP practice. What are the ethical issues we deal with? There’s competence--our own competence and the competence of our colleagues. Are we truly competent to provide the services that we provide? Way back, EAPs started our dealing with substance abuse problems, but now we have broad-brush programs and deal with a lot of family problems and stress-related issues. Are we really competent to provide these services? There’s also the competence of our referral resources. Are you sure that the person or organization to which you’re referring a client is competent? Then there’s conflict of interest, both in terms of your client employees and the client organization. There’s also privacy and confidentiality. You have to think about the relationships you have with people within your organizations. If you are an internal provider, sometimes you may make friends within the organization, and those friends may become clients. So you have to make sure that any relationships you develop are on a professional level. Informed consent is another ethical issue. Do we all get informed consent when we provide services to clients? Sometimes when I ask colleagues in the field that question, they say, “What do you mean by informed consent?” What I mean is, do you actually tell clients about your services and define those services before you provide them? It’s also very important to discuss confidentiality and the limitations to it. Another interesting ethical issue is termination of services. Many times, when an employee no longer works for the organization, we feel he or she isn’t entitled to services any longer. In fact, as professionals, we really are obligated to at least ensure he or she has follow-up services available. The best way to avoid ethical issues and ethical problems is to prepare. Preparing for issues of ethics and developing policies and informing your clients before providing services will help you prevent these dilemmas. For example, I have a written confidentiality statement to show to individual clients when they come in. The confidentiality statement has a short narrative on top and bullet points that mention suicidal and homicidal ideations and so forth as being reasons to breach confidentiality. I review the statement with clients and ask them to sign it, and I give them a copy. Let’s consider some scenarios and discuss the ethical issues they raise. First scenario: An employee comes to you and reports that she stole money from another employee’s locker. How should you respond? [Discussion among audience] Some very important points have come up here. Someone suggested conducting a deeper assessment. I think that’s key. Find out what’s happened in the past and what’s going on with this individual now. Why did she steal the money? What has she done about it so far? Why did she come to you to report it? She obviously wants some help, so strategize with her. Here’s another scenario: An employee comes to you and reports an instance of child abuse by her spouse. What do you do? [Discussion among audience] In almost any scenario, if there’s a law or policy involved that’s written down, people are likely to follow it. That’s why it’s so important to have written policies and explain them to individual clients before they say anything. But you need to assess the situation before you make any judgments. If someone tells you that a co-worker is abusing a child, how do you know that’s true? Maybe the person is saying that to get her co-worker in trouble. Until I’m pretty confident that abuse is taking place and a child’s life or health is in danger, I would not report it. Domestic violence creates unique dilemmas for us. An excellent strategy, again, is to inform clients ahead of time about your confidentiality and privacy obligations under the law. Then, if they start to reveal something to you, stop them right there and repeat that information--that you have an obligation and if they tell you this information, you must report it.” DISCUSSION (Member Exchange Forum) |
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© 2003 Exhange On-Line is a publication of the Employee Assistance Professionals Association, Inc. (EAPA). Reproduction in whole or in part without written permission is expressly prohibited. Publication of bylined articles does not constitute endorsement of personal views of authors. Appearance of paid advertisements does not constitute endorsement by EAPA. |
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