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by Allan Barsky, JD, MSW, PhD
Trust is a cornerstone of ethical social work practice. We promise confidentiality to create the safety that clients need in order to disclose deeply personal information. We extend similar respect for privacy to professional colleagues to sustain healthy co-worker relationships and collegial workplace environments. Although respect for confidentiality and privacy is vital to building and maintaining trust, there are many situations that require disclosure:
- Reporting suspected child abuse or neglect
- Protecting third parties from credible threats of serious, imminent harm
- Intervening when a client is at risk of self-harm
- Addressing impairment, incompetence, unethical behavior, or illegal conduct by professional colleagues
- Holding organizations accountable for misconduct or risky practices (whistleblowing)
(Barsky, 2023, National Association of Social Workers [NASW], 2021)
When exceptions to confidentiality and privacy arise, clients, colleagues, and others might perceive us as “snitches” or “tattlers.” The term snitch may refer to someone who tells authorities that another person broke rules or laws, or who discloses information to others to prevent some type of harm from occurring. This term implies a betrayal of trust. It carries highly negative connotations—inferences that most professional social workers would not want linked to their reputations.
In this article, we explore how social workers can fulfill their reporting obligations in ways that minimize the risk of betraying the trust of their clients and colleagues. In other words, how can we satisfy our reporting obligations as professional social workers in a manner that maintains respect and deference with our clients and colleagues?
Sources of Reporting Obligations
As social workers, our obligations to report may stem from a variety of sources, including ethical responsibilities, workplace (agency) policies, and public laws. The NASW (2021) Code of Ethics, for instance, states:
The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or others. [s.1.07(c)]
Note the language of this responsibility. A social worker’s primary obligation is to maintain confidentiality. The Code does not dictate to whom social workers should disclose or report information. Rather, it provides discretion about the best way to protect clients or others from serious harm, while safeguarding confidentiality as much as possible.
Workplace (agency) policies may provide reporting requirements that are different from the NASW Code, so it is important to understand possible differences and potential conflicts. For instance:
- A school might require that certain information be reported to a school principal or parents (e.g., if a student brings drugs to school property).
- An assisted living facility for people with dementia might require that any falls by residents be reported to risk management.
Statutory (legal) reporting requirements may also diverge from reporting responsibilities dictated by workplace policies or the NASW Code of Ethics. In some states, social workers may have a positive duty to warn potential victims of harm by their clients; in other states, there is a duty to protect, but not necessarily a duty to warn. Although reporting requirements for child abuse and neglect are similar across various states, there are significant differences in reporting requirements for the abuse or neglect of older adults, people with disabilities, people under guardianship orders, and other vulnerable populations. Accordingly, it is important for social workers to be well informed about the specific reporting requirements in each state where they serve clients (whether in person or remotely through technology such as videoconferencing).
Building Trust Through Informed Consent
A key strategy for maintaining client trust is ensuring that clients are properly informed about the extent of confidentiality and exceptions to confidentiality. Right from the outset of working with clients, it is important that they understand a social worker’s reporting responsibilities and relevant exceptions to confidentiality. For legal purposes and risk management, social workers should not only have a conversation with clients about confidentiality, but also document their agreement with clients about the limits of confidentiality.
Explaining the extent of confidentiality in an honest and transparent manner empowers clients to make informed decisions about whether they want to engage in services and—if they agree to services—what information they want to share and what information they may want to withhold. If a social worker later has a responsibility to share information with supervisors, law enforcement, child protection, potential victims of harm, or other entities, the social worker can then refer back to their agreement about confidentiality and its limits.
Proportionality
When considering whether to report information about a client, it is important to assess the seriousness of the concern that might trigger a reporting obligation. Not all concerns require the same level of response. If a co-worker engages in serious misconduct, for instance, reporting to a supervisor or licensing body may be required. If the co-worker engages in less serious misconduct—for instance, being five minutes late for a meeting or making a minor documentation error—reporting to a supervisor, licensing board, professional association, or others may not be called for. Determine what is an appropriate reporting response based on the seriousness of the concern and the least intrusive method to address the concern. The NASW Code, for instance, suggests speaking to a co-worker as a first step in resolving concerns about competence or incapacity (ss.2.08 and 2.09).
