Moral Disengagement in Social Work

Abstract

In recent years, social workers have paid increased attention to ethical issues. The profession’s literature has burgeoned on topics such as ethical dilemmas in social work practice, ethical decision making, boundary issues and dual relationships, ethics-related risk management, and moral injury. This noteworthy trend builds on social work’s rich and long-standing commitment to the development of core values and ethical standards evident throughout its history. Unlike allied human service and behavioral health professions, social work’s ethics-related literature has not focused on the critically important issue of moral disengagement. Moral disengagement is typically defined as the process whereby individuals convince themselves that ethical standards do not apply to them. In social work, moral disengagement can lead to ethics violations and practitioner liability, particularly when social workers believe that they are not beholden to widely embraced ethical standards in the profession. The purpose of this article is to explore the nature of moral disengagement in social work, identify possible causes and consequences, and present meaningful strategies designed to prevent and respond to moral disengagement in the profession.

In recent years, social workers have paid increased attention to ethical issues. The profession’s literature has burgeoned on topics such as ethical dilemmas in social work practice, ethical decision making, boundary issues and dual relationships, ethics-related risk management, and moral injury (Banks, 2020; Barsky, 2019; Reamer, 2018a, 2018b, 2021). This noteworthy trend builds on social work’s rich and long-standing commitment to the development of core values and ethical standards evident throughout its history.

However, unlike allied human service and behavioral health professions, social work’s ethics-related literature has not focused on the critically important issue of moral disengagement. The concept of moral disengagement was introduced in the 1990s by renowned psychologist Albert Bandura (1999; see also Bandura et al, 1996). Moral disengagement is typically defined as the process whereby individuals convince themselves that ethical standards do not apply to them. In social work, moral disengagement can lead to ethics violations and practitioner liability, particularly when social workers believe that they are not beholden to widely embraced ethical standards in the profession. In extreme cases, morally disengaged social workers abuse clients, exploit clients, or fail to meet clients’ needs.

Here are several real-life examples of moral disengagement in social work:

• A social worker employed in a Michigan program serving individuals with trauma histories pled guilty to engaging in sexual relationships with multiple clients. The social worker was sentenced to serve up to 10 years in prison. (Aisner, 2008)

• A Pennsylvania social worker was sentenced to 17½ years in federal prison for filing false reports claiming to provide social services to at-risk children and their families, when few or no services were ever provided. The social worker fabricated bogus records to give the appearance that the agency she directed had made required visits and provided services to the family of a child who was found dead in her home. (U.S. Attorney’s Office, Eastern District of Pennsylvania, 2010)

• A New York State social worker was convicted of healthcare fraud and sentenced to 30 months in federal prison after being convicted of submitting reimbursement claim forms to an insurance provider for services that were never rendered. Tape-recorded evidence showed that the social worker instructed a client not to share any information with the insurer regarding dates of service. (U.S. Attorney’s Office, Western District of New York, 2015)

• A social worker with the Mississippi Department of Child Protection Services was sentenced to eight years in prison after being convicted of sexual battery, child exploitation, and contributing to the delinquency and neglect of a minor. The social worker was charged with the sexual abuse of children under her care while she was working for the state protective services agency. (Carlisle, 2022)

Fortunately, the vast majority of social workers behave ethically—that is, they are morally engaged—and would not harm clients or violate ethical standards in these ways. After all, social work is known for its long-standing commitment to altruism and attracts professionals who are deeply committed to ethical practice and helping vulnerable people.

Moral Disengagement in Social Work

According to Bandura and colleagues (1996), moral disengagement develops in the form of six principal phenomena, all of which have direct relevance to social work: moral justification, euphemistic labeling, advantageous comparison, displacing or diffusing responsibility, disregarding or misrepresenting injurious consequences, and dehumanizing the victim.

Moral Justification

Social workers who engage in professional misconduct may view their behavior as having a moral purpose to make it appear socially acceptable. According to Bandura et al. (1996):

People do not ordinarily engage in reprehensible conduct until they have justified to themselves the rightness of their actions. What is culpable can be made righteous through cognitive reconstrual. In this process of moral justification, detrimental conduct is made personally and socially acceptable by portraying it in the service of valued social or moral purposes. (p. 365)

The next case scenario and those that follow are drawn directly from my extensive experience as an ethics consultant and expert witness in many court and licensing board cases involving social workers. Identifying information has been omitted to protect the parties’ privacy.

