Like all behavioral health professionals, social workers are making increased use of technology to deliver services to clients, communicate with clients, gather information about clients, and educate students and practitioners. The advent of technology—including Internet, text (SMS), email, video, social media and networking, cloud storage, and other forms of digital communication and software—has introduced novel and unprecedented ethical and risk management challenges. These dramatic changes in the ways that social workers use technology have led to major efforts to develop new standards in the profession. These efforts have occurred in three distinct, albeit related, domains: (1) practice standards, (2) regulatory and licensing standards, and (3) code of ethics standards. It is essential that today's social workers be thoroughly familiar with these significant developments to ensure that their practice complies with prevailing standards.
Technology Standards: Emerging Consensus
It is compelling that emerging standards pertaining to social workers' use of technology are reflected in three key documents: model regulatory laws promulgated by the Association of Social Work Boards, the NASW Code of Ethics, and standards of practice developed jointly by the National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, and Clinical Social Work Association. These documents highlight a number of common core concepts and themes concerning technology use: provision of information to the public; designing and delivering services; gathering, managing, and storing information; and educating students and practitioners. This cross-cutting pattern reflects emerging consensus thinking across key national social work organizations about current "best practices" when practitioners use technology.
The respective standards include four major sections: (1) provision of information to the public; (2) design and delivery of services; (3) gathering, managing, and storing of information; and (4) social work education and supervision.
Provision of information to the public. These standards summarize core issues involving social workers’ use of technology to educate the public about the profession, its practitioners, and its services. They focus especially on practitioners’ duty to take reasonable steps to ensure the accuracy and validity of the information they disseminate.
Design and delivery of services. These standards address a range of issues concerning practitioners’ use of technology to serve clients remotely and communicate with them between clinical and counseling sessions. They focus especially on issues related to informed consent, confidentiality, professional boundaries, client safety, and practitioner competence.
Gathering, managing, and storing of information. These standards focus on social workers’ use of technology to gather information about clients (for example, appropriate and inappropriate use of electronic search engines), manage information social workers receive about clients and information social workers transmit to others, and store client information in electronic health records (using “the cloud”). They focus especially on issues related to client privacy and encryption.
Social work education and supervision. These standards address the ways in which social workers use technology to design and deliver education and training in college and university programs and in post-graduate continuing education presentations. They focus especially on educators’ competence, privacy, and professional boundaries.
Technology Use and Risk Management
Social workers’ increasing use of digital and other technology to provide distance services and communicate with clients significantly increases potential risks to clients and practitioners. Improper or unethical use of this technology can expose clients to harm as a result of inadequate informed consent procedures; privacy and confidentiality breaches; mismanaged boundaries and dual relationships; conflicts of interest; practitioner incompetence; inadequate recordkeeping and documentation; improper termination of services; and mistreatment of colleagues. Further, social workers’ improper or unethical use of digital technology can expose them to the risk of lawsuits alleging professional malpractice and licensing board complaints alleging violation of standards related to technology use.
Some malpractice and liability claims result from genuine mistakes or inadvertent oversight on the part of social workers (a social worker sends an email message containing confidential information to the wrong recipient, uses an unencrypted smartphone texting app, or neglects to document a telephone counseling session); others ensue from a deliberate decision (a social worker engages with a client online on a social networking site or decides to divulge confidential information about a client who sent a threatening email message in order to protect a third party who was mentioned in the message). A social worker’s unethical behavior or misconduct (for example, engaging in an inappropriate and salacious online relationship with a client) can also lead to a lawsuit. Successful lawsuits against social workers require evidence that their conduct caused harm.
In contrast, in licensing board cases judgments against social workers do not require evidence that their actions caused harm. Rather, social workers can be sanctioned based simply on evidence that their conduct violated standards contained in licensing statutes and regulations.
Social workers are making increased use of technology to deliver services to clients, communicate with clients, gather information about clients, communicate with and about colleagues, administer programs, and educate and supervise students and practitioners. The advent of technology has greatly expanded social workers’ ability to assist vulnerable people. Yet, these impressive developments have also introduced novel and unprecedented ethical challenges. It behooves social workers to be thoroughly familiar with emerging ethical and practice standards.
We thank our guest columnist, Frederic G. Reamer, Ph.D. Dr. Reamer has provided courses for TCI participants with a focus on Ethics. Ethics & Risk Management in Telehealth and Boundary Issues and Dual Relationships in Telehealth: Ethics and Risk Management Implications are both available as online self-studies and each offers 3 Ethics CEs.
About Dr. Reamer:
Frederic G. Reamer, Ph.D. is professor in the graduate program, School of Social Work, Rhode Island College, where he has been on the faculty since 1983. His teaching and research focus on professional ethics, criminal justice, mental health, health care, and public policy. Dr. Reamer received his Ph.D. from the University of Chicago and has served as a social worker in correctional and mental health settings. He chaired the national task force that wrote the Code of Ethics adopted by the National Association of Social Workers in 1996 and served on the code revision task force. Dr. Reamer also chaired the national task force sponsored by the National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, and Clinical Social Work Association that developed technology standards for the profession. Dr. Reamer has lectured nationally and internationally on social work and professional ethics, including in India, China, Singapore, South Korea, Japan, Taiwan, and in various European nations. His books include Social Work Values and Ethics; Risk Management in Social Work; The Social Work Ethics Casebook; Ethical Standards in Social Work; Boundary Issues and Dual Relationships in the Human Services; Ethics and Risk Management in Online and Distance Behavioral Health; Moral Distress and Injury in Human Services; and The Social Work Ethics Audit, among others. Dr. Reamer has served as an expert witness in many court and licensing board cases throughout the United States. Read more about Dr. Reamer here.