Journal of Social Work

5(1): 21–43
Copyright
© 2005
Sage Publications:
London,
Thousand Oaks, CA
and New Delhi

‘Who Do I Tell?’ www.sagepublications.com

Support and Consultation in Cases of Ethical

Conflict
D O N N A M C AU L I F F E A N D J O H N S U D B E RY
University of Queensland, Australia and University of Salford, UK

Abstract
• Summary: Social workers cannot avoid ethical dilemmas. This
qualitative research investigated the question ‘who do I tell?’, exploring
who the people are that social workers approach for advice when a
course of action is ethically uncertain. Thirty Australian social workers
discussed how they managed a serious ethical dilemma, whether they
sought support, and reasons for not seeking support.
• Findings: All respondents had access to supervision, and regarded
supervision as critical. However, less than half discussed the incident in
organizational supervision, and supervision was more likely to be used if
external to the organization. In many cases, ethical dilemmas were
discussed with colleagues, and to a lesser extent with friends or family.
Respondents referred to ethical, practical, organizational, and
relationship reasons for not using potential sources of support. Typical
issues were: availability; the perceived ethical priorities of the
supervisor; the benefits and costs of seeking or not seeking support;
behaviour of colleagues, managers or supervisors as the problem at
issue; the ethics of discussing work with family and friends.
• Applications: The study provides empirical data about support for social
workers facing an ethical dilemma. Organizational supervision,
ostensibly functioning to ensure standards and ethical practice, appeared
the least satisfactory in doing so in critical situations. If relationships are
not prioritized, no amount of monitoring of service outputs will create
effective practice.

Keywords ethical dilemmas supervision support

Introduction
Social work is intrinsically a moral endeavour (Goldstein, 1998). As Jordan
(1990: 1) puts it, ‘Moral issues haunt social work; social workers stalk moral

DOI: 10.1177/1468017305051362 21
Journal of Social Work 5(1)

problems.’ When, for example, a baby is taken into care, the social worker’s
dilemma has ethical dimensions because of the moral enormity of the state
taking a child from its parents; the same is true of the dilemmas of self-
determination or state intrusion in relation to vulnerable older people. A body
of literature has steadily emerged since the mid-1980s that acknowledges and
addresses the range of ethical concerns and controversial issues faced by social
workers, managers, students and researchers across fields of practice. This
paper reports an empirical study of aspects of the psychosocial context of these
moral dilemmas – to whom do social workers talk when faced with an ethical
dilemma, and why, in some cases, do social workers elect not to talk to anyone?

Ethics in Social Work: The Context

This introduction sets the study in the context of existing work about ethics and
values in social work. A concern with values has long been prominent in social
work literature and education. Biestek’s classic account of social work prin-
ciples (1961) is closely related to other psychosocial literature in emphasizing
such features as ‘respect for persons’ and ‘the right to self-determination’. Early
debate about such values included Plant’s strictures (1970) that the principles
did not adequately disentangle value statements (like those just quoted), and
technical imperatives, such as ‘purposeful expression of feelings’, which can be
justified only by empirical evidence of functionality. Elements of this debate are
taken further as Horne (1999) points out that even within the ethical elements,
they can be ambiguous depending on whether they are interpreted as part of a
utilitarian ethical scheme (validated only if the principles empirically lead to
the greatest good), or deontological (based on intrinsic values of personhood).
Other debates, such as those set out by McDermott (1975) examined whether
social work, when considered in reality, in social context (for example in youth
justice or child protection), can in fact embody such principles.
By the 1980s, values of empowerment and anti-oppressive practice became
prominent, placing ethical responsibilities on social workers actively to chal-
lenge interpersonal and societal structures that were complicit in the problems
faced by their clients. These were embodied in educational and professional
codes through the 1990s (AASW, 1999; CCETSW, 1995; IFSW, 1994). Many
themes, such as the difficulty of responding to two people whose rights conflict,
are regular topics for educational and professional examination. Horne (1999)
reviews accepted statements of social work values and, after analysing two
empirical reports of typical state-based social work, concludes that social
workers must be ‘morally engaged’ and morally active practitioners. This, he
argues, is because the values they implement are repeatedly at the dynamic
interface of individual rights (sometimes competing) and the social imperatives
affecting the social worker and the user of service.
The critical incidents identified by the respondents in this study involved all
the dimensions pointed to in the above brief survey, as well as other more basic
issues of ethical professional practice.

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Psychosocial Dimensions of Ethical Decision-making: Some Gaps in

the Literature
In summary, the literature about ethics in social work has focused on the follow-
ing overlapping areas:

• Statements of ethics and moral precepts for social workers (for example,
Biestek 1961; revised codes such as AASW, 1999; CCETSW, 1995; IFSW,
1994; NASW, 1996).
• Philosophical and contextualized examinations of these codes and value
statements, their philosophical coherence, their internal contradictions,
their applicability to the reality of social work (Banks, 2001; Gray, 1995;
Horne, 1999; McDermott, 1975; Manning, 1997; Plant, 1970; Siporin, 1982;
Timms, 1983).
• Operationalization of these codes for the practical uses of educational,
professional or organizational governance (Haynes, 1999; Husband, 1995;
Levy, 1993; Payne, 1985; Reamer, 1982).
• Empirical studies of practice (for example by Holland and Kilpatrick, 1991;
Horne, 1999; Jayaratne et al., 1997; Kugelman, 1992; McAuliffe, 1999;
Waldon et al., 1990), the purpose of which is to elucidate the coherence or
applicability of value statements and ethical codes.
• Professional literature and educational material designed to promote
thoughtfulness in individual cases about ethical standards, including
competing or contested ethical standards (Morelock, 1997; NASW, 1998;
Reamer, 1998; Rhodes, 1986; Rothman, 1998; Shardlow, 1998; Steinman
et al., 1998).

