Considering Ethics

“Anytime we feel vulnerable or our self-esteem is implicated, when the issues at stake are important and the outcome uncertain, when we care deeply about what is being discussed or about the people with whom we are discussing it, there is potential for us to experience the conversation as difficult (p. xv)”

Stone, Patton, & Heen in Difficult Conversations

Considering Ethics: Tired of the same old sandwich? Another item on the strategy menu of professional practice choices.
By Renee N. Appaneal

As I reorganized my home office this summer, I came across a pamphlet published by the Center for Creative Leadership (CCL) entitled, Feedback that works: How to build and deliver your message, from their Ideas into Action Guidebooks series. I recalled having ordered this 33-page book when I was struggling with how to discuss a potential ethical violation by a colleague in the field. During that time, I frantically searched for articles, books, and began sending pleas for help across my professional network of people with expertise in sport psychology, professional ethics, clinical supervision, leadership, and communication. Now, about one month into my 2 month summer break, I’m considerably more relaxed than I recall being during that time. So, I decided to revisit the guide and share a strategy for having difficult conversations.

When we successfully navigate challenges, it can stimulate personal growth and professional development. If you supervise or mentor graduate students, lead members of a company or team, or consult with individuals and groups as many of us do, then you may attempt or avoid difficult conversations on a daily basis. Yet, why do we sometimes avoid difficult conversations or chose to withhold important feedback? A study by Ladany and colleagues (1996) on supervisees’ disclosure to supervisors identified reasons most often cited for withholding including:

Perceived to be too personal and/or unimportant

Negative feelings such as shame, embarrassment, or discomfort

Feelings of deference (i.e., not my place or responsibility to bring it up)

Poor alliance with the supervisor

Impression management (i.e., to avoid being perceived negatively) (p. 153)

While the above reasons were derived from supervisees, they reflect common experiences we might all relate to when faced with difficult conversations. Whether or not the situation involved an ethical violation, it likely prompted feelings of anxiety, embarrassment, shame or guilt.

Among those reasons listed, several pertain to the alliance or relationship between parties involved. As practitioners, we take pride in our ability to establish and maintain supportive and positive relationships with clients, and this by extension, can be applied to working with each other as colleagues. This relationship provides a solid foundation upon which to address the turbulence that can occur in a clinical practice, professional organization, academic department, or any other group of people.

One technique comes to mind almost immediately when providing effective feedback – the sandwich approach (i.e., positive statement, negative or critical feedback, positive instruction). The sandwich is an ol’ standby, the house special, if you might entertain the analogy. It’s been around forever it seems, a lot of restaurants (disciplines and professions) have it on their menu, and with its familiarity may even provide a little comfort during times of stress. I do not mind the sandwich, really, but sometimes I just want to try out something new. When the same item (action) is chosen over and over for so long it may eventually lose its appeal (effectiveness). Now, please understand that in no way am I suggesting that the sandwich be taken off the menu. It obviously has withstood the test of time. I am merely suggesting that as professionals we add a new item to the menu of strategies available to us.

During nearly four decades of conducting education and research with managers and executives, the faculty and staff at CCL have developed a rather simple technique referred to as an SBI, which stands for Situation-Behavior-Impact.

Step 1 – Recall the SITUATION.
The first step involves identifying specific details about the date, time, location or setting in which the event occurred. This allows a clear recollection of the event and context to be discussed, and enables each person to more accurately share his or her own thoughts and behaviors.

Step 2 – Describe the BEHAVIOR.
Provide feedback about overt behavior rather than making statements or judgments about the person. Focus on using verbs to describe the behavior (e.g., you were tapping your pen when the client was speaking, he rolled his eyes and looked away when the athlete winced in pain, she was text-messaging and drawing on her notepad during the lecture). In addition to describing what someone did, it is also important to share how they did it (i.e., nonverbal behaviors).

Step 3 – Share the IMPACT.
This final step involves sharing how the behavior described above impacted you. This resembles the idea of using “I” statements rather than vague generalizations (i.e., others could get upset, people might misunderstand, etc.). Specific ways to execute this step include: 1) evaluating and interpreting the behavior, and 2) identifying the emotional consequence(s) that the behavior had on you. The former may open the door for disagreement, whereas the latter may be difficult to dismiss and may foster empathy and understanding of your experience and perspective.

Below is a sample statement following the SBI steps. The situation was during a conversation I had with a new but important colleague who has on at least two occasions referred to me as a “Sport Psychologist” when I am not licensed as a Psychologist.

“Hi Nancy. It’s good to see you again. Do you have a few minutes now to chat? I’d like to share something with you that’s been bothering me. Last week, during the staff meeting you introduced me to a room full of coaches and athletic trainers as a sport psychologist. I felt rather uncomfortable when you used the term “sport psychologist,” and I was a bit frustrated since I had spoken with you in April about my title and how I prefer to be introduced. To be honest, I feel a little silly bringing this up again, but it is important to me. In fact, there can be serious ethical and legal consequences for me by misrepresenting my training and expertise.”

Although the situation may seem rather straightforward, it is not without its discomfort. This is something that continues to occur for me and causes me angst, especially when its done by someone with a lot more power, control, or leverage than I have with my clients or desired clientele. Yet, the SBI approach has been simple enough to follow regardless how frustrated or anxious I may feel about having the conversation again and again.

“Hearing this kind of feedback, the recipient can more easily see what actions he or she can take to continue and improve performance or to change behavior that is ineffective or even an obstacle to performance” (p 12, Weitzel).

In addition to using the SBI approach with difficult conversations about professional and (un)ethical behavior, it might also be helpful in guiding your own self-reflection of thoughts, emotions, and behaviors during a challenging consultation or interaction with a colleague. Reflection may actually be a very effective and accessible means by which to regulate our own professional and practice behavior. As Weitzel writes, it [reflection] “gives you time to understand the true nature of the impact the behavior had” (p.23).

You might be reading this and thinking “duh, that’s commonsense.” Well, to that I respond that most of what we do, to us anyway, seems like common knowledge. But, in fact, I am continuously reminded and amazed that it is not lay knowledge. Rather, there are many people in this world do not know anything about or how to use imagery, relaxation, or any of the other self-regulatory skills typical to our field. Regardless of your specific role or “hat” in the field, we acknowledge there are at least a few mental skills essential for optimal performance. It may be helpful to remind ourselves from time to time that our own self-regulatory and interpersonal skills are just that – skills, that can be modified, developed and refined to achieve optimal performance consulting and ethical professional practice.

References & Additional Resources

Flaherty, A. (March 2003). Feedback fundamentals. Leading Effectively e-Newsletter at http://www.ccl.org/leadership/enewsletter/ accessed on June 15, 2008.

Ladany, N., Hill, C.E., Corbett, M.M., & Nutt, E.A. (1996). Nature, extent, and importance of what psychotherapy trainees do not disclose to their supervisors. Journal of Counseling Psychology, 43, 10-24.

Ladany, N., Friedlander, M. L., & Nelson, M. L. (2005). Critical incidents in supervision . Washington, DC: American Psychological Association.

Stone, D., Patton, B., & Heen, S. (2000). Difficult conversations: How to discuss what matters most. New York: The Penguin Group.

Tyson, L. E., Culbreth, J. R., & Harrington, J. A. (Eds). (2008). Critical incidents in clinical supervision . Alexandria, VA: American Counseling Association.

Weitzel, S.R. (2000) Feedback that works: How to build and deliver your message. Greensboro, NC: Center for Creative Leadership.