Starting today, a new initiative: Let's start taking the NASW Code of Ethics section by section, sketching out how the ASWB exam use each a test question. Because you can be sure that's how a good chunk of the exam is being written. Writer X sits down to a blank page and has to make questions appear. Where to turn? How about the Code of Ethics?
First up (for us and for the imaginary Writer X), the first section of the Code, 1.01, Commitment to Clients. It says:
Social workers' primary responsibility is to promote the well-being of clients. In general, clients' interests are primary. However, social workers' responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be so advised. (Examples include when a social worker is required by law to report that a client has abused a child or has threatened to harm self or others.)
Unlike the rest of the Code, this section actually suggests its own exam questions. Abuse calls, duty to warn...anything about reporting is rooted, at least in part, in 1.01. So, here's today's free practice question:
A social worker meets with a client who says she's been thinking of killing herself by jumping off a freeway overpass. What should the social worker do?
That sounds serious. Suicidal ideation and a plan. Let's see the answer options...
A. Report the client's plans to the police.
B. Initiate a psychiatric hold.
C. Discuss the timeframe of the client's plan.
D. Explore the roots of the client's suicidality.
In essence, the questions asks, to report or not to report? The client has S/I and plan about how to do it. So how do you answer? There's one big thing missing here--a when. Lots of people think about suicide and how they'd attempt. Fewer people actually make an attempt. Does this client intend to carry out her plan? The vignette doesn't say. That means, more assessment is needed before a report should be made. That narrows things down to C or D. D may be helpful in ongoing therapy, but it doesn't address the here and now reporting question. The way to get that answers is to ask the client about her intent (aka "discuss the timeframe"). Voila, an answer.
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