The gap in the literature is about the psychosocial situation of the individual
worker – not with a view to improving the (analytical) conceptualization of
values, but as (empirical) knowledge about social workers’ experience of ethical
dilemmas in their work. One important exception is the study by Colton and
Vanstone (1996) of self-reports of ethical failure in social care. The topic
reported in this article is of great practical significance. By definition, moral
questions are intrinsically not matters of psychology, personal emotion or social
science; nevertheless, intellectual and emotional security, and interpersonal
support, are likely to be essential ingredients in ethical decision-making.
As we describe below, the respondents in the study made their own judge-
ments about what constitutes an ethical dilemma. Our own framework is to use
Sarah Banks’s definition (2001: 11) – ethical dilemmas occur when ‘the social
worker sees herself as faced with a choice between two equally unwelcome
alternatives which may involve a conflict of moral principles, and it is not clear
which choice will be the right one’. Ethical dilemmas, then, are difficult situ-
ations where often no ‘right’ answer can be found. They may leave workers
feeling uncertain about decisions, responsible for outcomes, self-doubting of
their professional capabilities and reluctant to face the next challenge. Social

23
Journal of Social Work 5(1)

workers are entitled to secure support in such demanding circumstances, and

their actual experience is one important aspect of study.

Sources of Support: An Overview of the Literature

Professional guidance is clear that consultation or supervision is a critical
element in sound ethical decision-making. The Guidelines for Ethical Decision-
Making (5.1) from the Australian Association of Social Workers Code of Ethics
(1999) states:

In making ethical decisions consultation with colleagues, supervisors, and/or other

competent professionals is advisable. Such consultation is essential when the situation
is outside the social worker’s experience or area of expertise. Social workers are often
called upon to justify their decisions and should be able to demonstrate clearly the
factors involved in arriving at these decisions.

The literature on social supports within the organizational context provides

less insight into who it is that front-line social workers in fact seek out when
confronted with ethical dilemmas. As Holland and Kilpatrick (1991: 138) have
pointed out from their research, ‘little is known about how practitioners
respond to moral and ethical issues, how they understand and cope with these
aspects of their work, or what resources are used or needed for improving
performance in this area’. Walsh-Bowers suggests that immediate peers are an
important informal resource to assist in negotiating ethical dilemmas (Walsh-
Bowers et al., 1996). It is not clear, however, from systematic empirical research
whether workers use resources within their professional sphere (supervisor,
colleague, other professional, ethics committee), or whether they move to the
personal arena for support (family, friends, clergy, anonymous others) in ethics-
related matters. One study on trauma in child protection work (Dane, 2000)
indicated that support systems were explored, but results were unfortunately
not reported. Evidence from the literature on burnout and job-related stress
suggests that co-worker and supervisor support is the most effective moderator
of work stress (Cherniss, 1980; Donovan, 1987; Um and Harrison, 1998),
although longitudinal studies on the moderating effect of work-related social
support are limited and have provided questionable results (Dormann and
Zapf, 1999). Conversely, there is some indication that poor worker/colleague
relationships can exacerbate work stress in dysfunctional environments
(Cherniss, 1995; Paine, 1982; Pines et al., 1980). Shapiro (1982) lists a number
of supervisory characteristics correlated with low staff burnout. These include
supportive leadership, accurate communication, an orderly environment,
explicit rules and policies, worker autonomy, supervisory and peer support, and
manageable job pressure. Hobfoll (1988) has also discussed social support
derived from intimate relationships in the context of stress and coping.
The ability to share common experiences, discuss problems and create an
environment of trust and support is important for constructive collegial

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relationships. This in turn will influence how prepared workers are to elicit
support in difficult ethical situations.
There is a clear expectation, then, that social workers will give consideration
to engaging in consultation as a critical part of the decision-making process.
Social workers have available to them a number of options in relation to
avenues for support and consultation. These options will vary according to the
geographic location, agency context, existing networks and personal factors;
some sources of support available in other crises (family and friends) may be
inappropriate for this particular type of crisis. One important area of study is
to establish usage of different types of support and to investigate reasons for
their non-use.

The Study
The findings reported here are part of a wider study into ethical dilemmas in
social work practice conducted by McAuliffe (2000). The overall aim of the
study was to determine how social workers engaged in direct practice under-
stood and managed situations defined by them as ‘ethical dilemmas’. Thirty
qualified social workers with more than five years’ practice experience
responded to a national recruitment call, and subsequently engaged in the
qualitative study by either in-depth email dialogue with the researcher
(McAuliffe, 2003), or face-to-face in-depth interview. The sample comprised
20 females and 10 males, employed in a variety of statutory, clinical, research
and community-based settings in Australia. Respondents were asked to discuss
in detail an ethical dilemma that, for them, had been a ‘critical incident’ in their
practice. The semi-structured interviews led social workers through an explo-
ration of the anatomy of the ethical issue, the personal, professional and
organizational factors that influenced decision-making, the supports and
resources called upon to assist in decision-making, and the resultant impacts of
the ethical dilemma at both a personal and a professional level (both the
outcomes of the event and the consequences of that outcome).
This paper arises particularly from answers to the following questions: From
whom did you seek advice or support about the issue in question (including
categories: supervisors; colleagues; family or friends; or other external)? If the
ethical dilemma was discussed with the appointed or chosen supervisor/line
manager, at what stage was it discussed (on occurrence and before the decision;
during the process of decision-making; or after closure of issue)? What was the
manner of discussion (brief mention; or ongoing reflective analysis)? Was it felt
that the discussion about the ethical dilemma was of benefit? What role did the
supervisor play in terms of support? Questions were similarly asked about use
or non-use of support from the other sources. We pay particular attention to a
last question, which was asked in relation to all potential sources of support: if
the issue was not discussed, what were the reasons for this?

