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Colton J. Cnossen

About the author:

Colton Cnossen, the author of this chapter, graduated with honors from the master’s program at Ferris State University in May of 2017. Cnossen also completed his undergrad in social work Ferris, and has been very passionate about contributing his knowledge to the field of social work. Cnossen hopes to work with youth throughout his career, particularly in a school setting or with a community mental health agency. Colton has coached middle school basketball the past five years and has been very successful. Coaching is something Cnossen wants to continue doing as he finds it a great way to help youth and give back to the community. Colton strongly encourages that all social workers find something they enjoy doing that is contributing to their local community.

Cnossen is a strong supporter of self-care and has been known as a master of self-care. He takes full advantage of every opportunity he can to keep his mind at peace. He truly enjoys being on the water, kayaking, boating, or fishing. Colton recently adopted an English Springer Spaniel puppy he named River. River has been a great fit for Colton’s self-care plan and enjoys every adventure with him. Above is a photo of Colton and his puppy, River.

Some advice Colton has for you as a social worker is to design a self-care plan that truly brings you happiness, and stick to it. He also recommends finding things to be thankful for in life and to not overlook the small things.

Ethics

Social work is considered a helping profession. Like many other helping professions such as nursing, counseling, teaching, and psychiatry, social work has ethical guidelines that help direct us in our work. Social workers are a vital membesr of the helping community and can be seen assisting many other helping professions (Cournoyer, 2011). Helping professions address a multitude of problems or dilemmas often involving a person’s physical, mental, social, intellectual, and spiritual well-being.

Therefore, as a social worker in the helping profession, you are responsible for many legal and important decisions. Often these decisions involve ethical choices in the best interest of clients’ lives. These decisions can be extremely difficult and emotionally charged and they may not always be the choices you are comfortable making.

The National Association of Social Work (NASW) Code of Ethics serves as guidelines for professional practice. It is relevant to all social workers, social work students, and social work educators regardless of their specific duties or settings. One should certainly use and become familiar with this website as a guide for learning about the Code of Ethics.

To be an ethical and professional social worker one must have a thorough understanding of the Code of Ethics and the legal obligations social workers are responsible for (Cournoyer, 2011). When encountering specific dilemmas, you as a social worker are responsible for knowing what ethical principle or value best applies to that situation. You must also be able to think critically to determine the best outcome for all parties involved (Woodcock, 2011).

The purpose of this chapter is to provide you with a brief understanding of the NASW Code of Ethics as you begin your journey through a social work program. This chapter is designed to help explore and provide a base understanding of these terms and overall principles. The goal is to prepare you for future courses and your future career so you are familiar with the general concepts. You will continue to explore the NASW Code of Ethics throughout your education, and will become much more applicable through continuing courses. (keywords: ethics, values, obligations and duties)

Establishment of the Code of Ethics

Social work is grounded on the concepts of social justice and fairness and the idea that all people should be treated equally. Clearly, when looking at the history of our nation, not all people have been treated equally. In the nineteenth century, social work became known as the calling that responded to the needs of vulnerable populations and those living in poverty. Through the rise of settlement houses and charity organization societies in the twentieth century and during the Great Depression, social workers promoted and provided new ways to address structural problems (Reamer, 2006)

As social work endeavored to gain recognition as a profession, the need arose for a formal code of ethics. While there were many social workers who helped pave the way, Mary Richmond is considered to be one of the most important. In 1920, Mary Richmond provided an experimental Code of Ethics which served as a base for many other social workers seeking social justice, equality, and fairness for vulnerable and oppressed populations (Reamer, 2006). Richmond’s Code of Ethics served as a guide to the first edition of the NASW Code of Ethics which was constructed in October of 1960. This document, developed by the NASW’s Delegate Assembly of the National Association of Social Workers, officially defined the duties and obligations for which a social worker is responsible. The 1960 edition defined fourteen responsibilities social workers were obligated to fulfill based on the mission of social work, and even included a discrimination clause. With the first revision in place the social work profession established a sense of professionalism.

Mary Richmond, a significant person in establishing social work as a profession.

