Date of Award
Spring 4-30-2026
Document Type
Dissertation
Degree Name
D.S.W. Social work
Department
Social Work
First Advisor
Dr. Yoon Mi Kim
Second Advisor
Dr. Juliana Svistova
Third Advisor
Dr. John Lizza
Abstract
Behavior contracts are frequently used in healthcare environments to manage behaviors labeled as disruptive; however, their use presents many ethical, legal, and practical concerns. This mixed-methods study examined behavior contracts through a social work lens, with particular attention to their impact on patient-centered care, professional ethics, and the patient–provider relationship. Based on the Person-in-Environment theory and core bioethical principles, the quantitative aspect of the study assessed healthcare social workers’ attitudes regarding the ethical implications of behavior contracts and their alignment with patient-centered care. The study looked further at how these perceptions differed based on years of professional experience as a social worker and frequency of use. The qualitative aspect explored how healthcare social workers experience and interpret the use of behavior contracts in their practice with patients, including how they navigate institutional expectations, ethical tensions, and advocacy for patient dignity and self-determination. Quantitative results suggest that healthcare social workers had differing views on behavior contracts, acknowledging their practical use while also identifying significant ethical concerns and professional tensions. Qualitative findings suggest that social workers view behavior contracts as complex tools that can both support and hinder patient care. The findings highlight the importance of individualized behavior management strategies, the benefits of interdisciplinary collaboration, and ethical decision-making to balance institutional pressure with patient-centered care. This study sheds light on the underrepresented professional perspectives of healthcare social workers within the current literature, and highlights the importance of ethically centered, trauma-informed alternatives to behavior contracts in healthcare environments.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Murphy, Katelyn E., "Between Care and Compliance: A Mixed-Methods Examination of Social Workers' Perspectives on Behavior Contracts in Healthcare" (2026). Social Work Doctoral Dissertations. 52.
https://research.library.kutztown.edu/socialworkdissertations/52