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The Ethical Dilemmas

The respondents talked frankly and with integrity about very difficult situ-
ations. Some were matters of life and death – whether, for example, to accede
to the request (against agency policy) of a dying client who requested infor-
mation about how to end his life with dignity, to commit suicide when he
returned home. The staff member in fact supplied some literature, including
information on legal dimensions, and discussed the issues with him, though he
decided not to document the discussions. The client did not take his own life.
This is illustrative of the most common category of conflict – respect for
clients’ human rights in conflict with responsibilities to the workplace (organiz-
ational compliance). One respondent stated that in retrospect their decision not
to seek formal review of a decision about change of placement was wrong, the
organizational termination of the existing placement being shown by events to
have severely destructive results for the client concerned. In another case, a 16-
year-old revealed that she was pregnant and requested information about
abortion options but the agency prohibited staff from providing information
about pregnancy termination (the outcome was the worker’s referral of the
client to an appropriate agency that would provide the requested information).
Conflicts between responsibilities to individual clients and responsibilities
to colleagues were commonplace. In one such situation, the worker in a mental
health service advocated on behalf of a client whom she saw to be discriminated
against and then supported the client in making a complaint against staff of one
of the disciplines involved. This effectively destroyed collegial relationships and
damaged interprofessional collaboration. As in many other situations, this
scenario also involved a number of other factors that the respondent identified
as management failures and conflicts between managers, all of which serve to
make the ethical dilemmas more complicated. In some cases the outcome of the
respondent’s decision was detrimental to their own career, or required them to
leave their employment.
In other situations, the choice involved personal gain – whether to continue
a (mutually beneficial) personal friendship with a client in one case, or whether
to pursue a mutual sexual attraction which arose in a research context.
Several involved an apparent choice between responsibilities to colleagues
and to the workplace – whether, for example, to report the financial malad-
ministration of a colleague who was a friend and whom the worker knew to be
suicidal.
The situations highlighted how workers have apparently to choose between
the interests of different clients because of resource constraints – for example,
a reviewing officer had to make a decision about the optimal placement for a
younger child, in which some options were detrimental to three other siblings
and none were satisfactory.
Related dilemmas occurred when the duty to respect an individual’s right
to choice was (or appeared to be) in conflict with some broader duty of care.
By genetic testing of her unborn baby, a wife was in a position to acquire

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information about her husband’s status in respect of Huntingdon’s Disease. If

the test was positive, she intended to say nothing to her husband, but to have
the pregnancy terminated. The information belonged to the wife – but the social
worker felt that, morally, she had a general duty of care towards the
husband/father as well. Related dilemmas occurred when a social worker learnt
from a confidential source that her client had problems which then required her
to take steps to remove the children (who were not directly her clients).
In a number of cases, as is typical of social work generally, the client’s right
to choose is in conflict with the social worker’s duty of care. In another case, an
older man was evicted from his home whilst he was in hospital. He did not at
any stage agree to the arrangements actually made for his subsequent daily
living, even though he had no psychiatric or other diagnosis that warranted
acting against his wishes.
Dilemmas were sometimes created by the vagaries of the legal system – for
one mental health social worker, acting responsibly involved supporting the
client’s legal responsibility for decisions about her children whilst at the same
time denying her competence to make decisions about her own life.
A number involved a complex and demanding mix of different dimensions
(the rights of indigenous people, responsibilities to colleagues, and responsi-
bilities to the workplace).
All the ‘critical incidents’ had severe implications for the rights, lives or
death of a user of service or the worker.

Support from Professional Supervision

In human services, accountability has become defined within managerialist
terms so that practice can be monitored within a ‘managers know best’ frame-
work (Ife, 1997). An important aspect of the social work education process is
the focus on field education where students are introduced to the concept of
professional supervision, the aim of which is to ‘help the learner to specify and
to apply knowledge’ (O’Connor et al., 1998: 211). Students are expected as
practitioners to incorporate supervision into their practice. Supervision for
graduates should, according to Lewis (1998), focus on accountability and best
practice.

Availability of Supervisory Support

Of the 30 respondents in the study, 21 reported that their employing organiz-
ation made some provision for supervision. These organizations were primarily
statutory state government departments, or hospitals characterized by hierar-
chical line-management structures. Supervisory arrangements described by
respondents were both formal and informal, and the term ‘immediate line
manager’ was commonly used to describe a person with supervisory authority.
Line managers did not necessarily have social work backgrounds, although
most were disciplined in the social sciences, human resource management or

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health professions. Of the practitioners who had access to internal supervision,

four also paid for ongoing, private external supervision. They did this to
complement what they saw as primarily ‘administrative supervision’ (Kadushin,
1976) by supervisors who were not social workers. They used additional
external social work supervision to focus more on professional development
and emotional support.
The nine respondents without access to internal supervision were employed
in the community sector, schools, or in bureaucratic ‘sole worker’ positions. As
a compensatory measure, all of these respondents took personal responsibility
for accessing external supervision. As this was a choice within their control, all
elected to find supervisors who had social work backgrounds.