For more information on Mary Richmond, see http://socialwelfare.library.vcu.edu/social-work/richmond-mary

The NASW Code of Ethics continues to be updated. Many significant revisions have been created as the needs of the increasingly diverse population social workers serve continue to change. Shortly after the publishing of the 1960 Code of Ethics, social workers became concerned with the Code’s suggestions for handling ethical dilemmas. In an effort to address these concerns, a task force was established to revise the original Code of Ethics (Reamer, 2006). In 1979, the NASW Delegate Assembly continued to work on the revisions as needed. It was not until the 1990’s when the NASW Code of Ethics was significantly modified again.

During the 1990’s the Code of Ethics had several impactful changes that were centered on the relationship between clients and social workers (Reamer, 2006). The profession began to stress the importance of maintaining professional boundaries with clients as social workers started to become more involved in clients’ lives. Five new principles were also included in the Code of Ethics that were centered on social work impairment and dual relationships. This lead to a major revision due to the profession’s developing understanding of ethical issues previously not addressed resulting in the public and media paying more attention to the NASW Code of Ethics.

In 2008, a major advancement occurred which incorporated the terms sexual orientation, gender identity, and immigration status into the non-discrimination standards in the Code of Ethics. This was a significant update because for a long period of time these groups of people have been heavily discriminated against in the United States and throughout the world.

Provided is a link with all updated changes: https://www.socialworkers.org/nasw/ethics/ethicshistory.asp

Overview of NASW Code of Ethics: Four Sections

 The NASW Code of Ethics consists of four sections:

• Preamble
• Purpose of the NASW Code of Ethics
• Ethical Principles
• Ethical Standards

(Woodcock, 2011).

The first section, the preamble, is intended to outline Social Work’s mission and core values while the second section provides a purpose and overview of the NASW Code of Ethics and how to handle or deal with ethical dilemmas (Woodcock, 2011). The third section, which is labeled Ethical Principles, helps define ethical principles based on Social Work’s six core values. Finally, the fourth section provides detailed ethical standards for which social workers are held accountable. It is important that as future social workers you are familiar with all four sections as they are intended to serve as guidelines for practice.

Preamble

Social Work’s mission is “to enhance human well-being and help meet the basic human needs of all people, with attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (Cournoyer, 2011, p. 160). With this mission, social workers should have a clear indication of what is expected when entering the field and practicing as a social worker. The six core values of Social Work are derived from the mission statement. These values will be further discussed in the chapter, but keep in mind the preamble section is rooted in these values.

Social workers should take pride in their work as they are seeking to improve the lives of others, and enhance the well-being of society. It is important to recognize social work’s primary mission, but as social workers you will also need to best represent the agency or organization you are working for. Every agency or organization will have their own guidelines or rules; it is then your responsibility to incorporate those guidelines along with the NASW Code of Ethics. Social workers have many different roles and can be found in many areas of work, but the primary goal is to endorse social justice (Woodcock, 2011).

Purpose of the NASW Code of Ethics

The purpose of the NASW Code of Ethics is to hold social workers to a high standard of professionalism.

The NASW Code of Ethics serves six purposes:

1. The Code identifies core values on which social work’s mission is based.
2. The Code summarizes broad ethical principles that reflect the profession’s core values and establishes a set of specific ethical standards that should be used to guide social work practice.
3. The Code is designed to help social workers identify relevant considerations when professional obligations conflict or ethical uncertainties arise.
4. The Code provides ethical standards to which the general public can hold the social work profession accountable.
5. The Code socializes practitioners new to the field to social work’s mission, values, ethical principles, and ethical standards.
6. The Code articulates standards that the social work profession itself can use to assess whether social workers have engaged in unethical conduct. NASW has formal procedures to adjudicate ethics complaints filed against its members.* In subscribing to this Code, social workers are required to cooperate in its implementation, participate in NASW adjudication proceedings, and abide by any NASW disciplinary rulings or sanctions based on it.