A social worker was the executive director and owner of a for-profit mental health counseling agency. Over time, the social worker became concerned about the agency’s profit margin, specifically the ratio between revenue and operating expenses. The social worker hoped to sell the agency to a group of private equity investors and worried that recent financial data might negatively affect valuation of the agency and jeopardize the sale. The social worker implemented a scheme to fraudulently bill insurers, including the state’s Medicaid program, by upcoding clinical services and circumventing strict requirements related to clinicians’ licensure and supervision. The social worker rationalized this misconduct by claiming that insurance companies’ reimbursement rates are unconscionably low and that the social worker’s billing practices are necessary to keep his practice afloat and meet the needs of clients.

Euphemistic Labeling

Morally disengaged social workers who violate ethical standards may use euphemistic language to camouflage their actions’ true purposes. Thus, “fraudulent billing” may become “revenue enhancement.” “Sexual misconduct” may become “emotional support.” Bandura et al. (1996) assert that euphemistic language

provides a convenient tool for masking reprehensible activities or even conferring a respectable status upon them… . Through sanitized and convoluted verbiage, destructive conduct is made benign and those who engage in it are relieved of a sense of personal agency. (p. 365)

Here is a case study as an example:

A social worker in private (independent) practice provided counseling to a 22-year-old woman who struggled with depression and anxiety. The client had been abandoned by her biological father and sexually abused by her stepfather. Over time, the client became increasingly dependent on the social worker for emotional support. Frequently the two exchanged text messages in the evening and during weekends. The client told the social worker that she felt like the social worker was the father she always wanted and never had. The social worker told the client that she awakened fatherly instincts in him.

One evening the client had a panic attack and texted the social worker for support. The social worker offered to come to the client’s home to comfort her. The two spent the evening talking. At one point the client started sobbing. The social worker held her and began to caress her. The couple started to kiss and then began a long-term sexual relationship. Eventually the client terminated the relationship and, with the support of a new therapist, filed a licensing board complaint. During the licensing board hearing the social worker emphasized the consensual nature of the intimate relationship and described his efforts to meet the client’s emotional needs.

Advantageous Comparison

By making self-serving comparisons with more reprehensible conduct, morally disengaged social workers can try to create the impression that their misbehavior is less severe or more benign than it is in fact. Social workers who engage in this sort of “advantageous comparison” (Bandura et al., 1996) may compare their misbehavior with other examples of immoral behavior to trivialize their wrongdoing. A case example:

A social worker employed at a family counseling agency provided therapy to a man who claimed that he needed some help with his “mid-life crisis.” The client told the social worker that he was bored with his lengthy career as an accountant and yearned to start a new life chapter by creating his own business. The client sought therapy because of his intense uncertainty about taking on this new risk and the pressures involved in raising investment capital.

During counseling sessions, the client shared his enthusiasm about starting a new horticultural consultation business. The social worker disclosed that he, too, loves horticulture. Shortly thereafter the client offered the social worker an opportunity to invest in his new business. The social worker accepted the offer and invested $15,000.

About six months later, the social worker and client disagreed about the client’s planned purchase of expensive equipment for the new business. The social worker threatened to withdraw his investment. As a result of the conflict, the client terminated counseling with the social worker and filed a licensing board complaint alleging a conflict of interest. At the licensing board hearing, the social worker acknowledged the dual relationship but claimed that his conduct was not nearly as bad as engaging in a sexual relationship with a client.

Displacing or Diffusing Responsibility

Morally disengaged practitioners sometimes try to shift responsibility for their misconduct. Unethical social workers may try to place blame and responsibility onto people under whom they serve. As Bandura et al. (1996) note, sometimes toxic group dynamics can diffuse responsibility: “Any harm done by a group can always be attributed largely to the behavior of others. People behave more cruelly under group responsibility than when they hold themselves personally accountable for their actions” (p. 365). For example:

A hospital-based social worker was part of a team working on the department’s upcoming national accreditation. The department director had reviewed a large collection of patient charts and was concerned about the quality of his staff members’ documentation. The department director identified documentation shortcomings—such as missing notes, date errors, and incomplete discharge summaries—and asked the social worker and her colleagues to revisit and revise those notes without any indication that the notes had been revised. The social worker complied with the director’s request.

A member of the accreditation team detected the patient chart alterations and confronted the social worker. The social worker admitted to the accreditation team member that she knew she should not have altered records without transparency; she explained to the accreditation team member and the director of the hospital’s quality assurance department that she “simply followed” the department director’s orders and did what she was told to do.

