Practitioners identified religious and spiritual issues that emerge in social work practice and that are salient factors during various life stages. The data suggest that attention should be directed to this area of practice so that workers can deal competently with these issues.

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Because of structural and philosophical changes in health care, social work practitioners are having to interact more with other practitioners in health care settings. Many of those interactions are interdisciplinary and often involve an understanding of the application of professional values and ethics. The authors have suggested that social workers' influence on ethical decision making is correlated directly to their ability to contribute to those decisions. In their study, the authors tested five independent variables and one dependent variable to show the factors that are related significantly to social workers' influence on ethical decision-making processes in multidisciplinary health care settings.

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Although clinical work with adolescents has long been recognized as technically difficult, ethical considerations may present an even greater challenge to the clinician. This is particularly true for social workers who work with adolescents who manifest self-harming behavior. This paper examines the ethical dilemmas inherent in clinical work with self-harming adolescents and illustrates the need to include a model for ethical decision making as an essential element in competent social work practice. Moreover, the analysis of the clinical situation underscores the importance of understanding the contemporary debate on children's rights.Clinical work with adolescents has long been recognized as technically challenging. Anna Freud (1958, p. 275) observed that "adolescence is by its nature an interruption of peaceful growth and the upholding of a steady equilibrium during this process is in itself abnormal." Consequently, adolescents commonly enter into treatment with an evolving symptomatology manifested as neurotic at one time, almost psychotic at another and with sudden acts of delinquency (Eissler, 1958). Nonetheless, adolescence is not an affliction but a normative process with increased conflict which contributes to the process of identity formation (Erikson, 1956). Differentiating behavior which is expectable of normal adolescent turmoil from behavior suggestive of psychopathology is one of the technical difficulties of social work practice with adolescents. Dealing with this difficulty is complicated by the fact that teenagers are frequently referred to treatment by parents and do not enter into the therapeutic setting willingly.