(NASW, 2008)

The NASW Code of Ethics cannot guarantee all ethical behavior, therefore it is up to you as a social worker to follow the Code of Ethics and best represent the profession. Become familiar with the Code of Ethics and continue to stay familiarized with them even beyond your education. There are going to be times when you as a social worker will not be sure what to do or what decision to make. This can be very frustrating. The Code of Ethics are intended to guide you through the process of difficult decision making so that you do come to the correct or best conclusion. Working closely with a supervisor will also be important.

When making ethical decisions where there is no clear answer on what to do, it becomes a difficult process. The simple answer is not always going to be present. Later in this chapter we will discuss ethical dilemmas, but remember to let the six core values, the NASW mission statement, and the Code of Ethics guide you in selecting the appropriate choice.

Ethical Principles

The ethical principles are based on the six core values of social work. These six values are important for all social workers to recognize and apply to their practice. They should help direct you in all ethical decisions or dilemmas you encounter. Social workers should also be conscientious of these values when working with clients, talking with co-workers, writing grants, or any other role a social worker performs, even if an ethical dilemma does not present itself. During your education, these six values will become much more significant than you may have imagined. You will learn true definitions of these terms and how to apply them to your practice.

Today the term value is used in a variety of ways with many meanings. In the field of social work the six core values provide a framework for us that are connected in three important ways. First, the six core values have a direct relationship with clients, colleagues, and members of the broader society. Secondly, these six values derive from social works overall mission statement, and lastly, these six values relate to the resolution of ethical dilemmas and interventions that social workers use in their work (Reamer, 2006).

The six core values of social work are listed as:

• Service
• Social Justice
• Dignity and Worth of a Person
• Importance of Human Relationships
• Integrity
• Competence

Service

One of social work’s primary goals is to help people who are in need and to address social problems (Cournoyer, 2011). This value defines what social workers should be responsible for and the dedication to their job. As a social worker, you are encouraged to volunteer your time and professional skills with no expectation of significant financial return (Reamer, 2011). Social workers need to be dedicated to their delivery of services and be fully committed to assisting to a client’s needs.

Social Justice

Social Justice is a significant value for all social workers, as we seek to promote equality for all people. This is often done by advocating for fair laws or policies, on behalf of clients (Cournoyer, 2011). When promoting social justice, social workers have a specific focus on vulnerable and oppressed individuals or groups of people (Reamer, 2006).

Dignity and Worth of a Person

As a social worker, you must respect that individuals come from a variety of different backgrounds and cultures and that all people deserve to be treated with respect. Social workers should certainly support equality without assigning levels of worth to an individual or group and it is important to honor in the uniqueness of all individuals. Social workers should also be consistent with all values, ethical principles, and ethical standards of the profession when working with clients (Reamer, 2006). As social workers, one of your duties is to help others find their worth as a person.

Importance of Human Relationships

While recognizing the worth of all individuals, social workers should also respect the relationship of humans as they are important for change or working through dilemmas (Reamer, 2011). Social workers should work to strengthen relationships among people of all backgrounds. Relationships are a key in being successful in the field and promoting all ethics and values.

Integrity

Integrity is a significant value as it underlines the trustworthy manner all social workers should demonstrate. Social workers should be honest, responsible, and promote the ethical practices to the fullest (Reamer, 2006). You should also be aware of the profession’s mission, vision, values, and ethical standards and apply them in a consistent manner as well as promote all ethical practices for any agency they are affiliated with. Social workers should take pride in their work.

Competence

Social workers should frequently enhance their professional knowledge and skills. As a social worker, it is important to continue to strive to best serve clients and represent the profession. Social workers must be competent in their practice and also know when they do not have the knowledge base or skill set, and therefore must refer out for services.