Disregarding or Misrepresenting Injurious Consequences

Morally disengaged social workers may try to minimize the impact of their misconduct. This may entail selective inattention or cognitive distortion (Bandura et al., 1996). As long as the detrimental results of one’s conduct are ignored, minimized, distorted, or disbelieved, there is little reason for self-reproach or true acceptance of responsibility. For example:

A social worker was a counselor at a substance use disorders treatment program. One of the social worker’s clients was being investigated by the police as a suspect in a methamphetamine drug distribution ring. A detective learned from a confidential informant that the suspect was receiving counseling services from the social worker.

The detective contacted the social worker and sought information from him about his most recent contact with the client and the social worker’s knowledge of the client’s last known whereabouts. The social worker mistakenly believed he was obligated to disclose this information to the detective. In fact, federal law governing this substance use disorders treatment program—Confidentiality of Substance Use Disorders Patient Records (42 CFR Part 2)—prohibits this disclosure in the absence of a court order.

The social worker’s disclosure led to the client’s arrest. On advice of his lawyer, the client sued the social worker for unauthorized disclosure of confidential information. Initially, the social worker told his lawyer that he did not think he had done anything wrong and that he resented the lawsuit because “After all, my client was dealing illegal drugs. And he’s going after me?! Doesn’t he realize how much harm he’s caused?”

Dehumanizing the Victim

Morally disengaged practitioners who perpetrate harm may cope with their misconduct by reducing the moral value and standing of their victims. Social workers who mistreat others may view their victims as subhuman. For example:

A social worker was employed in a county welfare office. The social worker met with individuals who apply for public assistance, housing subsidies, subsidized health coverage, and other benefits. Over time, the social worker became increasingly resentful of undocumented individuals who sought assistance.

The social worker learned of a recently introduced bill in the state legislature that would require all social workers to report to authorities the identity and addresses of undocumented individuals who sought assistance. The social worker strongly supported the legislation and, even before its passage, began reporting to local law enforcement authorities information about undocumented individuals who sought assistance.

Causes of Moral Disengagement in Social Work

There are complex reasons why some social workers become morally disengaged and violate well-known ethical standards. Research suggests that some social workers are impaired (Pooler et al., 2008; Reamer, 2015, 2023). Their mental health and other personal struggles have led them to use poor judgment and engage in ethical misconduct.

Other social workers are morally disengaged because of other personal crises, for example, practitioners who find themselves in deep financial trouble, which leads them to submit fraudulent invoices to insurers. In other instances, social workers are neither impaired nor desperate financially; rather, their moral disengagement is rooted in greed, for example, social workers who are determined to generate revenue fraudulently or exploit clients financially to support a lavish lifestyle. Further, some social workers who are morally disengaged manifest evidence of burnout and moral distress (Smullens, 2021).

Burnout in the human services has been addressed explicitly since the 1970s (Kerulis, 2013; Maslach & Leiter, 2017; Smullens, 2021). Research on burnout and moral distress has identified three common features that can lead to moral disengagement: emotional exhaustion, depersonalization, and feeling ineffective (Maslach et al., 2001; Reamer, 2021; Thompson et al., 2014). Emotional exhaustion occurs when practitioners feel overextended by work demands and depleted of emotional and physical resources. They feel drained and without clear prospects for replenishment and recovery (Maslach & Leiter, 2017).

Depersonalization entails the interpersonal aspect of burnout. It includes a negative, callous, or excessively detached response to various aspects of the job. Typically, depersonalization develops in response to intense exhaustion, as a way to cope emotionally. Feeling ineffective and a lack of personal accomplishment occurs when social workers sense that their work does not make enough of a difference to justify the effort (Thompson et al., 2014).

Research indicates that burnout in social work can lead to moral disengagement because of the impact that it has on practitioners’ relationships with clients and colleagues (Maslach & Leiter, 2017). Burned out and morally disengaged social workers often find themselves in the midst of conflict with clients and colleagues (Shanafelt et al., 2012).

Extensive research has identified six key sources of burnout for practitioners that can lead to moral disengagement (Maslach & Leiter, 2017): workload, control, reward, community, fairness, and values. Large caseloads can cause chronic stress that contributes to burnout. Also, social workers who experience a lack of control in their jobs can feel intense frustration. In addition, social workers who do not feel sufficiently rewarded in their jobs may become morally disengaged. Further, social workers who experience workplace conflict can become demoralized. Social workers who believe they are treated unfairly in the workplace—for example, due to draconian expectations or organizational policies—can become cynical. Finally, social workers who experience conflict between their professional values and their employer’s values may become dispirited and demoralized. A steady diet of work-related stressors can lead to some form of impairment and seriously compromise the quality of social work practice (Lamb et al., 1987).

Further, impairment among social workers can result from stressors in their personal lives, including relentless stress, mental illness, substance use, and other addictions (Coombs, 2000; Guy et al., 1989; Reamer, 2015; Straussner et al., 2018; Thoreson et al., 1989). As with all people, social workers can be affected by illness or death of family members, marital and relationship problems, financial problems, midlife crises, physical illness, legal problems, and addiction (Guy et al., 1989; Reamer, 2015, 2023; Thoreson et al., 1989). As Kilburg et al. (1988) concluded:

Stresses of daily life—family responsibilities, death of family members and friends, other severe losses, illnesses, financial difficulties, crises of all kinds—quite naturally place mental health professionals, like other people, under pressure. However, by virtue of their training and place in society, such professionals face unique stresses… . Mental health professionals are expected by everyone, including themselves, to be paragons. The fact that they may be unable to fill that role makes them a prime target for disillusionment, distress, and burnout. When this reaction occurs, the individual’s ability to function as a professional may become impaired. (p. 723)

Social Work Ethics Standards

The Code of Ethics of the National Association of Social Workers (NASW, 2021; Reamer, 2018a) includes several standards that are directly relevant to social workers’ moral duty to address impairment, incompetence, and unethical conduct that can be correlated with moral disengagement. First, according to the code, social workers have a duty to address personal challenges that may lead to moral disengagement and compromise the quality of their work:

Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. (Standard 4.05[a])

Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others. (Standard 4.05[b])

Further, according to the NASW (2021),Code of Ethics, social workers have a duty to intervene when they believe colleagues are impaired, incompetent, or engaging in unethical conduct. Practitioners must do what they can to ensure that their own risk of burnout does not prevent them from addressing colleagues’ moral disengagement (secondary moral disengagement). Regarding colleagues who appear to be impaired, the code states:

Social workers who have direct knowledge of a social work colleague’s impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action. (Standard 2.08[a])

Social workers who believe that a social work colleague’s impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations. (Standard 2.08[b])

Regarding colleagues who appear to be incompetent, the code states:

Social workers who have direct knowledge of a social work colleague’s incompetence should consult with that colleague when feasible and assist the colleague in taking remedial action. (Standard 2.09[a])

Social workers who believe that a social work colleague is incompetent and has not taken adequate steps to address the incompetence should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations. (Standard 2.09[b])

And, finally, regarding colleagues who appear to have engaged in unethical conduct, the code states:

Social workers who believe that a colleague has acted unethically should seek resolution by discussing their concerns with the colleague when feasible and when such discussion is likely to be productive. (Standard 2.10[c])

When necessary, social workers who believe that a colleague has acted unethically should take action through appropriate formal channels (such as contacting a state licensing board or regulatory body, the NASW National Ethics Committee, or other professional ethics committees). (Standard 2.10[d])

Most social workers are deeply concerned about clients’ well-being and would never knowingly become morally disengaged and behave in ways that harm clients or violate ethical standards. Social workers generally abide by the prominent principle in the NASW (2021)Code of Ethics to “treat each person in a caring and respectful fashion” (p. 5). In this regard, it is incumbent on all social workers to do what they can to prevent moral disengagement in their own lives, address any instances of moral disengagement displayed by colleagues, and seek to confront workplace and societal conditions that cause moral disengagement.

Evidence suggests that proper self-care can prevent moral disengagement that leads to harm (Cox & Steiner, 2013; Smullens, 2021). Social workers’ self-care includes various elements: physical well-being, psychological well-being, spiritual well-being, support, and workplace changes. Importantly, in 2021 NASW added language to the profession’s code of ethics referring explicitly to practitioners’ self-care:

Professional self-care is paramount for competent and ethical social work practice. Professional demands, challenging workplace climates, and exposure to trauma warrant that social workers maintain personal and professional health, safety, and integrity. Social work organizations, agencies, and educational institutions are encouraged to promote organizational policies, practices, and materials to support social workers’ self-care. (p. 4)

Organizational Reform and Advocacy

When moral disengagement is the result of onerous and toxic work conditions, social workers should engage in organizational change efforts and advocacy to improve workplace conditions and promote public policies that align with social work values. Planned change in social work organizations to prevent moral disengagement can incorporate a series of steps, including setting a change goal, assessing organizational conditions, choosing a strategy, implementing the change process using change tactics and specific change technologies, and assessing outcomes of the change process (Packard, 2013). For example, the change goal may be to hire more staffers to reduce workloads, make performance demands more reasonable, improve working conditions, and enhance employee compensation. These changes may enhance employee morale and help social workers avoid actions that cause moral disengagement. The NASW (2021)Code of Ethics highlights the importance of organizational change at the administrative level:

Social work administrators should take reasonable steps to ensure that the working environment for which they are responsible is consistent with and encourages compliance with the NASW Code of Ethics. Social work administrators should take reasonable steps to eliminate any conditions in their organizations that violate, interfere with, or discourage compliance with the Code. (Standard 3.07[b]).

Pursuing these goals requires systematic assessment of the organizational factors that increase the likelihood of moral disengagement. This assessment entails examining the organization’s readiness for and commitment to change, possible sources of resistance, capacity for change, and leadership options.

Constructive policy reform can also prevent moral disengagement. Policy advocacy, a form of policy practice, entails efforts to create or reform policies in the public and private sectors that address social justice issues. For example, social workers in healthcare organizations who feel demoralized by distressing court decisions and legislation related to reproductive rights that limit women’s autonomy can engage in advocacy to protect women’s rights (Ross & Solinger, 2017). Social workers employed in the criminal justice system who are morally distressed about discriminatory practices and policies (for example, related to arrest and sentencing patterns, the death penalty) can engage in reform-related advocacy (Ricciardelli, 2020). Social workers employed in human services agencies who feel morally compromised by their state’s treatment of undocumented citizens can engage in legislative advocacy (Chang-Muy & Congress, 2016). The NASW (2021),Code of Ethics implores social workers to engage in policy-related advocacy:

Social workers should engage in social and political action that seeks to ensure that all people have equal access to the resources, employment, services, and opportunities they require to meet their basic human needs and to develop fully. Social workers should be aware of the impact of the political arena on practice and should advocate for changes in policy and legislation to improve social conditions to meet basic human needs and promote social justice. (Standard 6.04[a]).

The advocacy process that can help prevent moral disengagement involves several key stages, including analysis of the policies that need to be addressed, implementation of policy creation or reform, and feedback to ensure adequate implementation (Henderson & Bullock, 2021; Jansson, 2018). The analysis stage begins with identification of the problems to be addressed and, when appropriate, analyses of socioeconomic conditions surrounding them.

It is then important for social workers to identify key players (individuals, groups, organizations, communities, and institutions) who shape policies, including elected and appointed officials, organized groups, consumers, and community leaders. Key players may also include prominent social work leaders in governmental and private agencies, community residents, current and former clients, influential politicians, local coalitions and neighborhood organizations, and religious leaders.

Identification of key players is followed by recognition of the nature of the problem and its socioeconomic environment, factors contributing to the problem, key policy issues and their implications, effectiveness of current policies, past efforts to resolve the problem, decision-making bodies, policy alternatives and their implications (comparisons, costs, and benefits), and recommendations (Henderson & Bullock, 2021; Jansson, 2018).

Conclusion

Some social workers—a minority of practitioners—violate ethical standards and harm clients and others. Often these social workers are morally disengaged at the time of their misconduct. The phenomena of moral justification, euphemistic labeling, advantageous comparison, displacing or diffusing responsibility, disregarding or misrepresenting injurious consequences, and dehumanizing the victim may lead some social workers to become morally disengaged. In some instances social workers engage in these same behaviors once they have behaved unethically. That is, these core components of moral disengagement can both precede and follow social workers’ ethical misconduct.

It is imperative that social workers understand the nature and causes of moral disengagement. Moral disengagement can be addressed by meaningful efforts on social workers’ part to engage in self-care, burnout and impairment prevention, organizational reform, and policy advocacy.

Further, it is essential that social work’s principal gatekeepers—licensing boards, the NASW, and social work education programs—take assertive steps to prevent moral disengagement and respond to it meaningfully to the greatest extent possible. Licensing boards and NASW exercise considerable influence and authority, especially in response to ethics complaints filed against social workers. Ideally, licensing boards and NASW’s National Ethics Committee should have rigorous policies and protocols to identify morally disengaged social workers and hold practitioners to high standards when corrective action and sanctions are necessary. Undergraduate and graduate social work education programs also have a moral duty to screen applicants diligently; educate students about the nature of moral disengagement and ways to prevent it, including proper self-care; monitor students for any signs of moral disengagement (both in the classroom and field placements); and take constructive steps to respond to instances of moral disengagement. These earnest efforts to address and prevent moral disengagement can greatly increase the likelihood that practitioners will fulfill the profession’s venerable mission. That, after all, is social work’s principal obligation.

References