Social Work Tech Notes: Is Google Good for Your Social Work Client?

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Google

by Stephen P. Cummings, MSW, ACSW, LCSW

     It’s 2018, and as it approaches its 20th anniversary, Google is everywhere. With a few exceptions, Google is free: cloud storage, email (Gmail/Inbox), mapping and way finding (Google Maps), video hosting (YouTube), just to name a few examples. In the classroom, Google’s web-based products, once considered stripped-down competitors to Microsoft Office, are the primary choice of my students. It’s easy to forget how, in the days of the “technology 1.0” boom of the late 1990s, Yahoo was the go-to online brand. Today, Google has probably discontinued more products and services than Yahoo ever managed. It’s impossible to ignore Google’s reach. If you use a cell phone, laptop, or other device in the ever-expanding Internet of Things, then it’s likely Google knows you and your world.

    As social work practitioners, we cannot ignore the role of Google in the world, and in the lives of our clients. We’re guided by the Standards for Technology in Social Work Practice, recently updated. That this document has expanded from 20+ pages in 2005 to 64 pages now is reflective in part of the ever-present nature of the Internet. According to the Pew Research Center in March 2018, almost a quarter of U.S. adults say they are online almost daily (Perrin & Jiang, 2018). So where does Google, a single name with a variety of contact points, fit in with practice? And beyond that, the key question remains: Is Google good for your client?

Focusing on Health Literacy

    The story goes like this: Patient goes online to learn about a problem, which then confounds the trained health professional attempting to complete an assessment. The stereotype assumes that health literacy is not a factor when patients or clients engage the web to obtain an understanding of their condition. This also discounts the social work principles of self-efficacy and empowerment. One recent study (Yom-Tov et al., 2016) evaluated patients seeking information online about diabetes. The predominant factor influencing health literacy was reading level (the study in question noted that government websites often require a reading level of 7th grade level or higher). This suggests other factors, such as the quality of the content created rather than the Internet itself, is the issue affecting health literacy.

    Our clients are using Google to learn about what they are going through, make community connections, and in general, help shape the paradigm of their lives. This isn’t new. In my pre-Google life, I remember interviewing a patient who was convinced his life would be improved if he could just “fix the RLS.” This patient had seen a series of commercials for medication meant to treat Restless Leg Syndrome. The patient was attempting to understand his condition, so the interdisciplinary team started there with the patient.

    Google is exponentially powerful, and its algorithm is complex. The sites that appear toward the top of the search results are there, in part, because other users have searched for them (Google, n.d.). This is intended to weed out sites designed to “game the system,” which can lead to results that emphasize bad information. What’s critical for social workers to address is how clients may be searching for information and what they’re finding. Are they seeking to confirm what they believe? Are clients taking one result and treating that as the only answer? Social workers should prepare to discuss what their clients may have learned from these searches. As noted earlier, the goal is not to dissuade clients from engaging in learning through Google, but to be more thoughtful about what they look for and how they are looking for it. If we are aware of good web-based resources, we should share those with our clients.

Googling the Social Worker (versus the Googling Social Worker)

     In a recent supervision session, I discussed how clients are able to search their social workers who use social media. In this instance, my supervisee discussed how much the client was able to learn prior to their first visit (including the social worker’s favorite hobby). This revelation led this social worker to delete her Facebook account completely.

    This sparked a discussion on the updated NASW Code of Ethics. In the Privacy and Confidentiality standard (1.07), section (q) states: “Social workers should avoid searching or gathering client information electronically unless there are compelling professional reasons, and when appropriate, with the client’s informed consent” (NASW, 2018). On the other hand, clients do have access to information on us on social media.

    Social workers are encouraged to consider the implications of the choices we make in the digital space. Do my political, spiritual, or community affiliations have any impact on my clients’ perceptions of me? What do my “likes” on Facebook and Twitter communicate? In my example, the social worker deleted her account entirely. However, this isn’t necessarily the only option available. Some platforms, like Facebook, allow users to opt out of search engine listings, should we choose to keep their information private. The key phrase here is “opt-out.” Every platform has its own process for managing these settings, but in most cases, the social worker must actively take this step.

