Eye on Ethics

Boundary Challenges in the Digital Age
By Frederic G. Reamer, PhD
January 2019

Throughout the profession's history, social workers have been aware of challenging boundary issues. For many decades, social workers have navigated boundary dilemmas involving self-disclosure of personal information to clients, living and working in small communities, responding to clients' social invitations and gifts, hiring former clients as employees, and performing favors for vulnerable clients, among others. Over time, the profession has produced increasingly comprehensive ethical standards pertaining to dual relationships and potential conflicts of interest.

Today's social workers now face a wide range of boundary challenges that are unprecedented because of the relatively recent emergence of digital and other forms of technology. Digital technology has transformed the ways in which social workers are delivering services to clients, including distance counseling using video, live chat, avatars, smartphone apps, and text messages, among other tools; communicating with clients using social media and social networking sites (e.g., Facebook); searching online for information about clients (e.g., Facebook, Google, and LinkedIn); storing sensitive information (e.g., in the cloud) and permitting clients to access their electronic records remotely; and being the subject of online searches by clients (e.g., when clients seek personal information online about their service providers). These phenomena have created new forms of boundary issues that could not have been imagined by earlier generations of social workers. Following are several examples.

• A clinical social worker at a mental health center provided services to a high school student who struggled with symptoms of depression. The client reported to the social worker that she was being bullied on Facebook by several former friends. The social worker considered searching the client's Facebook site to see examples of the online bullying.

• A clinical social worker in private (independent) practice communicated with a number of his clients via text messages and e-mail. The social worker received an increasing number of electronic messages from clients after traditional working hours, sometimes late at night and on weekends. The social worker wondered whether communicating with clients outside of traditional working hours was introducing boundary issues in his relationships with them.

• A social work administrator in a community action program facilitated monthly meetings with neighborhood residents who served on the agency's advisory board. The social worker received a Facebook friend request from one of the advisory board's members, with whom the social worker had a strong working relationship. He wondered whether it was appropriate to accept this online request.

• A social worker in a substance use disorder treatment program was in recovery and participated actively in an online support group. Occasionally, the social worker posted details about her own recovery. She discovered that one of her clients, who was also in recovery, gained access to this online support group and read a number of the social worker's postings about the practitioner's personal life.

• A social worker at a university counseling center provided services to a student who was struggling with anxiety symptoms. The social worker taught the client a number of coping mechanisms, including writing about her anxiety (bibliotherapy). The client created an online blog, on which she posted entries about her challenges and her efforts to cope with anxiety. The client invited her social worker to register for access to the client's blog, by creating a username and password, so that the social worker could read her client's postings.

New Regulatory, Ethical, and Practice Standards
Fortunately, social work's ethical, practice, and regulatory standards are addressing these new boundary-related challenges. Recognizing the profound impact that technology is having on social work practice, in 2013 the Association of Social Work Boards (ASWB) board of directors appointed an international task force to develop model regulatory standards for technology and social work practice. ASWB embarked on development of new ethics-related standards in response to requests from regulatory bodies around the globe for guidance concerning social workers' evolving use of technology and the ways in which regulatory standards might be updated. The ASWB task force included representatives from prominent social work practice, regulation, and education organizations throughout the world. The group developed model standards, a number of which focus explicitly on boundary issues. These model regulatory standards state that social workers who choose to provide "electronic social work services" shall, for example, "communicate with clients using digital and other electronic technology (such as social networking sites, online chat, e-mail, text messages, and video) only for professional or treatment-related purposes and only with client consent" (standard 4.03); "refrain from soliciting digital or online testimonials from clients or former clients who, because of their particular circumstances, are vulnerable to undue influence" (standard 4.09); and "refrain from accepting 'friend' or contact or blog response requests from clients on social networking sites. Exceptions may be made when such contact is an explicit component of a treatment or service-delivery model and meets prevailing standards regarding the use of digital technology to serve clients" (standard 4.10). These model standards, formally adopted in 2015, are now influencing the revision of licensing and regulatory laws around the world.

In 2015, NASW appointed a task force to determine whether changes were needed in its Code of Ethics to address concerns related to the use of technology. The last major revision of the code was approved in 1996. Since 1996, there has been significant growth in the use of computers, smartphones, tablets, e-mail, texting, online social networking, monitoring devices, video technology, and other electronic technology in various aspects of social work practice. In fact, many of the technologies currently used by social workers and clients did not exist in 1996.

In 2017, NASW adopted a revised code that includes extensive technology-related additions, a number of which specifically address boundary issues. Examples of boundary-related standards include "social workers should avoid communication with clients using technology (such as social networking sites, online chat, e-mail, text messages, telephone, and video) for personal or nonwork-related purposes" (standard 1.06[e]); "social workers should be aware that posting personal information on professional web sites or other media might cause boundary confusion, inappropriate dual relationships, or harm to clients" (standard 1.06[f]); and "social workers should be aware that personal affiliations may increase the likelihood that clients may discover the social worker's presence on Web sites, social media, and other forms of technology. Social workers should be aware that involvement in electronic communication with groups based on race, ethnicity, language, sexual orientation, gender identity or expression, mental or physical ability, religion, immigration status, and other personal affiliations may affect their ability to work effectively with particular clients" (standard 1.06[g]).

Also in 2017, following unprecedented collaboration among key social work organizations in the United States—NASW, ASWB, Council on Social Work Education, and Clinical Social Work Association—the profession formally adopted new comprehensive practice standards, including extensive ethics guidelines that focused on social workers' and social work educators' use of technology. Approved by these respective organizations' boards of directors, these transformational comprehensive standards address a wide range of compelling ethical issues related to social workers' use of technology, a number of which pertain specifically to boundary issues. Examples include, "social workers who provide electronic social work services shall maintain clear professional boundaries in their relationships with clients" (standard 2.09); "social workers who use social media shall develop a social media policy that they share with clients" (standard 2.10); "social workers shall consider the implications of their use of personal mobile phones and other electronic communication devices for work purposes" (standard 2.11); and "social workers who work with communities and organizations shall ensure that they maintain appropriate boundaries when they use technology" (standard 2.19).

Boundary issues in social work are not new. What is new are the novel boundary challenges brought about by the digital world in which social workers have greatly expanded the ways in which they serve clients. It is incumbent upon practitioners to draw on and apply evolving regulatory, ethical, and practice standards.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics.