During the semester, the student informed the faculty field coordinator of a history of sexual and emotional abuse causing difficulty in school and ability to work with certain client populations.. The student was in therapy with a social worker and psychiatrist. The field coordinator contacted the field instructor to discuss the student's performance in the field. There did not seem to be apparent problems. The field coordinator did not disclose any specific details about the student and focused only on obtaining information about the student's performance. The student deteriorated after the mid-semester break. The field coordinator found that the student had been admitted to a psychiatric hospital and suspended the student from the field placement and contacted the field instructor. The confusion both educators about confidentiality had worsened this situation. Due to additional problems, the student's field placement was terminated. The student was told that returning to school would require documentation of emotional well-being and appropriateness for clinical work. The student chose to withdraw from the program. This example was extreme, but nevertheless highlighted the need for thorough and consistent protocol to guide field faculty in resolving these kinds of situations (Gillis and Lewis, 2004, p. 403).
In a follow-up session with field coordinators and instructors, it was found that 34% of field instructors had had students with psychiatric problems in their placement, ranging from depression and anxiety to unresolved trauma and victimization, which were addressed through referral for mental health services, medication, increased supervision, and placement termination. Thirteen percent reported interns had been terminated from placements for nonacademic reasons. Inappropriate contact with clients and unprofessional conduct were the most-often reasons for termination. Over half of the field instructors had supervised students with psychiatric problems and many believed students should be asked about their mental health history prior to program admission questioned whether students with prior psychiatric problems should be admitted or to continue in the program. They were also unaware of the ADA requirements, which prohibit asking potential students about their preexisting psychiatric problems (Gillis and Lewis 2004, p. 403).
Recommendations included fostering a relationship between the field instructor and faculty field advisor to facilitate more consistent communication and collaboration, promote shared responsibility, and reduce the field educators' frustration and anxiety.
In addition, instructors stated they needed better candidate screening; increased awareness of available resources to students to allow them to be proactive in dealing with potential problems; increased training; mandated counseling for social work interns and student disclosure of problems early in the placement; support from the program for problem resolution, with an intervention plan that clarifies their roles and identifies the procedures for recourse; and more information about the ADA requirement (Gillis and Lewis 2004, p. 404).
Gillis and Lewis (2004) stated that organizations require a clearly articulated plan for addressing student suitability and psychiatric disability, which can be used in all situations to provide a structure for problem resolution and includes: They also stressed the following points:
1. Social Work education programs need a clear understanding of the policies required for the protection of everyone involved, including a familiarity with the ADA and legal requirements that affect the university, students, and agencies and their clients with whom the students have working relationships. The contract between the program and the field agency should detail the agency's responsibilities for compliance with the ADA and consequences of discrimination based on disability.
2. Social Work education programs should designate a key person to craft such policies and orient other faculty, staff, agency field colleagues, and students on policies and requirements.
3. Since many programs may need further resources to fully implement adequate and appropriate services for students experiencing psychiatric disability, programs need to designate someone to advocate for these resources on their campuses.
4. The most important need could be for a key point person to oversee a given situation to the point of resolution. Careful process documentation is essential to assure follow through toward a successful resolution. With agency, faculty, and students, monitoring progress is critical.
5.Orientation for agencies, faculty, and students on policies related to psychiatric disability and what to do if a student is identified is extremely helpful.
According to Strom-Gottfriend (2000, p. 241), "social work education is rife with the potential for ethical conflicts. As faculty carry out their instructional, evaluative, and gatekeeping responsibilities, challenges can arise around fairness, clear expectations, confidentiality, faculty-student boundaries, and overlapping relationships."...
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