Applying Ethical Decision-Making in Community-Based Practice

Therapists who practice in the home and community face unique ethical challenges related to professional boundaries, dual roles, and confidentiality. Unlike office settings, which are designed to maximize privacy, therapists working in the home are often at the mercy of happenstance encounters, such as family members or neighbors who may walk into a session unannounced. It is much more difficult to protect sensitive and confidential information, yet therapists are ethically obligated to do so. This training provides guidance on anticipating and navigating ethical challenges in home and community-based services involving confidentiality, dual roles, and boundary crossings.

A goal of this course is to ground therapists’ decision-making process in the ethical codes established by all the major professional associations, such as NASW, ACA, APA, and AMFT. The webinars in this course cover the key differences between ethics, law, and morality, and provide a model for ethical decision-making. Thought-evoking dilemmas are provided to build critical thinking skills associated with challenging decisions that clinicians face working in our field, such as handling family invitations to sit with them for meals, attending events with them, or becoming friends on Instagram or Facebook.

This course is an edited updated version of a live-streamed training provided to a large group of intensive, in-home therapists on November 4th, 2020. Dan and Rebecca have many years of experience both as front-line therapists providing home-based treatment and as supervisors/program directors of community-based programs. They inject their rich experiences into the content of these webinars, making ethics both practical and engaging.

This is an introductory level course. The target audience is all behavioral health professionals working with children and adolescents.

Objectives:

As a result of participating in this training, participants will be able to:

Define ethics in relation to law and morality.
Recognize the unique ethical challenges found in delivering home and community-based services.
State the difference between boundary crossings and boundary violations.
Identify Five Steps to Ethical Decision Making.
Name three ways to prevent a breach of confidentiality.

This course uses an online distance-learning self-paced format. It includes recorded audio, recorded video-based webinars, and selected readings. There are post-tests to ensure comprehension of the material. Participants can communicate with the instructors via the online moodle interface. Real-time communication with the instructor in our online, self-paced distance learning courses is not possible. However, participants can send an email to the instructor via the online moodle interface within the course and expect to receive a response within 48 hours. All course content, including post-tests, should take approximately two hours to complete.

Frequently Asked Questions
Visit our Self-Paced, Online Continuing Education Policies & FAQs for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.

An Ecosystemic Approach to Supporting LGBTQ Youth
and their Families

Click here for Sabrina Valente’s Bio.

Therapists working in intensive, in-home programs are increasingly encountering youth who identify as LGBTQ. One reason is that youth are coming out earlier and earlier. In families presenting for treatment, caregivers often do not understand their child’s experience and at times can be rejecting of their sexual orientation or gender identity. This markedly increases the risks of negative outcomes for LGBTQ youth. Therapists with little training in LGBTQ are at-risk of acting on myths or stereotypes and can become negatively isomorphic with nonaccepting communities. This course is comprised of five webinars designed to help therapists to work from an LGBTQ-informed perspective, understanding and helping LGBTQ youth in the context of their families and their communities. Particular focus is given to how to work with families in which caregivers are non-supportive/non-accepting of their LGBTQ youth. The webinars in this course are comprised of edited portions of a live webinar presented to therapists working in Pennsylvania FBMHS programs.

This is a Intermediate Level course. The target audience is all behavioral health professionals working with children and adolescents.

Learning Objectives

Identify current commonly used terminology for LGBTQ youth and why terms are important.
Describe the six stages of identity development and the “coming-out” experience of LGBTQ youth
Describe the transgender experience and how it differs from that of gender variant/non-conforming youth
Describe strategies for joining and maintaining equal empathy with LGBTQ youth and their caregivers in nonaccepting families
Describe strategies for strengthening family relationships by shifting caregivers to a more accepting and affirming relational posture with their LGBTQ child.

