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Revisioning Ethics: An Anti-Oppressive Framework for Practice – A Continuing Education Course by Cathleen M. Morey, PhD, LICSW
Estimated read time: 9 minutes
Ethical decision-making is central to mental health practice. Yet many clinicians find that traditional ethics frameworks do not fully prepare them for the complexity of real-world clinical environments.
Today's ethical dilemmas are shaped not only by professional standards but also by systems of power, institutional culture, and sociopolitical context. Questions related to race, gender identity, cultural values, and systemic inequality increasingly intersect with clinical care.
In the continuing education course "Revisioning Ethics: An Anti-Oppressive Framework for Practice," Dr. Cathleen Morey—Director of Clinical Social Work at the Austen Riggs Center—introduces a new approach to ethics that moves beyond rule compliance and risk management toward relational and justice-centered clinical practice.
The course explores how ethical decision-making operates within broader social systems and provides clinicians with practical tools to respond with greater reflection, accountability, and care.
Key Takeaways
- Ethics in mental health practice must account for systemic context, not just procedural rules and professional standards
- Anti-oppressive frameworks examine how power, identity, and institutional dynamics influence ethical decisions
- Ethical dilemmas often emerge from organizational culture and systemic dynamics, not just individual choices
- An ethical formulation helps clinicians integrate ethical analysis alongside clinical formulation
- Aspirational ethics encourages clinicians to actively embody professional values such as dignity, justice, and relational accountability
- Ethical discernment—a structured metacognitive process—supports clinicians in translating anti-oppressive principles into daily practice
- An 11-step Anti-Oppressive Ethical Decision-Making Framework provides a concrete, actionable guide for navigating complex ethical situations
This ethics course is approved for AMA PRA Credit™ risk management study.
Why Traditional Ethics Frameworks Often Fall Short
Most clinicians are introduced to ethics through professional codes and procedural decision-making models. These frameworks typically focus on issues such as confidentiality and privacy, professional boundaries and dual relationships, informed consent, documentation and legal standards, and risk management.
While these standards are essential, they often emphasize avoiding violations rather than developing deeper ethical awareness.
Dr. Morey notes that many traditional ethics models rarely address the influence of critical sociopolitical factors such as race, gender, power, and systemic oppression in shaping ethical decisions. Clients do not exist outside social context. They may be navigating systemic racism, economic inequality, political trauma, and discrimination related to gender identity or sexual orientation.
Ethical practice therefore requires clinicians to understand how systems shape both clinical encounters and ethical responsibilities.
What Is an Anti-Oppressive Framework for Ethics?
An anti-oppressive ethical framework examines how power, privilege, and structural inequality influence professional decision-making. Instead of viewing ethical dilemmas solely as individual choices, this approach recognizes that ethical challenges often emerge from broader contexts—including institutional policies, professional hierarchies, cultural assumptions, and systemic inequality.
The goal is not to replace traditional ethical standards but to expand them, helping clinicians integrate context, cultural awareness, and justice-oriented reflection into ethical reasoning.
From Compliance-Based Ethics to Aspirational Practice
A key distinction in Dr. Morey's framework is the difference between compliance-based ethics and aspirational ethics.
Compliance-driven ethics focuses on meeting minimum professional requirements and avoiding disciplinary consequences. In this model, clinicians often engage with ethics only when a dilemma arises—what Dr. Morey describes as operating from the "basement level."
Aspirational ethics encourages clinicians to embody the deeper values of their profession, including dignity, justice, relational responsibility, and professional integrity. This approach requires what Dr. Morey describes as ethical mindfulness—maintaining awareness of the ethical dimensions of clinical work even when no obvious dilemma is present. In this way, ethics becomes a guiding framework for everyday clinical decision-making rather than a reactive process.
Four Core Principles of Anti-Oppressive Ethical Practice
The course introduces four superordinate principles that help clinicians rethink ethical reasoning in contemporary mental health care.
- Moving Beyond Minimum Compliance Clinicians must decide whether their practice remains focused on minimal compliance or strives toward aspirational ethical practice grounded in justice and care.
- Examining Cultural Foundations of Ethical Frameworks Many professional ethics codes draw heavily from Western philosophical traditions emphasizing universal rules and individual autonomy. However, these assumptions may not reflect all cultural perspectives. Western frameworks often prioritize individual decision-making, while many cultures emphasize relational or family-based decision processes. Ignoring cultural context can lead to misinterpretations of ethically meaningful behavior.
- Applying an Intersectional Ethical Lens Intersectional ethics encourages clinicians to consider how the social identities of all parties involved shape ethical situations—including race and ethnicity, gender identity, socioeconomic status, culture and religion, and professional power.
- Recognizing Epistemic Ethical Injustice Ethical decision-making can also be influenced by testimonial injustice—a form of bias in which someone's perspective is dismissed because of their identity. In clinical settings, this may occur when marginalized clients are not believed, lived experience is minimized, or institutional authority overrides client voice.
A Case Study That Reveals Systemic Ethical Challenges
To illustrate these concepts, Dr. Morey presents a clinical case drawn from her qualitative research involving Teagan, a 14-year-old Black nonbinary adolescent navigating multiple institutional systems. Teagan's situation involved interactions among child welfare, juvenile justice, and psychiatric care systems. Conflicts between institutions, staff power dynamics, and systemic biases contributed to escalating interventions and ultimately unethical treatment.
