privacy and confidentiality social workOut of order, but welcome anywhere, 1.07, Privacy and Confidentiality. This is a huge part of the NASW Code of Ethics and a huge part of social work practice. Really, the section is gigantic, the biggest in the code (at least in part one). Here's are quick-ish summary of it's starting paragraphs:

Social workers should…

  • Respect privacy. Don't solicit private info unless part of treatment
  • Get consent before disclosing client info.
  • Protect confidentiality. Narrow exceptions apply.

Let's stop there. Paragraph C is the source code for a lot of social work exam questions. Here it is in full:

Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed.

Imagine the questions. A client makes a general threat ("I feel like killing someone"). Do you report? No. What could you report? Or, a client makes a specific, imminent threat ("I'm going to jump out of my office window during staff meeting today.") Do you report? Yes. Serious, foreseeable, imminent. Yes, yes, and yes.

How about in this situation?:

During a session with a social worker, an enraged client says he plans to ruin a philandering former friend's life. "I'm going to call his wife tonight and tell her that he's cheating--she'll kill herself for sure." The friend's wife has a history of severe depression and suicidality. If the social worker believes the client will carry through with the threat, how should she proceed?

A) Discuss duty to warn and report the client's threat to adult protective services.

B) Discuss duty to warn and report the client's threat to his former friend and the former friend's wife.

C) Discuss duty to warn and explore the client's motives for making the call.

D) Discuss duty to warn and report the client's threat to police.
Looks like the social worker is going to be discussing duty to warn no matter what. The question essentially asks, does potentially driving someone to self-harm constitute reportable harm? There are arguments to be made either way, but going by the code itself, the answer is no. A behavior that leads to a possible injury does not constitute reportable imminent harm. The best answer is C, discuss and explore, no report.

Who, by the way, should the social worker call in the event of credible, imminent threat? Answer: Adult protective services handles elder abuse. You'd contact the police and, if possible, the potential victim.

This section of the code has lots more content and lends itself to many, many more exam questions. Give it a full read. Think about what questions might spring from each section. And, if you like, read up more about social worker ethical obligations regarding privacy and confidentiality:

For more questions about privacy, confidentiality, social work ethics, and beyond, get started with Social Work Test Prep's full-length practice exams.

Good luck!

December 10, 2015
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