Use of Supervision
It is the nature of direct practice that finding time to discuss important issues is
often difficult. Eighteen respondents reported that they had had some
discussion with a supervisor about the ethical dilemma. Ten did not discuss the
ethical dilemma, and two could not recall. Respondents who had external
supervisors were more likely to have raised the ethical dilemma in supervision
sessions, requesting dedicated time for clarification of ethical dimensions and
problem-solving. In most cases, the ethical issues were discussed with super-
visors around the time that they were first recognized as being ‘ethical
dilemmas’ and assistance was sought with the decision-making process. Some
respondents did not discuss the situation until after it had reached closure. In
these situations, either supervisors could not be contacted, or decisions needed
to be made with a degree of urgency.

Reasons for Failing to Engage in Supervision

Although supervision may theoretically exist, it is not always smoothly trans-
lated to practice. Hawkins and Shohet (1989: 21) have identified blocks to
supervision as including (a) previous experience of supervision, (b) personal
inhibition, (c) difficulties in the supervisory relationship, (d) organizational
blocks, (e) practical blocks such as finances or geography, and (f) organizational
culture being antithetical to supervision; or a combination of these. All of these
blocks, with the exception of (a), were evidenced in the reasons cited by ten
respondents who indicated clearly that they did not discuss the ethical issue with
their supervisor at all (although many did discuss it with other colleagues or
family). Equally, respondents who did have some discussions with supervisors
also came up against some of these blocks.

(1) Practical blocks In some cases, the supervisor was not available when the
ethical dilemma arose and immediate decisions had to be taken. Issues such as
supervisors being on holiday or acting in different positions, frequent cancella-
tion of appointments due to busy schedules, difficulty contacting private super-
visors, and financial costs were raised as examples of practical blocks. For some,

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 McAuliffe & Sudbery: ‘Who Do I Tell?’

this reflected a more general lack of accessibility. Vivienne explained that her
supervisor was on holiday at the time of the ethical dilemma, but said:
I have had supervision twice in this office in the last two years . . . every now and again
I will make an appointment but they invariably get cancelled.

Lack of availability is also problematic in rural areas where one of the major
difficulties of practice is the absence of effective supervisory structures. The
enmeshed nature of many rural communities makes workers sensitive to issues
of privacy. Emma explained in relation to rural practice:
I was very nervous to share my situation with anyone where the whole town seemed
linked or related in some way or other. I had tried to set up various methods of super-
vision locally, but didn’t feel comfortable with any of them.

She eventually located a private supervisor and arranged telephone super-

vision, although ‘he was expensive and I had to pick up the tab’. Financial issues
were also problematic for Kimberley who said:
When the [ethical dilemma] occurred I was just starting professional supervision. I had
one session but because of the lack of money I stopped supervision for the next seven
months . . . during that time I did talk on the phone to my professional supervisor
twice, which was helpful.

(2) Organizational culture In some situations, line managers were primarily

concerned with administrative tasks and resource allocation and were therefore
not seen as well placed to offer supervisory advice on complex practice or
ethical issues. Rob illustrated this point with the comment:
My immediate line supervisor . . . was not a confident caseworker. His perception of
his task was to keep the work unit running and ensure that there were no problems
that might reflect on his ability to manage a welfare service unit.

Daniel also presented this view of his supervisors:

Their notion of clinical supervision was how to control you to operate this organis-
ation . . . all ethical considerations were funnelled towards the maintenance of the
system, not towards the goal of providing human services.

It could be argued, perhaps, that ‘no supervision is better than bad super-
vision’, particularly if supervisors lack the clinical skills to appreciate the diffi-
culties of casework. The perception of powerlessness or inability to effect
change was evident in situations where the ethical issues were based in organiz-
ational structures and policies. These comments reflect arguments mounted by
Ife (1997) and others who write from the critical perspective that views super-
vision as a control function of managerialist organizational contexts. Workers
who recognize attempts by supervisors to control and coerce in the name of
management and efficiency are unlikely to engage in honest reflection about
practice, and are likely to be those workers who adopt covert strategies
designed to maximize professional autonomy and resist the dominant culture.

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Journal of Social Work 5(1)

(3) Difficulties in the supervisory relationship Several respondents indicated

that if the quality of the supervisory relationship was problematic there could
be reluctance to engage in discussions about what were personally difficult
ethical issues. Several workers mentioned feeling ‘uncomfortable’ with their
supervisors, as illustrated in the following comment:
I did not raise it [the ethical dilemma] in supervision since, at the time, supervision
was intermittent and it wasn’t the right situation for me to feel comfortable doing so.
(Gordon)
In one case involving a difficult mental health client, the supervisory
relationship deteriorated to the point where a supervisor (medical) decided that
the ethical issue was not to be discussed, effectively banning any attempts at
exploration of the situation or the worker’s role in it. Belinda said:
Unfortunately I became emotional and he [the supervisor] said he was not prepared
to discuss the situation further and did not wish to discuss [the client] ever again.

In these situations, workers had little option but to turn to personal supports
and private supervisors. There were no situations in which respondents indi-
cated that the difficulties in the supervisory relationship actually improved or
were constructively addressed. Workers either actively avoided supervision
altogether, or changed their supervisor where this was an option, or, where it
was not an option, moved to another place of employment.
In one case, discussion about the ethical issue was actively avoided because
the worker’s actions constituted a clear ethical breach. Jack was clear that he
did not discuss his ethical conflict with his private supervisor until quite a while
later, saying:
I never brought this up because I knew his reaction . . . I’ve discussed this issue a lot
with him and I still know his reaction to it is that I made the wrong decision . . . it was
black and white, right and wrong, and I was in the wrong.