Ethical Standards

The ethical standards of social work consist of six important criteria for which all social workers are held responsible. They are social workers’ ethical responsibilities:

• To clients
• To colleagues
• In practice settings
• As professionals
• To the social work profession
• To broader society

This link from the NASW website specifically lists all ethical standards under the six criteria: https://www.socialworkers.org/pubs/code/code.asp

Common ethical violations to be aware of consist of the following:

• Sexual activity with clients and colleagues
• Dual relationship
• Boundary violations
• Failure to seek supervision
• Failure to use practice skills
• Fraudulent behavior
• Premature termination
• Inadequate provisions for case transfer or referral
• Failure to discuss policies as part of informed consent with clients

(Cournoyer, 2011)

Summary

The NASW Code of Ethics is a living document and will continue to be adjusted as new developments and issues arise. Therefore, as a social worker, you are responsible to stay updated on all changes that are made and apply them to your practice. The Code of Ethics enforces the belief that the public will not be taken advantage of by the work of social workers for their own benefit and that clients will be treated fairly.

Legal Duties/Obligations

Another critical role of becoming a social worker is the legal obligations or duties you are responsible for. These duties are very serious and all social workers must abide by them. These duties or obligations consist of the:

• Duty to maintain confidentiality
• Duty to report
• Duty to inform
• Duty to respect privacy
• Duty to warn and protect

Duty to Maintain Confidentiality

Another important term in this chapter is the term confidentiality. Confidentiality, is extremely important for social workers as they have a duty to maintain confidentiality with all clients and the conversations they have with them. The term confidentiality indicates that any information shared by a client or pertaining to a client will not be shared with third parties (Cournoyer, 2011). It must remain between the social worker and the client. If confidentiality is broken, it can be a serious violation.

When meeting with clients for the first time it is mandatory to inform the client of their rights of confidentiality. No matter who is trying to seek information about a client you are working with, you must follow your duty to maintain confidentiality. Even if a client is deceased, you as the social worker are still obligated to protect the information you have obtained. Social workers should not only protect the information gained from clients, but they should also respect information shared by colleagues.

An important confidentiality law that you are likely to encounter as a social worker is the U.S. Health Insurance Portability and Accountability Act (HIPAA) which is commonly found in the health profession. HIPAA assures that client information will remain private and between them and the professional, and includes provisions for the protection of health information, records, or other information (Cournoyer, 2011). If a client wishes to give consent for their information to be shared, then they will be asked to sign a release form provided by the social worker giving permission to share that information.

Duty to Report

There are times when a social worker is required to break the confidentiality rule. These circumstances are the only time that a social worker is legally obligated to breach confidentiality agreements and must be taken very serious. This is known as duty to report. As a social worker, you are a mandated reporter and have a legal obligation to report to the designated authority if a client disclosed any of the following:

• they are going to harm or kill another person or indications of outrages against humanity
• abuse or neglect of a child, disabled person or senior citizen
• have a plan to commit suicide and admit to wanting to commit suicide

(Cournoyer, 2011)

For example, if a client discloses they have or plan to abuse a child or if a person’s life is at imminent risk, then you are required to act. These are the times when confidentiality agreements are broken and the social worker must report to a supervisor or the proper authority, so the authority can take further action. If not reported, the social worker can face serious legal offenses. Upon taking a job and throughout your education you will learn who the proper person or agency is that you should report to.

At times, it may be difficult to determine if you should report or not report. This can be known as an ethical dilemma. Throughout your education you will better learn about the times when you as a social worker will be required to breach confidentiality. For now it is extremely important to understand that as a social worker there are times when it is necessary to report.

Duty to Inform

Another important duty you will be obligated to abide by is duty to inform. As a social worker, you are required to educate clients concerning the scope of your services. This consists of informing the client about confidentiality, duty to report, but also the cost, length of treatment, risks, alternative services and anything else your agency requires (Cournoyer, 2011). When you are hired by an agency they will certainly walk you through the steps of your duty to inform and what they require, but it is your obligation as a social worker to best inform the client of your role. This is often completed early in the process when you are first meeting with a client.

If you are taking any actions regarding the care of client, it is your job to inform them and consult with the client first. It is best to inform the client in advance and have informed consent. Not informing a client of your role can be a form of malpractice.

