A client  struggling with substance abuse issues has shared sensitive information during a counseling session including illegal activities related to their substance use. The client's spouse has contacted you and requested information about the client's progress in therapy--they are concerned with the client’s recent behavior. How should the social worker proceed? 

A) Provide the spouse with a summary of the client's progress, excluding the illegal activities disclosed.

B) Inform the spouse that you cannot disclose any information without the client's written consent.

C) Share only non-sensitive, general information about the client's therapy progress with the spouse.

D) Report the client's illegal activities to the appropriate authorities.

Before we get to the answer, let’s explore the topic.

Confidentiality is a fundamental ethical principle in social work practice. Social workers are bound by a duty to protect the confidentiality and privacy of their clients, with few exceptions (which are noted below).

Some key elements of confidentiality--all of which are fairly likely to show up in one form or another on the social work licensing exam:

Informed Consent: Social workers should obtain informed consent from clients before sharing any information about them. This means that clients should be fully aware of the purpose, potential risks, and possible consequences of sharing their information and should provide their consent willingly and without coercion.

Exceptions to Confidentiality: While confidentiality is a foundational principle, there are situations where social workers may be required or permitted to breach confidentiality. Some common exceptions include:

  • When there is a risk of harm to the client or others.
  • When required by law, such as reporting child abuse or neglect.
  • When there is a court order or subpoena.

Record Keeping: Social workers should take reasonable steps to protect the privacy of their clients, including ensuring that conversations and records are kept secure. Access to these records should be limited to those who have a legitimate need to review them.

Client Access to Records: Clients have the right to access their own records, and social workers should facilitate this process while protecting the privacy of other individuals mentioned in those records.

Limits of Technology: Social workers should be mindful of the use of technology in their practice, as electronic communication and record-keeping can pose unique challenges to maintaining confidentiality. They should take steps to secure electronic communications and records.

Supervision and Consultation: When seeking supervision or consultation, social workers should take care to avoid disclosing identifying information about their clients.

Social workers often face ethical dilemmas when it comes to confidentiality, especially in situations where there may be a conflict between preserving client confidentiality and protecting the client or others from harm. In such cases, social workers should carefully consider their ethical obligations and seek consultation when necessary. Prepare to see just those types of dilemmas on the ASWB exam.

Okay, so now that you’ve read up, how do you answer the question?

Simple: Inform the spouse that you cannot disclose any information without the client's written consent.

Social workers not disclose sensitive information without the client's written consent--even to a concerned family member. Sharing sensitive information, such as illegal activities, with the client's spouse without consent would be a breach of confidentiality. 

For more about confidentiality, go straight to the source, the NASW Code of Ethics

Fore more (and more challenging) practice questions about confidentiality and all else, get started now with SWTP's full-length exams and boosters.

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Happy studying and good luck on the exam!

September 6, 2023
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