Barriers were experienced more commonly in relation to internal super-

visors where the organizational culture set up situations of power imbalance
between supervisors and supervisees, or where there were problematic
relationship issues. Difficult supervisory relationships were less likely to be
resolved in hierarchical organizational structures as supervision or line manage-
ment was tied to a particular senior position. Choice of supervisor in these cases
was limited. Where difficult relationships arose in external supervision, the
worker at least had the power by virtue of contract to cease the arrangement.
Blocks in relation to external supervision were therefore more practical in
nature and more easily able to be resolved.
A consistent theme from the respondents was that supervision was critical
to sound and accountable social work practice. Those who found it beneficial
expressed relief that good supervision was available to them. Those who did
not find the particular experience useful were not overtly hostile towards super-
vision in general terms. Those who failed to make use of supervision, even

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 McAuliffe & Sudbery: ‘Who Do I Tell?’

though it may have been available, commented that they may have reached a
clearer level of resolution had they taken the opportunity to thoroughly work
through the ethical components. The views of respondents in relation to the
importance of professional supervision reflect the position of the profession
that ethical practice is enhanced by access to appropriate consultation and
supervisory processes (AASW, 1999). While front-line workers are directly
responsible to supervisors in most organizations, they are also part of a work
context that includes other staff. The following section will move on to explore
worker–colleague relationships in the context of professional support.

Support from Colleagues

Colleagues are often the people with whom workers have most contact on a
day-to-day basis. Negotiation with colleagues involves sharing of office space
and other physical resources, as well as the treatment of clients and operations
of the workplace. The colleagues of respondents covered a broad range of
professional disciplines including medicine, nursing, psychiatry, psychology,
occupational therapy, teaching, human resource management and business.
Colleagues also included untrained volunteer staff employed in some
community-based programmes. Pines (1982: 202) acknowledged that relation-
ships in the workplace can be a source of stress, but said that ‘a supportive
network of colleagues is especially crucial when work is emotionally demand-
ing and when it involves making critical decisions that can effect the life and
well being of other people’.
Of the 30 respondents, 24 indicated that they discussed the ethical dilemma
(at some stage through its progression) with people they defined as colleagues.
This discussion was more likely to have taken place at some point through the
duration of the dilemma rather than after the issue had reached closure.
Although the majority of respondents worked closely with colleagues from other
disciplines, there was a strong propensity for workers to gravitate back to social
work or social science trained colleagues for support in cases of ethical conflict.
In the discussions of colleague support, it was like-minded social workers who
rated the highest mention. Where there were no social work (or equivalent)
colleagues in the actual workplace, social workers from other organizations were
approached, or social workers who were friends or partners were contacted. A
sole social worker in a community-based organization, for example, sought
support from a social worker at a nearby youth service who she knew had also
been in the position of dealing with a similar ethical issue. Another derived
support from a colleague with a social science background who he knew had ‘a
very strong social justice critique’. The linking thread in the seeking of support
was the finding of a commonality of interest. For some, it was the shared work
with a client or family, or the acknowledgement of similar practice experiences.
For others it was the sharing of a strong value position, or the development of
a united front against perceived organizational abuse.

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Reasons for Not Discussing the Ethical Issue with Colleagues

Respondents who did not receive any form of support from colleagues were in
the minority. The reasons given for failure or reluctance to seek support fell
into five main categories.

(1) Feelings of personal and professional inadequacy Not surprisingly, some

respondents felt that they may have been judged harshly by colleagues and felt
uncomfortable seeking their support. When allegations of sexual abuse of a
child client were made against Rob, he said:
I did not discuss the matter with many people, because I remember feeling that I had
done something wrong (even though I knew that was not the case). I felt dirty
somehow and also felt that I had failed as a clinician.

Wendy, when diagnosed with serious depression and needing to decide

whether it was ethical for her to continue working with clients, said that she
tried to keep her situation secret for as long as possible. She stated:
I didn’t say anything else about it because I was quite embarrassed about it . . . it’s the
whole thing of you should cope . . . you should be able to cope otherwise you’re a
failure . . . the stigma of people feeling that you’re a failure or an ineffective social
worker.

These feelings are common, according to Turner (in Lishman, 1998: 99), as
‘Many workers feel they must appear to be coping well with their work at all
times. What they see as their less acceptable thoughts, feelings and actions are
suppressed, denied and avoided, for fear of being seen as not a good enough
worker.’ Workers who experience problems in their personal lives or who suffer
‘impairment’ are often reluctant to seek assistance for a range of reasons,
including fear of exposure and the belief that they should be able to work out
their own problems (Reamer, 1992).

(2) Lack of confidence and trust in colleagues Some respondents expressed a

decided lack of trust in colleagues and were concerned about unanticipated
outcomes for themselves and their programmes. Lucy felt unable to trust her
committee of management and therefore did not feel confident in talking to
them about her co-worker’s drug problems. She said:
It would have been good if the people who had been managing me had been people
who I felt confident would understand these issues . . . but these are just people in the
community.

Kimberley showed a similar distrust of other workers in the welfare sector

when she said:
I wanted to tell my community workers network to get support from them, but I felt
the network was a bit wide and the confidentiality of the issue was important as we
did not want to do unnecessary damage to the name of our centre.

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These comments show a lack of trust in others working in human services,

whether these be managers or co-workers. Literature on job-related stress and
burnout indicates that negative attitudes towards others can be a beginning
cause for concern (Maslach, 1982).

