Confidentiality is likely to come up again and again as you prepare for the social work licensing exam. Most questions are likely to cover client confidentiality. If a client's family member calls to discuss the client, what is the best way for a social worker to proceed? Another therapist wants to discuss your former client's case--what then? After enough exam prep, these questions will become very familiar. (Hint: There's no confirming or denying that someone is a client, even to family or a former therapist.)
But how do you answer if you see something like this?
After a staff meeting, a clinician tells another social worker that she is "losing it...totally burnt out...I'm starting to hate my clients!" She says she's going to call in sick tomorrow and "get blackout drunk." What is the BEST course of action for the social worker to take regarding this colleague.
A. Discuss ways to cope with burnout other than binge drinking.
B. Consult with a supervisor regarding the clinician's confession.
C. Report the clinician's misconduct to the state licensing board.
D. Explore how the clinician's burnout is affecting her work with clients.
What do you think?
Let's do a decision tree. Two answers involve going to others--a supervisor or the state licensing board. The other two answers keep things between the clinician and the social worker. Let's look at the code for guidance.
2.02 Confidentiality
Social workers should respect confidential information shared by colleagues in the course of their professional relationships and transactions. Social workers should ensure that such colleagues understand social workers' obligation to respect confidentiality and any exceptions related to it.
This points to the not-going-to-others choices, A & D. But what about the hating clients? What about the blackout drinking? There's also this:
2.09 Impairment of Colleagues
(a) Social workers who have direct knowledge of a social work colleague's impairment that is due to personal problems, psychosocial distress, substance abuse, or mental health difficulties and that interferes with practice effectiveness should consult with that colleague when feasible and assist the colleague in taking remedial action.
(b) Social workers who believe that a social work colleague's impairment interferes with practice effectiveness and that the colleague has not taken adequate steps to address the impairment should take action through appropriate channels established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.
The clinician is voicing psychosocial distress and a planned day of substance use/abuse. But still the code dictates first consulting with the colleague, not with others. There is an exception to this: If the colleague's impairment is undermining her work with clients (that is, her "practice effectiveness"), something more needs to be done. Is there a way to know whether that's happening here? Nothing in the stem is definitive. (Harboring hatred toward clients is part of burnout, not reportable impairment.) Are clients being negatively impacted? The first thing to do to find that out is ask. And, happily, one of the choices here--"Explore..."--has the social worker doing just that! Discussing coping skills, which may or may not be useful to the clinician, can wait. Our answer is D!
Want to read more on the topic? Take a look at these articles:
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