    In the recently published Standards for Technology in Social Work Practice, Standard 3.09 reiterates this ethical standard with a framing for practice: “except for compelling professional reasons, social workers should not gather information about clients using electronic resources without the client’s consent” (2017). From this practice perspective, the language of this standard is even proscriptive: even if the social worker interprets the need to seek information, would another profession be more appropriate? For example, would a law enforcement officer be more directly responsible to investigate information? In my work as a hospital social worker in the emergency department, I would be tasked with locating next-of-kin when newly admitted patients were unable to communicate or make emergent decisions for themselves. I would use social media to the extent that the needed information was obtainable (contact information of a next-of-kin, or person known to the patient who could provide the needed information quickly).

Googling and Anxiety

     Related to this discussion of health literacy is the role of patient anxiety in using search engines such as Google. A lot of conventional discussion on the topic seems to reinforce the notion that Googling symptoms in search of treatment or a cure can increase anxiety. This can be attributed to several direct factors. On the Internet, anyone can publish information—this includes companies hoping to connect patients to their products (think brand name medications that the client should “talk to their doctor” about). Again, social work professionals should anticipate this and discuss with clients what constitutes a preferable resource, as well as have a larger discussion about their health literacy. It’s fair to discuss the client’s motivations to seek out information on the Internet. Is the goal to gain more insight, or to avoid a formal evaluation or treatment plan? As Joshua Williams notes in The Guardian, “Because the Internet is always at our fingertips, it is always there waiting for our weaker moments” (2016).

What Social Workers Can Do

• Talk about the use of Google (and other forms of technology) with the people we serve. Our clients are using Google to learn about what they are going through. It’s advisable to support clients in their digital and health literacy, rather than suggesting they remain incurious or dependent on us as the “experts.”
• Be leaders in technology. As social work practitioners, we should be constantly up to date with best practices for technology use. Review the NASW, ASWB, CSWE, and CSWA Standards for Technology in Social Work Practice, seek out other sources of insight, and be aware of the issues surrounding the use of Google and other popular platforms.
• Address problems actively. Google is a behemoth, but as users, we still need to bring problems to Google’s attention. The virtual infrastructure that gives Google the power it does has great value, but it should be expected to be held to a level of ethical standard worthy of its reach and stature. Google’s motto was updated from “Don’t be evil” to “Do the right thing” in 2015. However, its own employees, angry over the company’s role in defense department contracts, have reportedly led it to work on a set of ethical principles (Meyer, 2018). Users should always reach out to Google with concerns about what appears in searches, or if conduct on a Google-supported site is abusive. This should include when bad or inflammatory information is being promoted in the Google search algorithm (https://www.google.com/contact/).

References

Google. (n.d.). Google: How search works. Retrieved from https://www.google.com/search/howsearchworks/algorithms

Meyer, D. (2018, April 15). Google is reportedly drafting “ethical principles” after employee fury over defense department projects. Fortune. Retrieved from: http://fortune.com/2018/04/13/google-defense-department-contract-pentagon-ethical-principles/

NASW, ASWB, CSWE, & CSWA Standards for Technology in Social Work Practice. (2017). Retrieved from: https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf

National Association of Social Workers. (2018). Code of ethics. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

Perrin, A., & Jiang, J. (2018, March 14), About a quarter of U.S. adults say they are ‘almost constantly’ online. Pew Research. Retrieved from: http://www.pewresearch.org/fact-tank/2018/03/14/about-a-quarter-of-americans-report-going-online-almost-constantly/

Williams, J. (2016, March 8). Anxious, depressed, scared? Close down the browser and face your fears. The Guardian. Retrieved from: https://www.theguardian.com/commentisfree/2016/mar/08/anxious-depressed-panic-attacks-close-browser-internet-distraction

Yom-Tov, E., Marino, B., Pai, J., Harris, D., & Wolf, M. (2016). The effect of limited health literacy on how internet users learn about diabetes. Journal of Health Communication, 21(10), 1107-1114.

Stephen Cummings, MSW, ACSW, LSW, is a clinical assistant professor at the University of Iowa School of Social Work, where he is the administrator for distance education.