(3) Concern about negative consequences The issue of vulnerability of clients

and programmes has been previously discussed and was again highlighted when
exploring reasons for not consulting others in the workplace about sensitive
issues. Belinda was aware of the difficult context in which she was advocating
for a mental health client, and said:
I was wary about discussing X [the client] with others in case it somehow made it worse
for her [e.g. directed to withdraw from representing her at negotiations].
Nell expressed similar concern for both her client and herself, saying:
I didn’t use any local employee (for support) because I realized once I had embarked
on this course of action, I had to be strong and keep it very much to myself . . . any
leak may not only be detrimental to myself but also would have definitely run the risk
of information getting back to management, resulting in the parent losing any possible
chance of a positive outcome.
In these situations, workers were both client-focused and self-protective,
and strategies involved covert plans that necessitated secrecy. The negative
impact of this secrecy was the inability to trust others, resulting in experiences
of intense isolation within the workplace. It was little wonder that these
workers, who subsequently resigned, were unable to continue working in an
environment where the constant concern was that something bad was going to
happen to either themselves or their clients.

(4) Difference of ethical perspectives Some respondents were concerned that

colleagues would not comprehend the ethical nature of the issues with which
they were struggling, and chose as a result not to discuss them with others. Ivy
found it very difficult to understand why other social workers did not appear to
have similar ethical concerns about the aged care industry. She said:
Even if I have cases like this now I don’t discuss them with other social workers
because they do see aged care as their bread and butter and do not appear to have the
same ethical dilemmas that I do . . . I haven’t met a social worker yet who feels that
we should be arguing with the system.
Don also expressed surprise that other social workers in his organization
did not pick up on the ethical contradictions of what he clearly saw as exploi-
tation of an indigenous family. He said:
In [the organization] there were those social workers around but not those who
seemed to see the significance of the event.
Social workers who work from a critical perspective are in the minority, and
it is not surprising that structural or oppressive issues are not viewed in the same

33
Journal of Social Work 5(1)

way by many in the profession who take a more traditional approach to the
work.

(5) Sensitivity of ethical issues involving colleagues There were a number of

ethical issues that involved colleagues, and this made it quite difficult in some
situations to openly discuss concerns with others in or outside the workplace.
Samantha illustrated this point clearly when she said:
It was difficult to have sounding boards given the involvement of a staff member. It is
not unusual within the social work team, of which there are six, to discuss difficult or
complex cases and get another perspective. However, given the confidential nature of
a staff member, this was felt not to be appropriate.
Lucy found the same difficulty in her situation, saying:
I suppose if I had things to talk about, we’d talk about them in a staff meeting time,
that was sort of a supervisory debriefing session as well as the staff meeting . . . but
you could never talk about those sorts of things in a staff meeting in front of social
work students.
In summary, findings indicate that although there was sometimes reluctance
to discuss sensitive issues with colleagues, there was still a relatively heavy
reliance on colleagues for advice and emotional support. Colleagues provided
a range of support roles that were both similar to and different from the roles
played by supervisors. Power dynamics inherent in supervisory relationships
were largely responsible for some of the differences. Overall, the support from
colleagues was perceived positively, and it was interesting to note that the
primary source of colleague support was from other social workers, or
professionals with social science backgrounds. This finding lends strength to the
argument that professional values provide a common sense of purpose and
understanding in what is often a hostile and competitive environment.

Support from Family and Friends

While the different models of ethical decision-making (Congress, 1999;
Loewenberg et al., 2000; Rothman, 1998), and the AASW Code of Ethics
(1999), strongly encourage practitioners to consult with supervisors and
colleagues, there is little mention of the role of significant others. The literature
on social work ethics has not addressed the question of the personal supports
social workers turn to when involved in complex ethical issues that may intrude
on out-of-work time. One of the aims of this study was to investigate whether
respondents elected to discuss the ethical dilemma with people outside the
workplace, and if so, were these family, friends or significant others? If respon-
dents did not seek support outside the boundaries of work, what were their
reasons for not doing so? This was one area that respondents discussed with a
degree of reluctance. The general sense from the researcher perspective was
that for many respondents, the acknowledgement that discussions about

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 McAuliffe & Sudbery: ‘Who Do I Tell?’

sensitive cases may have taken place outside the organization could have consti-
tuted a breach of ethics (confidentiality) or unprofessional practice in itself.
The data suggest that there were varying levels of disclosure and discussion
with partners and immediate and extended families in relation to the ethical
dilemma. Twenty-four respondents made some comment about the role
partners or family played (or did not play) during the course of the ethical
conflict. Only 18 of these indicated that they had actually discussed the ethical
dilemma with a partner or family member. The others gave reasons for not
entering into such discussions. Levels of support, or lack of it in some cases,
were influenced by a combination of the quality of personal relationships, the
understanding that partner/family had of social work, and partner/family’s
expressed views on the actual ethical issue.
While there were some examples of medium- to high-level support, these
findings indicate that the support sought and received by partners and family
members was predominantly low-level. Support in the majority of cases was
limited to brief discussion and reassurance that the workers had the confidence
of their partner/family in whatever course of action they ultimately decided to
follow. A number of respondents described partners who were significantly
detached, and in some cases overtly hostile. Those few social workers who did
indicate that they received high levels of support from partners, also indicated
that their partners were professionals (e.g. social workers, lawyers, police,
managers) who had a good understanding of human service work and its
inherent difficulties. The understanding of practice context appears to be a
critical factor in meaningful social support, as will also be seen in findings in
relation to support elicited from friends.
Only six respondents indicated that they turned to external friendship
networks for support and advice at some point during the ethical dilemma.
Three others mentioned the role played by friends in a more general sense.
These friendship supports tended to be people who were also social workers,
members of a social-science-related discipline, or people who had some
common understanding of the sensitivity of the issues involved. Friends played
one of two roles in the context of support in relation to ethical dilemmas. Some
friends played the role of providing general support and discussion of the
ethical dilemma within its broader context. In addition to general discussions,
friends were also asked for specific advice and support in relation to the ethical
issue. In these situations, friends were sought out for their expertise or knowl-
edge in a particular area. Lucy, for example, contacted a friend who was a nurse
and a previous heroin user to seek his advice about how to approach her
colleague to ascertain the extent of his drug problem. She also spoke to another
social work friend about whether or not she should inform management of the
colleague’s behaviour. She found the advice of these trusted friends highly
valuable.
These findings indicate that friends played a relatively minor, although
important, role in providing support and advice to the respondents in this study.

