Eye on Ethics
New Technology Standards for Social Work: Ethical Implications
Mental health services emerged on the Internet as early as 1982 in the form of online self-help support groups. By the late 1990s, groups of clinicians were forming companies and e-clinics that offered online counseling services to the public using secure websites. In social work, the earliest discussions of electronic tools focused on practitioners' use of information technology and the ways in which social workers could use Internet resources, such as online chat rooms and Listservs joined by colleagues, professional networking sites, news groups, and e-mail.
Today's social work services include a much wider range of digital and electronic options, including a large number of tools for communication with and delivery of services to clients—
Recognizing the profound impact that technology is having on social work practice, in April 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 technology standards in response to demand from regulatory bodies that make up its membership for guidance concerning social workers' evolving use of technology in practice.
The ASWB task force, which I was privileged to chair, included representatives from prominent social work practice, regulation, and education organizations. Task force members hailed from New Zealand, Ireland, Wales, Canada, and the United States. The first organizing virtual meeting of the ASWB task force was held on July 8, 2013, followed by additional virtual meetings through August 2014. Following a public comment period and revisions, the ASWB board of directors adopted the final version of the standards at its January 22, 2015, meeting (www.aswb.org/wp-content/uploads/2015/03/ASWB-Model-Regulatory-Standards-for-Technology-and-Social-Work-Practice.pdf). ASWB anticipates that social work licensing and regulatory bodies worldwide will draw on these model standards as they develop new guidelines governing social workers' use of technology.
New Technology Standards: The Ethical Dimensions
The task force sought to develop standards for social workers who use digital or other electronic technology to provide information to the public, deliver services to clients, communicate with and about clients, manage confidential information and case records, and store and access information about clients. The group developed standards addressing seven key concepts: practitioner competence; informed consent; privacy and confidentiality; boundaries, dual relationships, and conflicts of interest; records and documentation; collegial relationships; and social work practice across jurisdictional boundaries.
The various standards address a wide range of novel ethical issues.
• Practitioner competence: The standards state that social workers who choose to provide electronic social work services (which includes the use of the Internet, social media, online chat, text, e-mail, smartphones, landline telephones, and video technology) must engage in appropriate education, study, training, consultation, and supervision from people who are competent in the use of this technology to provide social work services. Social workers must be aware of unique communication challenges associated with electronic social work services (e.g., the absence of visual cues and limitations associated with the use of online written communication). Practitioners are expected to establish reasonable strategies to address these issues (e.g., using interpretive gestures and emotions, enhancing clients' ability to communicate online or with other technology). Social workers are expected to assess whether clients' needs can be met using electronic social work services and, when necessary, refer clients to another professional.
• Informed consent: Technology creates new expectations regarding social workers' efforts to obtain clients' informed consent. Under the standards, social workers are expected to develop policies and inform clients about the nature of available services, potential benefits and risks, alternative ways of receiving assistance, fees, involvement of and sharing information with third parties, and limits of confidentiality. Examples of potential benefits are immediate access to services, convenient scheduling, privacy, and reduced or eliminated transportation barriers. Examples of potential risks are the lack of visual and auditory cues, delayed responses, the need for crisis services, confidentiality breaches, and technological failures. In addition, social workers are expected to develop and disclose to clients policies regarding the use of Internet-based search engines to gather information about clients.
• Privacy and confidentiality: Electronic communication with and about clients has introduced novel privacy and confidentiality challenges. Under the standards, social workers should inform clients about risks associated with disclosure of confidential information on the Internet, social media sites, text-messaging sites, and videoconferencing sites, and the potential consequences. Practitioners are expected to use proper safeguards, including encryption, when storing and sharing confidential information using digital or other electronic technology.
• Boundaries, dual relationships, and conflicts of interest: Electronic communication has introduced new challenges related to social worker-client boundaries. According to the standards, social workers should communicate with clients using digital and other electronic technology (e.g., social networking sites, online chat, e-mail, text messages, and video) only for professional or treatment-related purposes and only with client consent. Practitioners are expected to take reasonable steps to prevent client access to social workers' personal social networking sites to avoid electronically based boundary confusion and inappropriate dual relationships.
• Records and documentation: The model standards require social workers to develop policies regarding sharing, retention, and storage of digital and other electronic communications and records and inform clients of these policies. Also, practitioners are expected to inform clients about the mechanisms they use to secure and back up records (e.g., hard drives, external drives, and third-party servers), and the length of time records will be stored before being destroyed.
• Collegial relationships: Technology has created new ways for social workers to interact with each other. According to the ASWB standards, social workers must avoid cyberbullying and take reasonable steps to correct or remove any inaccurate or offensive information they have posted or transmitted about a colleague using digital or other electronic technology. Also, social workers are expected to take appropriate action if they believe that a colleague who provides electronic social work services is behaving unethically, isn't using safeguards such as firewalls or encryption, or is allowing unauthorized access to digitally or electronically stored information.
• Social work practice across jurisdictional boundaries: Technology has enabled social workers to deliver services to clients across jurisdictional boundaries. According to the standards, social workers must comply with the laws and regulations that govern electronic social work services within the jurisdictions in which the social worker is located and in which the client is located. In a growing number of jurisdictions, social workers who provide services to clients electronically must be licensed within the jurisdiction in which the client is located, even if the social worker is licensed in another jurisdiction.
There seems to be little doubt that technology in social work is here to stay. Moving forward, social workers' biggest challenge is deciding how to incorporate technology in their practice and ensuring adherence to prevailing ethical standards.
— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He's the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics.