Ethics Alive: Special Report on the 2021 Revisions to the NASW Code of Ethics

by Allan Barsky, JD, MSW, PhD

     The time has come. For the first time in the history of the National Association of Social Workers, the Code of Ethics will include specific provisions on self-care and cultural humility. On May 18, 2021, NASW introduced these new provisions in an informative and inspirational webinar led by Dawn Hobdy (NASW’s Vice President of Ethics, Diversity, and Inclusion), Terrika Hardy (focusing on self-care), and Stephanie Azare Nti (focusing on cultural competence and humility). The revisions take effect on June 1, 2021. The purpose of this article is to provide an overview of the revisions to the Code and their implications for practice.

     For social workers and the people we serve, the recent additions to the Code are transformational. For social workers who may be concerned about whether these revisions will create new legal liabilities or ethics complaints against social workers, the presenters suggested that most of the changes are aspirational. They are not intended to make life more difficult for social workers, but rather to provide guidance in a supportive manner. The principles of self-care, cultural competence, and cultural humility should be viewed as ongoing commitments to awareness, learning, integrity, and best practices.

Self-Care

     Prior to the 2021 revisions, the Code of Ethics made no explicit references to self-care. The Code did include provisions concerning a social worker’s duty to ensure that personal issues and impairments do not inhibit their work with clients. When workers experienced personal problems, psychological distress, legal problems, substance abuse, or mental health issues that might interfere with their work, Standard 4.05 encourages them to “immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients or others.” Although these strategies could be interpreted as self-care, they focus on dealing with personal problems after they arise rather than acting in a proactive or preventative manner. Standard 2.08 states that when social workers become aware of colleagues with possible impairments, they should first speak with their colleagues about remedying the possible impairments. If the colleagues do not adequately address these concerns, then social workers should “take appropriate actions established by employers, agencies, NASW, licensing and regulatory bodies, and other professional organizations.” Once again, these provisions are more reactive than proactive.

     To address the lack of guidance on proactive self-care in the Code of Ethics, new language was added to the purpose and principles sections of the Code. No new standards were added, and no new revisions were made to existing standards. The first change in the purpose section is indicated by the bolded language below:

5. The Code socializes practitioners new to the field to social work’s mission, values, ethical principles, and ethical standards, and encourages all social workers to engage in self-care, ongoing education, and other activities to ensure their commitment to those same core features of the profession.

     This revision highlights the importance of self-care, ongoing education, and other activities as part of social workers’ commitment to the mission, values, and ethics of the profession. Note that the language is supportive and aspirational, rather than mandatory. This addition is meant to educate social workers, social work organizations, and others about the fundamental role of self-care in social work. Self-care is not an add-on to social work practice; it is integral to practice, enabling social workers to serve clients in a competent manner, promote social justice, and foster the other ideals of the profession.

     The following paragraph is a completely new addition to the purpose section of the Code.

Professional self-care is paramount for competent and ethical social work practice. Professional demands, challenging workplace climates, and exposure to trauma warrant that social workers maintain personal and professional health, safety, and integrity. Social work organizations, agencies, and educational institutions are encouraged to promote organizational policies, practices, and materials to support social workers’ self-care.

     This statement reinforces the importance of self-care in social work practice. It highlights how social workers may experience various stressors. Challenging workplace climates may include concerns such as large caseloads, insufficient resources, competing ethical demands, and policies and practices that may not align with or support social work values and ethics. In terms of exposure to trauma, social workers may experience secondary trauma or vicarious traumatic stress when working with clients who have experienced racism, abuse, neglect, community violence, natural disasters, or other forms of trauma. As the final sentence of this paragraph explains, self-care is not solely the responsibility of each social worker. Social work organizations, agencies, and educational organizations are also responsible for ensuring that social workers have the support that they need and deserve. This statement may be helpful for social workers advocating for changes in policies, procedures, and resources to support their ongoing mental health, social well-being, and resilience.

