Implementing Intensive Home-Based Treatment (IHBT) can bring unique ethical challenges of Home and Community-Based Work.
The nature of the mission calls for more relationships and closer relationships. It entails managing confidentiality in the natural environment, which can prove more challenging as their seeks to be an atmosphere of eliminating barriers while maintaining boundaries, first among which is confidentiality. To say the least, it is more challenging.
On another level, there are more decisions to make. You are asked to think on your feet constantly. You are invited by a young person’s family to attend family graduations, birthdays, or weddings. You might also be asked for concrete services not typically included in IHBT (i.e., transportation to job etc.). You might be invited by a client to share a meal. You may be invited/needed/required to meet with a young client when an adult is not at home.
Sometimes, the more you are involved in the work of IHBT, the more there is an increase in ambiguity.
And, in the end, as you help a young person complete the final stages of treatment, there correlates less immediate access to other clinical staff for consultation.