35
Journal of Social Work 5(1)

Friendships with people of similar professional backgrounds were valued for

their commonality of understanding and ability to debate issues within a shared
value context. Shared social backgrounds were also important in some cases
where a professional perspective was not the common link. Friends were
respected for their professional experience, acknowledgement of feelings, and
ability to listen, reflect and offer reality checks where appropriate. There were
also comments made about why friends were not consulted. These reasons will
be discussed in relation to personal relationships generally and will therefore
include family and partners.

Reasons for Not Seeking Personal Support

In discussions about whether respondents sought advice, support or assistance
from partners, family or friends (i.e. the personal sphere), the data suggest five
reasons for reluctance to rely on personal supports. These comments relate
primarily to the specific ethical issue, but also relate more generally in some
cases to the participant’s day-to-day work and role in the organization.

(1) Detachment from social work A common theme was the perception by some
respondents that their partner or family members had a lack of interest in, or
understanding of, the context and value of their work, or a remoteness from
social work by virtue of different occupational status or culture. This detach-
ment made some respondents reluctant to discuss work issues at home. Rob
explained his sense of isolation from immediate and extended family and his
perception of the negative value ascribed to his career in this statement:
While the family group were interested to hear periodically about some of the case
scenarios in the work that I did, my job was not (I believe) seen as a real job that was
worthwhile and my profession regarded positively especially by the males in the family
group. It was like ‘Rob is a really nice guy, but it is a shame that he doesn’t have a real
man’s job.’
Ruth also described a sense of family detachment by virtue of different
occupations as she discussed one of the reasons for not discussing ethical or
other social work issues at home:
The people at home are pretty remote from social work. My husband doesn’t have a
job that is anything like social work. My son is a doctor, which is pretty remote from
social work. A teacher, someone in the bank . . . they really aren’t close to social work.
These experiences of detachment are not always necessarily negative, as
some workers welcome the opportunity to escape home to a situation where
there is no expectation that work will be discussed. Where detachment can be
damaging, however, is where this is combined with a lack of value and respect
for the nature of the work.

(2) Personal/professional boundaries In some cases, respondents indicated that

they had made efforts to maintain a separation between work and home, which

36
 McAuliffe & Sudbery: ‘Who Do I Tell?’

precluded discussion of work-related issues outside the workplace. This

creation of personal/professional boundaries is a common self-care strategy to
manage increasingly stressful workloads, and a way of ensuring that personal
needs are given priority. As April said:
I didn’t discuss the issue with people in my home life, because I still felt it was a
professional issue and I was very clear about not imposing my work life on my personal
life.

(3) Negative impact for significant others In some cases, respondents were
aware of the potential negative impact for significant others by discussing diffi-
cult work-related issues. Annie relied on her knowledge of vicarious trau-
matization in her refusal to discuss work issues with friends. As she pointed out:
The work that I do is really intense and distressing and not many people can deal with
that or like to hear it . . . I’ve got a very good personal network normally, but there’s
just detailed stuff that you can’t share . . . we know so much now about vicarious
traumatization . . . I’m conscious that I wouldn’t want to put my friends through that
sort of thing so it doesn’t go anywhere other than supervision . . . sort of unfortunate
but that’s the nature of the beast.

The effects on others of hearing details of the situations that social workers
engage in can be distressing, particularly as many issues involve emotive stories
of tragedy, loss and destruction of human lives. Social workers do need to be
very sensitive to the potential impact on others when discussing difficult
situations.

(4) Confidentiality and appropriateness Some respondents considered dis-

cussion of work-related issues outside the organization to be a breach of confi-
dentiality, and a number mentioned that when they did discuss issues with
family or friends, they went to great lengths to disguise details. As Ruth said:
I might tell them the funny things, the general funny things that happen, but no, I never
take anything like that home . . . also just the confidentiality issue. I just never do that.

Julie echoed this view, saying in relation to her family:

I couldn’t breach confidentiality or anything else . . . they were aware he was a young
person who was on my caseload and I had responsibility for him and that was sort of it,
and they didn’t know very much else and I didn’t really speak much to them about it.

In summary, a number of reasons have been presented that support the

finding that respondents did not rely heavily on personal supports, be these
family or friends, in managing the ethical issue with which they were
confronted. Some of these reasons, such as taking care with confidentiality,
maintaining boundaries and awareness of negative impacts, are indicative of
good practice. These are strategies that social workers are encouraged to adopt
to maintain practice standards and combat work-related stress. There was little

37
Journal of Social Work 5(1)

evidence to suggest that respondents gained more than general support from
the personal context, and in many cases this support was clearly lacking.