     The third change is an additional sentence (bolded) in the paragraph describing the value of integrity and its related ethical principle, being trustworthy.

Ethical Principle: Social workers behave in a trustworthy manner.

Social workers are continually aware of the profession’s mission, values, ethical principles, and ethical standards and practice in a manner consistent with them. Social workers should take measures to care for themselves professionally and personally. Social workers act honestly and responsibly and promote ethical practices on the part of the organizations with which they are affiliated.

     By placing this new sentence under integrity and trustworthiness, this addition highlights the ethical risks that may arise when social workers do not have adequate self-care. As Dawn Hobdy noted, among the professional complaints received by the NASW National Ethics Committee, many of the ethical problems may be connected to personal issues in the social worker’s life (e.g., a social worker who is going through a challenging divorce, experiencing depression, or struggling with financial concerns). To practice in a trustworthy manner, social workers need to be aware of how personal issues are affecting them and ensure that they put proper self-care measures in place.

     NASW offers a number of self-care podcasts, activities, and articles at this self-care resource page. Erlene Grise-Owens also provides a helpful article on self-care where she talks about the importance of organizational accountability AND practitioner self-care. Whether you are a frontline social worker, an administrator, a policy advocate, a supervisor, an educator, or a student, it is vital to be proactive in supporting the self-care of all social workers. We are in the mission of self-care together.

Cultural Competence

     The Code of Ethics revisions regarding cultural competence are all included in Standard 1.05 (as bolded below).

1.05 Cultural Competence

(a) Social workers should demonstrate understanding of culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.

(b) Social workers should demonstrate knowledge that guides practice with clients of various cultures and be able to demonstrate skills in the provision of culturally informed services that empower marginalized individuals and groups. Social workers must take action against oppression, racism, discrimination, and inequities, and acknowledge personal privilege.

(c) Social workers should demonstrate awareness and cultural humility by engaging in critical self-reflection (understanding their own bias and engaging in self-correction), recognizing clients as experts of their own culture, committing to lifelong learning, and holding institutions accountable for advancing cultural humility.

(d) Social workers should obtain education about and demonstrate understanding of the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical ability.

(e) Social workers who provide electronic social work services should be aware of cultural and socioeconomic differences among clients’ use of and access to electronic technology and seek to prevent such potential barriers. Social workers should assess cultural, environmental, economic, mental or physical ability, linguistic, and other issues that may affect the delivery or use of these services.

     The first revision is in the title of this heading, changing it from “Cultural Awareness and Diversity” to “Cultural Competence.” Different social workers may have different views on whether we should be focusing on cultural competence, cultural awareness, cultural sensitivity, cultural responsiveness, or cultural humility (as explored in my article Ethics Alive! Cultural Competence, Awareness, Sensitivity, Humility, and Responsiveness: What's the Difference?). Terrika Hardy explained that cultural competence was used in the title of this standard because, as a profession, social work requires its members to be competent and to practice with competence. She further explained that the new language includes the notions of cultural humility, culturally informed practice, and cultural awareness, incorporating them into the notion of cultural competence. A similar approach was used in the NASW’s Standards and Indicators for Culturally Competent Practice. It is likely that social workers will continue to debate the merits of each of these terms and what they mean – and this discussion could be very healthy for the profession as we determine how to incorporate them in our policies and practices.

     In subsections (a), (b), and (c), note the addition of the word “demonstrate” before “understanding” and “knowledge.” These additions recognize that having knowledge and understanding of cultural issues is not sufficient. We should demonstrate them in practice. “Demonstrate” means responding and doing, not just being aware, feeling, knowing, or thinking.

     In some of the strongest language in the Code of Ethics, Standard 1.05(b) says, “Social workers must take action against oppression, racism, discrimination, and inequities, and acknowledge personal privilege.” I have bolded the word “must,” because no other standard in the Code uses this mandatory term. Most sections use the term “should” to denote that the provisions are intended to guide social workers about good standards of practice. “Should” also suggests that there may be exceptions to these general expectations depending on the circumstances of the situation. By using the term “must,” this revision creates a positive duty on social workers to take action against “oppression, racism, discrimination, and inequities, and acknowledge personal privilege.”

