The New York City Chapter frequently receives calls from members inquiring about ethical concerns. One of these, which has on several occasions resulted in ethical violations, relates to those times when social workers must reveal information about a client.

While communications made by clients to certified social workers are usually confidential, there are exceptions. When it becomes necessary to reveal what has been communicated, social workers become vulnerable to violating two ethical principles, namely informing clients when the relationship is first established of possible risks associated with accepting service as well as the limits on privileged communication.

In recent cases that came to NASW's Committee on Inquiry, which hears charges of alleged ethical violations, both an agency and a private practitioner failed to explain to clients that their communications could at some point, for compelling professional reasons, be shared with colleagues or legal authorities. The sense of the Committee is that the two cases may represent common practice. One major reason given for side stepping a discussion with clients about the limits of confidentiality and its potential risk to them is that such a discussion conflicts with the message that what is told to the worker is completely safe. Focussing on limits of confidentiality is not only contradictory, it is likely to be confusing at the beginning of service. This is the dilemma.

One suggestion for resolving the problem is for social workers and agencies to present clients with written policies connected to the service, not only including the extent and limits of confidentiality, but also fees, billing, and scheduling appointments. Then if there are any questions, they can be discussed as part of the initial contracting phase of service.

This brings me to one other point about independent practice in particular.

I find myself on the phone with members on a regular basis discussing legal issues that arise in their work. My observation is that social workers are several times more likely to have access to an accountant than to a lawyer. Given the types of binds that social workers can find themselves in, such as the one just discussed on confidentiality, it will be necessary from time to time to confer with an attorney. While NASW can attempt to answer questions, there is no substitute for expert legal advice. To find an attorney, social workers can call the Association for the Bar of the City of New York and request a referral.

In addition, three short NASW publications are strongly recommended for framing the ethical and legal issues in private practice: the Code of Ethics, the NASW Standards for the Practice of Clinical Social Work, and the NASW Guidelines on the Private Practice of Clinical Social Work. All of these can be ordered from the publications Department of NASW at 800 638-8799 (the last one has a small cost).