conferring with clinicianFrom the earliest days of SWTP, here's a question that never got included in an exam. It may have been too easy. We've toyed with it a little--made it a little trickier--and present here as another in our long series of free practice questions. Follow along on Facebook to see what others are saying. 

A client comes to a social worker for help with recurring bouts of depression. She's new in town, but has received therapy from a mental health clinic where she used to live. The client is not sure whether she's comfortable having the old and new clinicians communicating. In order to be MOST effective, the new social worker should:

A. Explore the client's discomfort with the communication before contacting the previous therapist.

B. Contact the client's previous therapist just once to discuss general impressions of the client.

C. Explain to the client that it will be easier to make progress with thorough information about prior treatment.

D. Ask the client to explain her reluctance to share information about her prior treatment.

What do you say?

Let's take the answers one by one:

A. may be appealing since it involves checking in with the client before reaching out to the prior clinician. But exploring isn't the same as getting permission. Without written consent, contacting the previous clinician violates the client's confidentiality.

B. has the same problem. Whether it's one contact or a thousand, no consent means no contact allowed.

C. While it may be true that more information equals more progress, the best, most effective of the choices offered here is...

D. Exploring the reluctance to share information about prior treatment is the best choice. Don't be fooled by "MOST effective." On the exam (as in practice!), abiding by the Code of Ethics is always the first priority.

So, breaking confidentiality? No good. Trying to get to comply and cooperate. Better, but still not great. Being where the client is, discussing her feelings, exploring her history--that's doing social work. The correct answer is D!

For more about client confidentiality, read up in the Code of Ethics and then in these articles, which each present different exam-like questions about client rights, records, and confidentiality:

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January 9, 2017
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