Back for more ASWB exam outline exploration. Next up: The principles and processes of obtaining informed consent. Let's dive in.

Informed consent is a crucial ethical and legal concept in social work that emphasizes the importance of respecting the autonomy and rights of clients. Obtaining informed consent is an ongoing process that involves clear communication, transparency, and ensuring that individuals fully understand the nature and implications of their participation. Here are the key principles and processes of obtaining informed consent in social work:

Principles of Informed Consent

  • Autonomy and Respect for Persons:

    • Individuals have the right to make decisions about their own lives. Social workers must respect the autonomy and independence of clients.
  • Voluntariness:

    • Consent should be given voluntarily without coercion or manipulation. Individuals should feel free to refuse or withdraw consent at any time without fear of negative consequences.
  • Information Disclosure:

    • Social workers must provide clear and comprehensive information about the purpose, nature, risks, benefits, and alternatives of the proposed intervention. Information should be presented in a language and format that the individual can understand.
  • Competence:

    • Individuals must be deemed mentally and emotionally competent to give informed consent. Social workers should assess the individual's capacity to understand and make decisions.
  • Ongoing Process:

    • Informed consent is not a one-time event; it is an ongoing process throughout the intervention. Any changes in the intervention or circumstances should be communicated and re-consent obtained if necessary.

Processes of Obtaining Informed Consent

  • Introduction and Rapport Building:

    • Establish a trusting and respectful relationship with the individual. Introduce the purpose of the intervention and the role of the social worker.
  • Information Sharing:

    • Clearly explain the purpose, goals, and methods of the intervention. Provide information about potential risks, benefits, and any alternatives available.
  • Clarification and Questions:

    • Encourage individuals to ask questions and seek clarification. Ensure they have a clear understanding of the information provided.
  • Documenting Consent:

    • Use written consent forms to document the agreement. Ensure that the form includes all relevant information and is signed and dated by both parties.
  • Capacity Assessment:

    • Assess the individual's capacity to make decisions. If there are concerns about capacity, involve appropriate professionals and legal processes.
  • Confidentiality and Limits:

    • Explain the limits of confidentiality and any situations where confidentiality may need to be breached (e.g., imminent harm to self or others).
  • Review and Re-consent:

    • Periodically review the consent process with the individual. If there are any changes in the intervention or circumstances, seek re-consent.
  • Cultural Competence:

    • Consider cultural factors that may impact the understanding of informed consent. Use culturally sensitive and appropriate methods of communication.
  • Withdrawal of Consent:

    • Clearly communicate that individuals have the right to withdraw their consent at any time. Discuss the implications of withdrawal and any potential consequences.

By adhering to these principles and processes, social workers can ensure that informed consent is obtained in a manner that upholds the rights and dignity of the individuals they serve. Regular ethical supervision and training are essential to maintain and enhance the quality of informed consent practices in social work.

In the NASW Code of Ethics

Here's the informed consent section of the NASW Code of Ethics--where you've likely encountered most of the above--in full:

1.03 Informed Consent

(a) Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Social workers should use clear and understandable language to inform clients of the purpose of the services, risks related to the services, limits to services because of the requirements of a third-party payer, relevant costs, reasonable alternatives, clients’ right to refuse or withdraw consent, and the time frame covered by the consent. Social workers should provide clients with an opportunity to ask questions.

(b) In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients’ comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible.

(c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with their level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.

(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.

(e) Social workers should discuss with clients the social workers’ policies concerning the use of technology in the provision of professional services.

(f) Social workers who use technology to provide social work services should obtain informed consent from the individuals using these services during the initial screening or interview and prior to initiating services. Social workers should assess clients’ capacity to provide informed consent and, when using technology to communicate, verify the identity and location of clients.

(g) Social workers who use technology to provide social work services should assess the clients’ suitability and capacity for electronic and remote services. Social workers should consider the clients’ intellectual, emotional, and physical ability to use technology to receive services and ability to understand the potential benefits, risks, and limitations of such services. If clients do not wish to use services provided through technology, social workers should help them identify alternate methods of service.

(h) Social workers should obtain clients’ informed consent before making audio or video recordings of clients or permitting observation of service provision by a third party.

(i) Social workers should obtain client consent before conducting an electronic search on the client. Exceptions may arise when the search is for purposes of protecting the client or others from serious, foreseeable, and imminent harm, or for other compelling professional reasons.

On the ASWB Exam

Will you see questions about informed consent on the ASWB exam? Chances are...yes! This is social work ethics 101--a big part of what the ASWB is testing for with the licensing exam. Questions might look something like this:

  • During an initial assessment, a client expresses reluctance to provide informed consent due to concerns about privacy. What is the most appropriate response from the social worker?
  • A social worker is working with a client from a culturally diverse background [the exam may be more specific]. What is an essential consideration when obtaining informed consent in a culturally sensitive manner?
  • A client has been diagnosed with significant learning difficulties. What is the most important consideration for the social worker when obtaining informed consent from the client?

Get questions (and answers and rationales!) about informed consent and lots more ASWB exam content topics with SWTP's full-length practice tests. To drill down on ethics questions, try the all-ethics Ethics Booster.

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January 29, 2024
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