Summary
This study examined the experiences of individuals caught up in events some
of which were profoundly disturbing. These events involved the life or death of
their clients, their own livelihoods or careers, and those of colleagues or
untrained workers. In general, it was clear that many practitioners experienced
intense feelings of isolation at points through the ethical conflict.
Dividing potential sources of support into three categories (supervision,
colleagues and personal/social contacts), this paper has discussed whom the
workers turned to for support, and the reasons respondents gave when the
resources were unavailable or inappropriate.
Of the 30 respondents:
• All had access to professional supervision, although nine made their own
arrangements to access external supervision.
• All respondents believed that good supervision was critical to sound and
accountable practice, but only 18 had had some discussion about the ethical
issue in supervision. This was more likely to have occurred, and been a
thorough discussion, if the supervision was external to the organization.
• Less than half had been able to discuss the issue with the organizationally
arranged internal supervisor.
• 24 respondents discussed the issue with people they defined as colleagues.
These colleagues came from a broad range of disciplines, but there was a
clear preference for discussion with colleagues who had a social work or
social science background.
• 18 indicated they had discussed the issue with friends or family, but this was
predominantly at a low level.
Table 1 presents an overview of the primary themes that emerged from the
data for respondents failing to elicit support from family, friends, colleagues or
supervisors.
The picture from this overview is that respondents were acutely sensitive
about the impacts of the ethical issue not only on themselves but on significant
others, and in some cases this caused them to reject possible sources of social
support. There was a general recognition that support was an important factor
in ethical management. There were no respondents who made their way
through the course of the ethical dilemma without some recourse to another
person. All sought support at some level, although in many cases the level of
discussion was only minimal. There were few situations in which a participant
engaged with someone else in a comprehensive and soul-searching personal
and professional exploration of the conflicting ethical principles, professional
responsibilities and rationales.

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 McAuliffe & Sudbery: ‘Who Do I Tell?’

Table 1 Reasons for failure to elicit personal and professional support

Reasons for failure to elicit • Practical blocks (availability, geography, finance)

supervisory support • Organizational culture
• Difficulty in supervisory relationship

Reasons for failure to elicit • Feelings of personal and professional inadequacy

colleague support • Lack of confidence and trust in colleagues
• Concerns about negative consequences
• Difference of ethical perspectives
• Sensitivity of ethical issue involving colleague

Reasons for failure to elicit • Family detached from social work

personal support • Personal/professional boundaries
• Negative impact on significant others
• Confidentiality and appropriateness

Conclusion
The boundaries of this study are that the data arise from self-report from a self-
selected sample, and are based on social workers working in direct practice in
a specific welfare regime. Intrinsically, the incidents referred to will have
contested meanings (and one, albeit with the consent of the client, involved an
ethical breach) – and this study does not attempt to investigate perceptions of
other stakeholders. The study points to the importance of further research to
expand our knowledge of such critical ethical incidents. For operational
managers, it suggests the value of investigating confidential incident reporting
mechanisms – such as the techniques being developed in safety critical areas in
rail transport (Davies et al., 2003; Wallace et al., in press) or the health services
(Australian Patient Safety Foundation, 1998).
Perhaps the greatest cause for concern from this study is that organizational
supervision within social services agencies, which is established ostensibly to
ensure standards and ethical practice, appears at the moment to be the least
satisfactory in enabling effective opportunities for staff to examine the most
crucial of the situations that confront them, the situations when standards and
ethical practice are most central. Many policies introduced for apparently
rational and laudable purposes have unintended negative consequences, and it
may well be that organizational emphasis on performance management,
procedural monitoring, and staff control have the effect of minimizing effective
attention to critical aspects of effective and ethical service. Stated more broadly
so as to cover the situations in which the problem is the infrequency or in-
accessibility of supervisory contact (as well as its content), the issue is that social
services agencies need to be acutely aware that from the user of service onwards
they are essentially managing (and therefore supporting) relationships. If this

39
Journal of Social Work 5(1)

is not prioritized, no amount of monitoring of material resource or service

outputs will create effective and ethical practice.

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 McAuliffe & Sudbery: ‘Who Do I Tell?’

D O N NA M C AU L I F F E is a lecturer in the School of Social Work and Applied

Human Sciences at the University of Queensland, Australia. She lectures on social
work theory and practice, supervision, ethical issues in social work practice, ethics
in education and ethics in direct practice. Her recent publications reflect empirical
and analytical research in these areas. She is convenor of the Queensland Branch
Ethics Committee of the Australian Association of Social Workers. Address:
School of Social Work and Applied Human Sciences, St Lucia, Queensland 4072,
Australia. [email: d.mcauliffe@social.uq.edu.au]

J O H N S U D B E RYis a member of Salford Centre for Social Work Research and a

Senior Lecturer at the University of Salford, UK. He is an accredited
psychotherapist with the UK Council for Psychotherapy (UKCP) and Chair of the
Group for the Advancement of Psychodynamics and Psychotherapy in Social
Work (GAPS). He has wide experience in voluntary, statutory and independent
social work. His research and teaching interests focus on relationship-based social
work. Recent publications relate to therapeutic social work and to children who
use assisted ventilation. He pays particular attention to cross-disciplinary and
transnational perspectives. Address: School of Community, Health Sciences and
Social Work, University of Salford, Frederick Rd, Salford M6 6PU, UK.
[email: j.sudbery@salford.ac.uk]

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