Ethical considerations for unorthodox practice

When we reflect on our engagement practice(s) as CoS, BIS, and COBU practitioners, can we think about the things that we do that stretch the boundaries, practices which might be seen as unorthodox or that might raise eyebrows with agencies such as the NDIA?

These unorthodox practices are not written into our role descriptions, and some of these are sensitive issues, sometimes presenting as dilemmas to us around the familiar topic of boundaries.

A key skill of a good ‘paid’ supporter is developing relationships of trust that are reliable, consistent, and not over-promising. Relationships and trust can be difficult, and practitioners can often face challenges in establishing and maintaining their roles and boundaries.

We are not immune to these ‘difficulties’ at the Jeder Institute. In the NDIS world, we are bound by the NDIS Code of Conduct – one of many regulatory guidelines that set an ethical framework for our work.

I want to initiate an Ethics Focus Group / Jedlet under the Culture Jedi to explore the following:

1. Our practices might impact on or present tensions to our paid roles and boundaries – essentially, to name some of these practices, as this builds a more realistic picture of what it means to be a paid practitioner and a fellow member at the Jeder Institute.

2. “The ultimate person-centred approach is arguably to save lives (that want to be saved), and how one gets to that place with some of the most disadvantaged, complex and chaotic individuals may, on occasion, raise the eyebrows of those not directly immersed in this work or engaged in certain relationship dynamics.”

3. Unusual practice or practice which sits outside of standards and policy.

Examples of practices that may raise eyebrows or which people sense would not be allowed by other agencies:

• The time we spend with participants and the time we have to get to know them – Giving too much or too little? Do we set boundaries?

• Advocating for clients, particularly around ‘unwise decisions’ – We have examples of paid workers “enabling unhelpful behaviours” in advocating for their participants. Specifically about support on the ‘choices’ participants make to use substances.

• The luxury of being able to spend time doing normal things with participants – We have examples of participants saying things like, “I don’t want to talk about my NDIS Goals and my disability; I would rather go out with you and have some fun. How do we approach this in the long run? What is the purpose of our relationship with the participant?

• Physical affection towards participants, for example, to greet them or when they are upset: “We decide to be physically affectionate because we have high levels of sympathy for people; perhaps we want them to feel that they belong. Do we need to do that to build trust and progress towards THEIR QOL?

• Sharing personal experiences with Participants, “Some of my participants don’t know much about the professionals involved in their lives; they often get told, “you’re not here to talk to me about how I am. I’m here about your life”. This idea that you either don’t share anything or are in danger of becoming a friend is very polarising. How aware are we of the positive/negative outcomes resulting from our actions and commitment?

• Working with participants when they are under the influence. Should we say:  “they’re not fit for us to work with them?” Can we work with people under the influence? Can the experience still be a positive, a one?

• Keeping contact with some clients even after they have moved on (unpaid support). Do we have the emotional capacity for this?

• What are our boundaries? Do we set clear expectations/ground rules early!? Are we ready to manage disclosures, past traumas, and clinical support needs? Do we assume accidental counsellor roles? Do we feel competent?

• Boundaries concerning encouraging clients to do things that might be out of their comfort zone. When providing advice regarding risk-taking, do we apply a team approach or back ourselves?

These are just a few common examples and apply to our member-to-member relationships. We’ve discovered that boundaries are essential for having healthy relationships. The challenge will be that some of us will say that we are personally very comfortable with some practices, and others will say the same is not necessary. We need to identify our own boundaries within the context of our regulatory and ethical constraints.  

We will often apply higher than necessary levels of kindness and generosity only because we cannot think about long-term effects. We have many examples of kindness being used as a short-term solution to problems that we had to “think on our feet”. Often, these short-term solutions may disempower participants and fellow members – in the long run.

Essentially, I would like our focus group to emphasise reflective practice. This means that our members' views on many practice examples are changing and developing, and we establish a space for exploring our practice from an ethical lens, challenging each other’s thinking on our practice and the quality of relationships.

Ethics:

Part of what makes us humans unique is our freedom to determine how we’ll act. Whenever we made a choice, we could have made a different one. [Ethics.org.au]

Values tell us what’s good – they are the things we strive for, desire, and seek to protect

Principles tell us what’s right – outlining how we may or may not achieve our values

The purpose is your reason for being – it gives life to your values and principles

Ethics is the process of questioning, discovering, and defending our values.

Questions to guide our decision-making: 2 Page Poster developed collaboratively in July 2022. See Below.

Related resources:

• Decision Making Process/Matrix

• Jeder Code of Conduct

• NDIS Code of Conduct Policy

• Relationships Policy

• Alignment with Funding Body expectations and registration commitments.

• Compliance and Enforcement policy suite | NDIS Quality and Safeguards Commission (ndiscommission.gov.au)

The NDIS Commission has a range of tools for responding to non-compliance. The overarching Compliance and Enforcement Policy provides a broad overview of our compliance and enforcement functions, strategies and tools. A number of more specific policies have been developed to provide guidance on the NDIS Commission’s approach to the use of particular compliance and enforcement tools. These policies are available on this page and are:

• Compliance Notices Policy

• Infringement Notice Policy

• Enforceable Undertakings Policy

• Injunctions Policy

• Civil Penalties Policy

• Vary, Suspend or Revoke Registration Policy

When: Last Friday of each month

Time: 3pm – 4:30pm

Zoom: https://us02web.zoom.us/j/81476028545?pwd=ZzEzNStOS3g0Z2dEWWdMOEdoVGNkZz09

Meeting ID: 814 7602 8545 Passcode: 802774