Duty to Respect Privacy

When becoming a social worker, it is extremely important to follow your duty to respect the privacy of the people you serve and work with. As a social worker, you should protect all information obtained during services and respect the client’s right to privacy. Privacy differs from confidentiality because it refers to the client’s right to choose what to share and what to not share with a social worker. Social workers must respect that there may be things the client does not wish to disclose and we must not force them to do so.

Often social workers help or assist people during vulnerable times and become a part of many people’s lives. As a social worker, it is your duty to respect the relationship you have with clients and to not intrude on their lives outside of your sessions. For example, if you are working in a small town and run into a client you regularly meet with at the grocery store it is in your best interest as a social worker to respect the privacy of that individual and not approach them. Nor should you approach them and begin talking about what you previously talked about during one of your sessions together. You should discuss these possibilities with your client so they are aware of how you will react to them if you meet them in a public setting.

Duty to Warn and Protect.

Another duty social workers take on is the responsibility to warn potential victims a client may harm (Cournoyer, 2011). Along with many other helping professions a social worker is obligated to act to insure that anybody who may be in danger is aware of the possible danger. Therefore, as a social worker you must take serious action in deciding if a client is serious about harming another person. This is a great example of an ethical dilemma, deciding if the client is serious and has intent. If they do, then you are obligated to warn and protect. It is best to consult with a supervisor if there is any indication a client has stated he or she is going to act out and kill or harm another individual.

 Malpractice

Another key term to be aware of related to the NASW Code of Ethics is malpractice. Malpractice can be defined as a form of negligence which occurs when a licensed social worker is not consistent with the professions’ Code of Ethics, standards of care, and is negligent to his or her legal duties and obligations (Reamer, 2006). Often this involves poor delivery of services or a social worker failing to meet the standard of care at his or her agency.

Malpractice is one reason why social workers need to be conscious of the Code of Ethics and make sure they are doing everything ethically correct. Malpractice lawsuits are common among many helping professions, not just social work, but due to the nature of and intimacy of social workers’ roles it is extremely important to best represent the NASW Code of Ethics. If not, serious consequences can follow.

Three common forms of malpractice include:

• Malfeasance: when the social worker intentionally engages in practice known to be harmful
• Misfeasance: when the social worker makes a mistake in the application of an acceptable practice
• Nonfeasance: when the social worker fails to apply standard and acceptable practice if the circumstances include such practice

(Cournoyer, 2011).

Clearly, malpractice can occur even if one intentionally or unintentionally is aware of the wrongdoing. For example, a genuine mistake social workers make is simply forgetting to obtain a client’s consent before sharing confidential records with third parties. This alone can lead to serious civil lawsuits and can jeopardize your social work license. When these mistakes occur, the social worker does not intend to provide harm, but due to the many responsibilities social workers have it is easy to forget and unintentionally make this mistake (Reamer, 2006).

Some common examples of malpractice include the following (Reamer, 2006; Cournoyer, 2011):

• Failure to report abuse of neglect of a child
• Failure to consult or refer other health professionals
• Failure to prevent a client from committing suicide
• Failure to warn or protect third parties of harm or abuse
• Failure to diagnose or incorrectly diagnosis for treatment
• Failure to provide treatment without consent
• Failure to renew their social work license
• Inappropriate or inaccurate billing of services
• Breach of confidentiality, even if the client is deceased
• Being sexually involved with a client
• Professional incompetence

It is your job as a social worker to know exactly what kinds of unethical behavior or misconduct result in malpractice. Simply acting inconsistent with the professions standard of care can place you in a civil lawsuit you may have never thought possible (Reamer, 2006). As a practicing social worker, it is important to have insurance coverage to protect you in case of a lawsuit. You will often be covered by your agency, and the NASW also provides legal coverage to social workers.

Ethical Dilemmas

Discussed earlier, as a social worker you are likely to face a situation where there is no clear answer or a time when you as a social worker are forced to choose between two or more decisions, but contradictory decisions with often undesirable outcomes for one or more persons (Dolgoff, Harrington, & Loewenberg, 2009). These are known as ethical dilemmas.

Dilemmas will occur often and you must be prepared to handle them. Whether you are working with individual clients, families, small groups, or community organizations in policy and planning, administration, or research and evaluation there will be ethical decisions/dilemmas along the way (Reamer, 2006).

