What kind of legal and ethical obligations do clinical social workers (i.e., counselors/therapists) have with regard to confidential statements made to them by their clients? I’m specifically thinking with regard to criminal matters. E.g., is their some sort of equivalent to physician-patient privilege that prevents them from testifying in court? Conversely, do they have a legal obligation to inform the police if their client admits to committing a crime, or says that he intends to commit a crime? What about according to the ethical standards of the profession – are there rules for what a social worker is expected to keep confidential, or rules about when they are expected to violate confidentiality?
For what it’s worth, these questions are purely academic – I am neither a social worker nor a criminal intending to confess my actions to a social worker.
I am not a LCSW (Licensed Clinical Social Worker), but I am a MHP (Mental Health Professional).
I can tell you confidently that where I work, I am expected to hold my clients accountable to law enforcement. If a client were to admit to a crime to me, I would encourage him to turn himself in immediately. If he didn’t, I would turn him in. In a heartbeat.
— Of course, this would only be for serious crimes. If a client said “I smoked a fattie last night” or said “I’ve got an ounce in my dresser drawer,” I wouldn’t bat an eye.
I have no idea what this means. You could be anything from an orderly on a psych floor to an M.D. psychiatrist.
Golly. And you’re in Illinois, it seems. Are you and your employer familiar with the applicable law, including (1) the Mental Health and Developmental Disabilities Confidentiality Act (740 ILCS 110/1 et seq.; (2) (to the extent that there is a physician in the picture somewhere) 735 ILCS 5/8-802; and (3) HIPAA?
I respect confidence. Really, I do. Assuming that there’s some basis for it, that is. tim, the real answer is: it depends. Among other things, it may depend on what state you are in, the nature of the crime, the type of counselor involved, the nature of the relationship with the client, whether the crime is ongoing and serious, and whether the patient has signed a waiver.
Generally, in my state (Illinois, imagine that?), a mental health therapist (term includes social workers) may not report a crime disclosed by a patient. There are exceptions. Under one or two of those exceptions, disclosure might be mandatory.
Disclaimer: Although IAAL, I am not your lawyer, and may not be licensed in your state. This is general information, and not reliable legal advice. If you need that, see a lawyer licensed in your state., who can evaluate your own individual circumstances.
My job title is MHP. What that means from a legal standpoint, I have no idea. My boss has made it clear that “Social Worker” and “Mental Health Professional” are two different things, but they’re related. My job duties are basically the same thing as a social worker does.
I consulted with my supervisor, and it turns out that legally we “are in kind-of a murky area” (my supervisor’s words). She told me that, if it ever comes up, to consult her, and she’ll in turn consult our legal counsel.
Nevertheless, I would still encourage the client to turn theirself in.
I am an MSW, although I’ve never worked as a clinical.
As with clergy and attorneys, it is part of our own profession’s ethical standards that we respect the confidentiality of our clients. Applicable laws generally state that we are obliged to report our client’s activities or statements under certain circumstances, and those laws may reflect less respect for social work than is granted to other professions for which confidentiality is claimed.
However, the profession of social work is not as historically committed to the need to be in the right side of the law, and, at least in advocacy social work, a social worker may determine that it is not in the best interests of the client to abide by the law and report activity for which reporting is mandated. Indeed, social work is sufficiently uppity as to conceive of the possibility that a social worker may advise a client to violate a law, or advise a client in how not to get caught doing so, etc.
Your confidence level (about automatically turning in one of your clients to law enforcement) seems to have dropped a bit. That’s good. So is the idea that someone at your place of employment might need to talk to an attorney if this issue ever comes up.
As for what “MHP” “means from a legal standpoint”, I also have no idea. This is not a title or profession defined by statute in Illinois. However, people who provide mental health services in the nature of social work are generally required to have a license, and calling a position that is “basically the same thing as a social worker” by a different name doesn’t avoid this requirement. (There are exceptions for clergy and volunteers, and some state employees are grandfathered in.) See 225 ILCS 20/1 et seq..
Clarification: I will agree that there is a licensure gray area if the person and his agency carefully avoid the use of the phrase “social work” or any of its synonyms in describing their role. In my opinion, someone who says “I basically perform the role of a social worker” just removed any doubt that he needs a license (unless another exception applies).
Even if a person is careful to avoid such statements, or otherwise avoids the need to get a license, that doesn’t mean that such a person may freely disclose his client’s law violations, though.
Same disclaimer.
My first real job out of college was as a social worker (with appropriate roman numerals behind the title indicating that I was a raw trainee). I only lasted six weeks–two weeks to decide I really, really hated it, two more weeks after having been talked into giving it another chance, and two weeks’ notice–but had I stayed, a significant portion of my job would have taken place in a courtroom, testifying about one thing or another related to my clients.
I would have ended up with a title something like, “alcohol and drug abuse counselor.”
(My aunt was a social worker for many years, although not the kind characterized in the OP who would be providing therapy. Due to the nature of her job, she was in court quite a bit. Once, going through her educational credentials, the judge noted her undergraduate degree in vocal performance and asked her to sing! However, she was forbidden to discuss her clients’ affairs and charged with keeping the strictest confidentiality except when testifying.)
No, I don’t. Although the agency I work for does employ some LCSW’s (Licensed Clinical Social Worker).
My role is that of an advocate. I help people apply for and maintain public entitlements, I help them connect with social services in the community (Meals on Wheels, for example), and do rather mundane work like that. I don’t provide any therapy beyond providing helpful advice and being a shoulder to cry on, though if someone needs therapy I can fill out a page of paperwork and have them seeing a therapist by the end of the week. I don’t have any authority to have anyone committed to the hospital against their will (although I can and do have to petition judges of the need to do so). I don’t have any authority in child-custody matters, meaning that I can’t have someone’s kids taken away (though, again, I could petition the courts if need be) or anything like that. If that comes close enough to Illinois’ textbook definition of “Social Work” that I’d need a license, then that requirement has been lost on my boss, her boss, and her boss’ boss.
In my experience, that sort of work is referred to as “casework” or “case management”, even if it is performed by LCSW’s. And I suspect (correct me if I’m wrong, Random) that the work actually being done is more important legally than the license when it comes to confidentiality. For example, when I was a parole officer , many of my coworkers were social workers by training, were licenses, and had part-time, outside jobs providing therapy. They were not providing therapy when they were working as parole officers, and were bound by the same rules as the other parole officers- which did not include a requirement to keep confidential any information regarding a crime.