Course Outline

Unit I: The Spectrum of Gender Identity and Sexual Orientation (70 minutes)
- Slide handouts
- Webinars
  - Gender, Sex, and Identity
  - Understanding the Transgender Experience
Unit 2: Coming out as LGBTQ (65 minutes)
- Slide handouts
- Webinars
  - What It’s Like to Hide One’s LGBTQ Identity
  - Themes and Experiences of Coming Out as LGBTQ
  - The Six Stages of Coming Out as LGBTQ

Unit 3: Application of ESFT in Working with Non-Accepting Families (60 minutes)
- Slide handouts
- Webinars
  - Tips for Joining with LGBTQ Youth and their Families
  - Strengthening LGBTQ Youth Relationships with their Families

Identifying Family Patterns Using the Relational Genogram

Genograms have a long and rich history in family therapy practice, both as an assessment tool and as a tool for reframing problems and their solutions as relational. In this course, Dr. Browning introduces the basic three generation genogram which identifies in pictorial form members of the larger family system and the pivotal events shaping the life of the family and integrates it with a structural map. A detailed symbol legend for describing the qualitative or interactional dimension of relationships between different family subsystems is introduced and demonstrated. A scoring system for quantifying the symbols used in the genogram developed by Dr. Browning and his colleagues, the Genogram Based Interaction Measure, is described as a potentially useful way to assess change in family relationships across treatment. Together, the webinars in this course show how the interactional/relational genogram can be used to construct a systemic case conceptualization that focuses systemic intervention. The course includes a case demonstration in which Dr. Browning conducts a cultural genogram interview, showing how to open and deepen family conversation about strengths, traditions, and experiences with bias in an ethnically diverse, multi-racial family.

This course is designed for intermediate level practitioners. The target audience is behavioral health professionals working with children and adolescents.

Course Objectives
As a result of completing this course, participants will be able to:

Describe the basic genogram symbol legend and the expanded genogram-based interaction measure.
Utilize the genogram as a tool in constructing a systemic case conceptualization and focusing systemic intervention.
Describe roles and methods for conducting a cultural genogram interview.

About the Trainer
Dr. Browning is a professor in the Department of in the Department of Professional Psychology at Chestnut Hill College in Philadelphia. He is a noted authority on psychological treatment with stepfamilies, families of homicide, and families on the spectrum. He has published numerous books, chapters and articles on these topics, as well as on the genogram. Dr. Browning is a diplomat in couple and family psychology and is part of the clinical training team of the National Stepfamily Resource Center. In 2017 Dr. Browning was given an award for Distinguished Contributions to Family Psychology by division 43 of the American Psychological Association.

Constructing a Relational Timeline

Timelines, like genograms, can be useful both in assessment and in creating a relational frame for intervention. As an assessment, the timeline places presenting symptoms in a historical context. The timeline interview, when conducted with the entire family and critical life events of all family members are asked about, the timeline places presenting symptoms in a relational context. Using excerpts from a videotaped family session, this course demonstrates how to conduct a relational timeline, highlighting how it can used as therapeutic tool for shifting the family’s perspective from a behavioral to a relational or systemic perspective.

This course is designed for beginning to intermediate level behavioral health professionals.

Course Objectives
As a result of completing this course, participants will be able to:

Describe the goals of a relational timeline and how to introduce it to families
Demonstrate how to conduct a timeline interview such that it evokes empathy in caregivers and reframes presenting problem as relational.

Uncovering Another Family Secret: Child to Caregiver Violence

Child violence directed at caregivers (CCV) involves coercive actions intended to gain power and control in the home. CCV may involve physical, psychological, or financial damage, and is typically kept secret by families. This introductory webinar reviews the prevalence of CCV, as well as relevant research on the problem. A strong case is made for routine screening for CCV in family treatment. Treatment recommendations based on an eco-systemic structural model of family therapy (ESFT) are described.

This is an edited version of a presentation by the three Pennsylvania FBMHS training directors to a group of FBMHS supervisors on 9/14 for the Behavioral Health Alliance of Rural Pennsylvania (BEHARP), a collaborative representing 24 counties.

This is a Beginning Level course. The target audience is behavioral health professionals working with children and adolescents.

Course Objectives
As a result of completing this course, participants will be able to:

Describe the nature of and prevalence of CCV from a family systems perspective
Describe tools for screening for the presence of CCV in the home
Identify tips for using ESFT to create safety and restore parental control in the home

Trainer Info:
Steve Simms, PhD, LMFT
Pat Johnston, LSW, QCSW, BCD
Wayne Jones, PhD

Frequently Asked Questions
Visit our Online Course Policies for additional information regarding the CFBT online learning center, accommodations for disabilities, reporting problems with the course, instructions for viewing webinars, etc.