Similarly, consider what is a proportional response to a concern raised by a client. Assume that a client discloses wanting to “get back” at a former partner for infidelity. Initially, you are concerned that the client might seriously hurt the former partner. Upon further assessment, you find that the client has no plans to cause harm, but was just venting. Reporting the risk of harm to the former partner would not be appropriate at this time. Providing further counseling and monitoring the client may be a more proportionate response. Supervisors can help you assess the seriousness of a risk and what would be an appropriate response at this point in time. They can also help you avoid escalating conflicts over relatively minor issues.
Notification and Consent Prior to Disclosure
In situations requiring disclosures, social workers can demonstrate honesty, transparency, and respect with clients by letting them know the reason that a particular disclosure is required. Let clients or colleagues know about the good intent behind your duty to report—for instance, to protect the client or others from harm, not to have them punished or embarrassed.
Social workers can also negotiate an agreement with the client about how to make the disclosure. If a client agrees to the disclosure, the social worker may be in a better position to maintain trust with the client and continue working together. When a child abuse situation arises, for instance, a client might want to be present when the social worker calls child protection services. The client may also want to speak directly with the person receiving the report to share their perspectives or how they intend to address the child protection concern. In some situations, a client or colleague may want to self-report. By self-reporting, clients or colleagues may be in a better position to obtain corrective actions rather than punitive responses. In volatile situations—such as urgent threats of harm—prior notification or consent may not be feasible.
Limiting Disclosure
In the event that a social worker has a responsibility to disclose information to others, the worker should take all due precautions to limit the disclosures and preserve confidentiality as much as possible (NASW, 2021, s.1.07). Limiting disclosure fits with the least harm principle in ethics. Although disclosing client information with others may have negative impacts on the client and the worker-client relationship, managing what information is shared can reduce potential harm.
To determine how to respond to a particular situation, social workers should consult with a supervisor and, in appropriate cases, with an attorney. They can provide guidance on the best way to limit disclosure while also fulfilling ethical, workplace, and legal duties. For instance, it may be possible to protect a threatened person from harm without contacting law enforcement. Similarly, it might be possible to share limited information with adult protection services, focusing on what they need to know to investigate the situation. If you do not have experience in making reports, you might make your report in collaboration with your supervisor. If you are making an oral report, you might role-play making a report with your supervisor before conducting the actual report.
Following Up After Disclosure
Disclosing confidential information can strain relationships. After disclosing, it may be helpful to follow up with your client or professional colleague. Follow-up conversations may allow them to express their concerns and begin to work through them. You may be able to validate their concerns as well as rebuild trust by discussing whether and how you can continue to move forward. Once again, it may be helpful to consult your supervisor and attorney before having such conversations. In some instances, they may discourage you from having direct conversations—particularly if there are threats of lawsuits (e.g., a malpractice lawsuit for alleged breach of confidentiality). On the other hand, informal conversations can be used to resolve conflicts in a collaborative manner, preventing issues from escalating into legal disputes.
Conclusion
As social work students learn early in their education, maintaining confidentiality is vital to maintaining trusting work relationships. In some instances, you may feel hesitant to disclose client or co-worker information to others even when there are ethical, agency policy, or legal justifications for doing so. You may not want to be perceived as a snitch or risk losing your client’s or colleague’s trust. You may have questions about whether reporting a situation may do more harm than good. You may also be concerned about how your client or colleague may react. Could there be a risk of violence or some other form of retaliation? It is important to be aware of such issues and how they may be affecting you. Self-awareness enables you to make deliberate, prudent decisions
Reporting situations can raise a complex set of ethical, legal, clinical, social, and emotional concerns. Know that you do not have to make decisions alone. When potential reporting situations arise, speak with your supervisor. Also, consider whether to consult an attorney or others in your workplace who are responsible for helping social workers manage such situations. Make sure you obtain appropriate support—not just for making a decision about whether you have a reporting obligation, but also, how to carry out the reporting obligation, whether to speak with your client or colleague before reporting, and how to manage other concerns that may arise as a result of reporting.
We can’t always protect ourselves from being perceived as “snitches” in reporting situations. Still, through informed consent, transparency, collaboration, and proportionality, we can strive to maintain trust and carry out our obligations in a professionally responsible manner.
References
Barsky, A. E. (2023). Essential ethics for social work practice. Oxford University Press.
National Association of Social Workers. (2021). Code of ethics. Author. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
Office of the Whistleblowers Ombuds. (n.d.). Whistleblower survival tips. https://whistleblower.house.gov/sites/evo-subsites/whistleblower.house.gov/files/whistleblower_survival_tips.pdf
Allan Barsky, JD, MSW, PhD, 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.