Some social workers are uncomfortable with making difficult ethical decisions and ignore them while other social workers have no problem making a difficult decision (Dolgoff, Harrington, & Loewenberg, 2009). Ethical dilemmas are often known as the grey area of social work. Therefore, as a social worker, you must know yourself very well; be conscious of the Code of Ethics and let it guide you in making these decisions.

Some common ethical dilemmas include:

• Confidentiality and privacy issues
• Divided loyalties
• Professional boundaries with clients (this is a common and one of the most difficult dilemmas)
• Delivery of services
• When to terminate services
• Budget cuts (administration positions)
• Hiring and firing of staff members (administration positions)
• Conflicts of interest
• Relationship between professional and personal values

(Reamer, 2006)

There are many tips and suggestions for ethical problem solving, Dolgoff, Harrington, & Lowewenberg (2009) suggest considering the following when making ethical decisions:

• Who is my client?
• What obligations do I owe my client?
• Do I have professional obligations to people other than my clients? If so what are my obligations?
• What are my own personal values? Are these values compatible with the professions six core values?
• What are my ethical priorities when these value sets are not identical?
• What is the ethical way to respond when I have conflicting professional responsibilities to different people?

Often social workers are alone when they must make difficult choices and can’t always seek supervision right away. Therefore, you must be prepared to handle these situations on your own. After encountering an ethical decision alone, it is still a great idea to seek supervision afterward and talk the process over with a supervisor.

Social workers are encouraged to adopt this model; it is very helpful when struggling with ethical dilemmas, (Cournoyer, 2011; Congress, 2000, p. 10):

Summary

The NASW Code of Ethics does not list any value or ethic as more important than the next; you must consider all values and ethics as equal. To be a professional social worker you should be well acquainted with the Social Work Code of Ethics along with the six core values. Mentioned earlier, it is necessary to be familiar with the Code of Ethics to be an ethical social worker and to able to work with clients (Cournoyer, 2011). The NASW Code of Ethics is not something to take lightly and as you advance through your social work education these values and ethics will become much more ingrained. Having a copy of the NASW Code of Ethics with you or in your office is certainly a useful idea. Keep in mind that simply forgetting or unintentionally providing a standard of care can result in a malpractice lawsuit.

Ethical decision-making takes skill and practice, and is a never-ending process (Reamer, 2006). The more you prepare yourself, know yourself, and follow the Code of Ethics the greater skill you will obtain as a professional social worker (Cournoyer, 2011). There will always be ethical dilemmas during your career no matter the setting of your work. It is important to treat each dilemma as its own by using the suggested tips. Consulting with a supervisor before or after an ethical dilemma is a great suggestion. Supervisors are there to help and support you through difficult times.

Remember the Code of Ethics and values originated from the idea that all people are equal and deserving of the same entitlements. As a social worker, you are responsible for continuing and promoting social justice. In addition, you should always apply the ethical standards and legal duties to your work.

References

Congress, E. P. (2000). What social workers should know about ethics: Understanding and resolving ethical dilemmas. Advances in Social Work, 1(1), 1-25.

Cournoyer, B. (2011). The social work skills workbook (7^th ed.). Belmont, CA: Brooks/Cole.

Dolgoff, R., Harrington, D., & Loewenberg, F. M. (2009). Ethical decisions for social work practice (9^th ed.). Belmont, CA: Brooks/Cole

Morales, A. T.., Sheafor, B. W., & Scott, M. E. (2010). Social work: A profession of many faces. New York: Pearson Custom Publishing.

National Association of Social Workers. (2017). NASW Code of Ethics. Retrieved from https://www.socialworkers.org/pubs/code/default.asp

Reamer, F. G. (2006). Social work values and ethics (2^nd ed.). New York, NY: Columbia University Press.

Woodcock, R. (2011). Ethical standards in the NASW code of ethics: The explicit legal model and beyond. Families in Society, 92(1), 21-27. doi.org/10.1606/1044-3894.4052