The New Social Worker Vol. 20, No. 4, Fall 2013 | Page 21
where he or she resides*) have to make
a report involving people he or she has
never met.
In some agencies or practice settings, informed consent involves the
client signing a form that acknowledges
receipt of certain information. Although
a written tool is a good idea, it is important that there be additional methods for
ensuring informed consent.
In all cases, with or without written
informed consent tools, the social worker
and client should discuss, face-to-face,
expectations for confidentiality and
when confidentiality will be breached.
The social worker should use language
the client can understand. So, the social
worker can say that he or she will keep
information “private” or “between the
two of us.” But it is very important that
the social worker make
it clear that
there
may
be times
when the
“private”
information
will be shared
with others.
Basic language
can be used, such as, “I will have to
share this private information if I think
that you are going to hurt yourself, or
hurt someone else, or if I think someone
may be hurting you or someone else.”
As with other forms of communication with clients, it is important to ensure
that the client understands what you
outline through informed consent. With
child clients, or clients with impaired
cognitive ability, you can start by asking
them if they understand, but it is best to
follow up. You can ask a question like, “If
a boy told me that his mother was hurting him, would I keep that private?” And
then explain who you would report to
and why, highlighting that child protective services would then help protect that
person from being hurt again.
It is possible that by explaining to
your client the limits of confidentiality,
the client may choose not to disclose
information that would warrant you to
make a report to child protective services. It is important to remember that it
is the client’s right to choose what information to share with you. That is part of
the client’s right to “self-determination”
(NASW Code, Standard 1.02).
Informed consent is most often
thought of in the context of the contract-
ing stage with a client, which comes at
the beginning of the professional relationship. To be effective, informed consent should be seen as an ongoing process.
Informed consent can be integrated into
each session with a client, or at regular/
periodic intervals throughout a professional relationship. As the goals of the
relationship change, informed consent
should be revisited.
Protecting Your Clients
Even When Breaking
Confidentiality
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