Next item in our question-a-section voyage through the NASW Code of Ethics: 1.13, Payment for Services. This is a three-parter that boils down like this:
- Social workers should set reasonable fees and taken clients' ability to pay into consideration.
- Social workers should avoid bartering, with rare exceptions.
- Social workers should not solicit extra fees from clients at an agency where the services are already available.
There are lots of licensing exam items that can spring from this section of the code. Or, really, from the first two parts of the section. The don't-solicit-extra-fees edict doesn't really lend itself to the kind of close-call vignettes that appear on the exam. The bartering exception is pretty straightforward too. It reads that bartering is okay only when:
...it can be demonstrated that such arrangements are an accepted practice among professionals in the local community, considered to be essential for the provision of services, negotiated without coercion, and entered into at the client's initiative and with the client's informed consent. Social workers who accept goods or services from clients as payment for professional services assume the full burden of demonstrating that this arrangement will not be detrimental to the client or the professional relationship.
On the exam, that might look something like this:
A social worker in a poor, rural community sees a client who can no longer afford the social worker's fee. The client offers to repair the social worker's dented car in exchange for a couple of sessions of therapy. How should the social worker respond?
A) Seek legal advice before deciding how to proceed.
B) Discuss the pros and cons of the arrangement and decline the client's offer.
C) Discuss the pros and cons of the arrangement and accept the client's offer.
D) Accept the client's offer so long as the bartering arrangement is temporary.
Never mind that the answers are somewhat clunkily stated. You're being tested on your knowledge of the code, not proofreading or editing skills. The code says bartering is okay in rare situations, and this looks to be one of those. The correct answer here is C.
Take note: Bartering arrangements must be "entered into at the client's initiative." If the vignette had the social worker suggesting a bartering arrangement, that would not meet the code's standards.
Section 1.13 also comes up in complicated questions about client's fees. How much is too much for a social worker to charge? Is it ethical to charge only a dollar for services? (Sure. But what is the impact of that arrangement on the therapeutic relationship?) At what point should a social worker refer a client to more affordable services? Some of these are too tricky to lend themselves to simple exam questions. But, if these situations do come up, on the exam as in life, check the code!
For more Payment for Services questions and much more, sign up to try SWTP's practice tests.