Carolyn I. Polowy, Sherri Morgan, W. Dwight Bailey, and Carol Gorenberg
Confidentiality of client communications is one of the ethical foundations of the social work profession and has become a legal obligation in most states. Many problems arise in the application of the principles of confidentiality and privilege to the professional services provided by social workers. This entry discusses the concepts of client confidentiality and privileged communications and outlines some of the applicable exceptions. While the general concept of confidentiality applies in many interactions between social workers and clients, the application of confidentiality and privilege laws are particularly key to the practice of clinical social workers in various practice settings.
Since the start of the human immunodeficiency virus (HIV) pandemic, numerous biomedical advances have caused the social-work response to shift from management of a crisis to prevention of an incurable, but treatable chronic disease. About 1.3 million people in the United States and more than 33 million people worldwide are estimated to be living with HIV. Rates of incidence in impoverished, marginalized communities are highest, with the rates continuing to increase among young African American gay and bisexual men. Other communities at high risk are people who are incarcerated, engage in sex work or other kinds of exchange sex, and participate in risky injection-drug use. Minority groups are often impacted because of reduced access to quality medical care and HIV testing. Social workers in HIV prevention work are challenged to educate clients and communities on the sexual risk continuum, provide more interventions that are culturally tailored for disadvantaged at-risk groups, and implement evidence-based HIV prevention and testing programs worldwide. The National HIV/AIDS Strategy now provides structure to funding opportunities for HIV prevention programs, and there is disparate access to effective treatments worldwide for those living with HIV.
Frederic G. Reamer
The possibility of practitioner impairment exists in every profession. Stress related to employment, illness or death of family members, marital or relationship problems, financial problems, midlife crises, personal physical or mental illness, legal problems, substance abuse, and professional education can lead to impairment. This article provides an overview of the nature and extent of impairment in social work, practitioners’ coping strategies, responses to impairment, and rehabilitation options and protocols. Particular attention is paid to the problem of sexual misconduct in social workers’ relationships with clients. The author reviews relevant ethical standards and presents a model assessment and action plan for social workers who encounter an impaired colleague.
Practitioners who were presumed to be competent may develop difficulties that interfere with job performance. Such professionals are considered impaired and may suffer from compassion fatigue, substance abuse, mental disorders, and other forms of distress associated with daily living. Practicing while impaired is unethical and can potentially be harmful to clients. Colleague Assistance Programs from professional associations or diversion systems and legal sanctions imposed by state regulatory boards are forms of intervention strategies that are employed. Self-care strategies and consciousness-raising among professionals are the best forms of prevention.