Self-determination shows up multiple times in
ASWB exam content outlines. Here's how self-determination appears
in the clinical outline's Professional Values and Ethics
- Techniques for protecting and enhancing client/client system
- Client/client system competence and self-determination (e.g.,
financial decisions, treatment decisions, emancipation, age of
consent, permanency planning)
- The client's/client system's right to refuse services (e.g.,
medication, medical treatment, counseling, placement, etc.)
Three appearances? That tells you something. This is a topic
worth knowing-not just for the social work licensing exam, but for
social work practice.
Okay, so what's to know? Let's first open up the
NASW Code of Ethics for basic principles. Here's the section,
which appears right up top in Social Workers' Ethical
Responsibilities to Clients:
Social workers respect and promote the right of clients to
self-determination and assist clients in their efforts to identify
and clarify their goals. Social workers may limit clients' right to
self-determination when, in the social workers' professional
judgment, clients' actions or potential actions pose a serious,
foreseeable, and imminent risk to themselves or others.
What does this mean in practice? Julie Fanning puts it nicely in
If I Were My Client I Would…:
Clients often make life choices we wouldn't choose for
ourselves. Sometimes people prefer to be homeless rather than
live in an apartment. Sometimes people will choose to cheat
on their spouse. Sometime people will stay in a job that
seems to be completely unhealthy. Someone could choose to not
take psychotropic medication and still function in the
community. A client's religious or other cultural
values might feel abhorrent to you but it is not on the social
worker to change them but to meet the client where they are at and
let them live their own destiny. It can be frustrating for a
social worker because you want so much for your client's to be
successful. Each of the clients we work with know themselves
better than we know them.
If you were your client, you'd do things your way. But clients
don't have to do things your way. They get to choose. That's
How might this look on the exam? Exam writers might grab any of
the examples from the above paragraph and throw them into a
vignette. Like this:
After many months of effort, a social worker finds a
Section 8 apartment for a homeless client. After seeing the
apartment, the client says he prefers to sleep on the street. "I
like the open air," he says. The social work is worried that the
client's judgment is impaired and that he is putting himself in
unnecessary danger. How should the social worker
Right? Thinking like an exam writer, what options would you
include? One correct answer (the self-determination one) is
required. Plus a couple of look-good-but-aren't-the-right-answer
choices. And maybe one clearly wrong one. Something like these:
A. Convince the client to try the apartment out for a
month before deciding.
B. Discuss the pros and cons of apartment versus street
living with the client.
C. Bring up the client's decision in a group setting so
he can hear from others in a similar situation.
D. Insist that the client try the apartment for his own
How would you answer?
Taking the options one-by-one. A has "convince." That's acting
on the social worker's worries, not the clients self-determination.
Not the answer. B has "discuss"-usually a good idea (except
sometimes in imminent harm situations where more decisive action is
indicated). Put a pin in it as a maybe. Answer C involves eliciting
help from group members. This might be an effective way to shame
the client into a safer decision, but again, the client can make a
dangerous choice. It's his choice to make. Finally, D, "insist."
That leaves B and C as the only viable answers. One doesn't
involve shame or using others to bend the client to the will o the
social worker. So, there you have it. The correct answer is B.
Got it? Great! Will this be on the exam? Very likely. Maybe not
exactly in this form, but the basic concept is a crucial part of
social work and something the ASWB will often test for. Now you're
Find more questions about self-determination and many, many
other topics on our full-length practice tests. Sign up to get
Happy studying and good luck on the exam!