The case illustrates that ethical failures rarely stem from a single clinician’s actions. Instead, they emerge from the interplay of organizational culture, systemic pressures, and institutional dynamics. As Dr. Morey notes, traditional ethics education often emphasizes ethical individualism—the tendency to attribute complex ethical breakdowns to individual missteps rather than examining the structural conditions that enabled harm.
The Role of Organizational Ethical Culture
Ethical practice does not exist solely within individual clinicians. It is shaped by the culture of the institutions where care occurs. Dr. Morey describes a continuum of organizational ethical cultures ranging from punitive and hierarchical environments (fear-based, with rigid authority and limited ethical dialogue) to bureaucratic cultures (procedure-heavy with reduced ethical reflection), to relational cultures (which support learning and dialogue), and finally to justice-centered environments that actively prioritize dignity, equity, and inclusion.
Recognizing where an organization falls along this spectrum helps clinicians understand how ethical challenges develop and how institutions can evolve toward more ethical care environments.
Introducing the Ethical Formulation
One practical concept presented in the course is the ethical formulation—a structured tool that extends the familiar clinical formulation process to explicitly address the ethical dimensions of a case.
Where a clinical formulation organizes psychological and developmental information to guide treatment planning, an ethical formulation asks: What systems of power are operating in this situation? How do identity and social context influence clinical decisions? Whose perspectives are missing from the conversation? What ethical responsibilities arise from these dynamics?
Integrating ethical formulation into clinical reasoning helps practitioners proactively engage the ethical dimensions of complex cases in a more intentional and justice-oriented way.
Ethical Discernment: A Practical Tool for Anti-Oppressive Practice
One of the most immediately applicable frameworks Dr. Morey introduces is the process of ethical discernment—a three-step metacognitive practice designed to help individual clinicians translate anti-oppressive principles into daily work. Metacognition, simply put, is the practice of thinking about one's own thinking. In ethical practice, this means developing the self-awareness to pause, reflect, and examine how our assumptions and values are shaping our decisions.
The three interconnected components of ethical discernment are:
1. Ethical Reflexivity — the cornerstone of the process, involving intentional, continuous examination of how one's own values, assumptions, and internal narratives shape ethical thinking.
2. Ethical Humility — a disposition of attentiveness marked by curiosity, caution, and openness. Rather than approaching ethical decisions with certainty, clinicians are invited into a posture of ethical inquiry.
3. Critical Examination of Values — an exploration of the values system underlying ethical judgments, including where personal beliefs, professional standards, and social context align or conflict.
The 11-Step Anti-Oppressive Ethical Decision-Making Framework
At the heart of the course is Dr. Morey's original 11-step Anti-Oppressive Ethical Decision-Making Framework—a structured, actionable process that weaves together traditional ethical analysis with intersectional, justice-oriented, and restorative principles. It is designed to be used proactively, not only when a crisis emerges.
1. Identify the ethical issue or dilemma
2. Assess organizational context and systemic forces
3. Determine whether epistemic ethical injustice is present
4. Consider intersectionality and power dynamics
5. Apply ethical and legal standards
6. Evaluate rights, responsibilities, and vulnerabilities of all involved parties
7. Consider possible consequences, risks, and benefits
8. Decide on a course of action
9. Engage in restorative practices
10. Implement the decision and monitor its impact
11. Document the decision-making process
Ethical practice in contemporary mental health care cannot be reduced to rule compliance without risking harm, blind spots, and complicity in unjust systems. Dr. Morey’s anti-oppressive framework invites clinicians to move beyond compliance toward aspirational practice, reframing ethics as an active, ongoing commitment that requires engagement with power, identity, and institutional context. Within this approach, ethical formulation serves as an analytic lens for understanding how systemic forces shape a given case, while ethical discernment cultivates the reflective discipline needed to examine one’s own assumptions and values in real time. The 11-step Anti-Oppressive Ethical Decision-Making Framework anchors this work in action, providing a structured, consistent process that moves clinicians from abstract awareness to accountable decision-making. Equally critical is the assessment of organizational ethical culture as a diagnostic tool: identifying whether a setting operates within punitive, bureaucratic, relational, or justice-centered dynamics reveals not only how ethical dilemmas emerge, but where intervention and advocacy are necessary. Together, these tools shift ethics from a reactive exercise to a deliberate, proactive practice, one that positions clinicians to navigate complexity with greater clarity while actively shaping more equitable systems of care.
About the Instructor
Cathleen Morey, PhD, LICSW, is the Director of Clinical Social Work at the Austen Riggs Center, an open psychiatric treatment facility serving adults with complex psychiatric challenges.
With more than 25 years of clinical experience, her work spans community mental health, forensic and inpatient settings, private practice, and academic teaching and research. She also teaches at the Smith College School for Social Work and collaborates internationally to advance trauma-informed care and social justice in mental health systems.
Her scholarship focuses on ethical practice, systemic dynamics in treatment settings, and anti-oppressive approaches to clinical care.
Learn More About the Course
"Revisioning Ethics: An Anti-Oppressive Framework for Practice" is designed for social workers, psychologists, psychiatrists, counselors, and mental health professionals seeking continuing education.
To hear the full presentation and receive CE/CME credits, please visit the Revisioning Ethics: An Anti-Oppressive Framework for Practice page.