     Given our heightened awareness of racism and oppression in the past few years (including incidents of police brutality and other acts of violence and discrimination against Black, Indigenous peoples, and other people of color), this addition is certainly a call to action. It is not sufficient to be nonracist; we must also be committed to be antiracist. The provision about “acknowledge personal privilege” may also provide social workers with a response to executive orders and laws that try to restrict education or training related to racial bias, critical race theory, systemic discrimination, and privilege. The profession of social work deems the acknowledgment of personal privilege as an ethical obligation. Although the Code does not define “personal privilege,” this term could include white privilege, male privilege, heterosexual privilege, cisgender privilege, and privileges associated with other social identity groups that have certain unearned advantages within particular societies, organizations, or groups.

     Standard 1.05(c) is a completely new subsection of 1.05. It not only says that social workers should demonstrate cultural awareness and humility; it provides examples of how to do so. As social work ethicist Dr. Frederic Reamer often explains, one of the primary roles of a code of ethics is to educate. By describing how to put cultural humility into practice, this new provision gives social workers practical guidance. In the past, social workers have often talked about the importance of self-awareness and not imposing values on clients from different cultural backgrounds. Now, the concept of critical self-reflection goes further, inviting social workers to reflect on their biases and take actions to correct for them. As with self-care, the processes of cultural humility invite social workers to collaborate with others. Supervisors and peer consultants may assist with heightening critical reflection and awareness. Treating clients and community members as experts in their own cultures builds on the principle of respect for the dignity and worth of all people. Making a commitment to lifelong learning means understanding the limits of what we currently know, questioning our assumptions, reading research and ethnographic narratives, taking courses, seeking assistance from people from various backgrounds, reflecting on practice with clients from diverse backgrounds, and taking note of what is helpful and what is not so helpful in working with particular individuals and groups. The provision that requires social workers to “hold institutions accountable for advancing cultural humility” reinforces that social workers need to engage with others, including administrators and colleagues, to engage in practice from the perspectives of cultural humility.

     The language added to Standard 1.05(e) [formerly 1.05(d)] deals with social workers’ obligations to clients when providing services electronically (e.g., through videoconferencing, messaging, avatars, and behavioral intervention technologies). The existing language suggests that social workers should be aware of and assess for cultural diversity factors that may affect a client’s use of technology. The new language clarifies that social workers should also take appropriate steps to help clients by preventing and addressing potential barriers to using technology (e.g., lack of resources, familiarity, knowledge, or comfort with the technology among different individuals and groups).

Conclusion

     If there is one phrase that encompasses the primary changes to the Code of Ethics, perhaps it is “taking care.” First, social workers should take care of themselves to preserve their well-being and to ensure that they can serve clients and communities in a competent and ethical manner. Second, social workers should take care of their clients by making continuous efforts to foster their cultural competence, awareness, and humility. And third, social workers should take care to address issues of racism and other forms of discrimination and injustice.

     Social workers sometimes suggest that we should start with our clients. This maxim still holds true. Simultaneously, we also need to start with ourselves, using self-care and critical self-reflection to ensure that we are ready and able to start with our clients.

For More Information

     For additional insight and analysis of the 2021 revisions to the NASW Code of Ethics, listen to an interview with Dr. Allan Barsky by Dr. Jonathan Singer of the Social Work Podcast: Self-Care and Cultural Humility in the 2021 NASW Code of Ethics: Interview With Allan Barsky. Social Work Podcast. https://socialworkpodcast.blogspot.com/2021/05/2021CoE.html

Allan Barsky, PhD, JD, MSW, is Professor of Social Work at Florida Atlantic University and author of  Social Work Values and Ethics (Oxford University Press).

The views expressed in this article do not necessarily represent the views of any of the organizations to which the author is affiliated, or the views of  The New Social Worker magazine or White Hat Communications.