Blog

Social Work Exam Content: Self-Determination

downtownSelf-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 section:

  • Techniques for protecting and enhancing client/client system self-determination
  • 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:

1.02 Self-Determination

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 her article, 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 self-determination.

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 intervene?

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 safety.

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." Pass.

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 ready!

Find more questions about self-determination and many, many other topics on our full-length practice tests. Sign up to get started.

Happy studying and good luck on the exam!

Categories :

Ethics and the ASWB Exam

Social Work EthicsRegardless of which ASWB exam you're taking-Bachelors, Masters, Advanced Generalist, or Clinical-questions about ethics are going to take up a big chunk of the test (between 19-25%). The ASWB exam outlines (available on the ASWB site) each break ethics knowledge, skills, and abilities (KSAs, in ASWB-speak) the same way:

1. PROFESSIONAL VALUES AND ETHICAL ISSUES

2. CONFIDENTIALITY

3. PROFESSIONAL DEVELOPMENT AND USE OF SELF

In future posts, we'll start tackling some of the specifics, exam feeding fundamentals like informed consent, self-determination, and boundaries. But you already know where to find just about everything you need to know about social work ethics to prepare for the social work licensing exam. Yep, the NASW Code of Ethics. Exam-prepping isn't complete without careful review of this crucial doc.

Just reading the ethical principles and standards can be a little less than scintillating, though. To read about ethical principles playing out in social work practice, take a look at the long-running Eye on Ethics column from Social Work Today. Or tune into this two-part conversation on social work ethics from the Social Work Podcast (generally a great, free test-prep resource). YouTube has a collection of ethics-educations offerings as well.

And of course, there's SWTP. Our exams are loaded with ethics questions just like the ones you'll encounter on the licensing exam. If those aren't enough for you, we have a booster test that contains only ethics questions.

See you back here for more ethics exploration. Until then, happy studying and good luck on the exam!

Categories :

Free Social Work Practice Question: Vaccine Line-Skipping for Sale

vaccineHere's a free social work exam practice question ripped from recent headlines. Most of the ASWB exam will be involve more timeless social work topics. But exam writers are people too. Don't be surprised to see current events folded into exam questions. One way to add some additional prep to your day: when you encounter a provocative news item, consider how it might be transformed a social work licensing exam item. Like this:

A social worker has a regular client who has been underemployed and struggling during the pandemic. He says he has now found a way to get and sell special sign-up codes that allow people to skip the line and get early access to the COVID-19 vaccine. How should the social worker respond?

A. Contact the local health department regarding the breach in vaccine protocol.

B. Explore the client's feelings about his new enterprise.

C. Contact the CDC regarding the breach in vaccine protocol

D. Explore the client's feelings about his role in the breach in vaccine protocol.

How would you answer?

First, notice there are two types of answers, "Contact" and "Explore." So initially, you can approach this as an ethics question. Does the client's behavior warrant a breach of confidentiality. (And look, there's that word in the question itself.) What do you think? Should the social worker contact someone about the client's enterprise? The code-selling isn't victimless, to be sure. But it does not meet the criteria for breaching confidentiality. Take a look back a the confidentiality section of the Code of Ethics if that doesn't seem right to you.

That leaves two "Explore" responses. Which one of those is the better choice? Explore the client's feelings…about his new enterprise (vague, non-judgmental) or …about his role in the breach of vaccine protocol (more specific, more judgmental).

Here's the thing: while you have intense judgment about a client's behavior, it generally does little good for the therapeutic relationship to voice that judgment. The ethics of selling line-skipping privileges certainly warrants discussion here, but the vague first "Explore" answer doesn't rule that out. Instead, it allows the client room to voice his own misgivings (or not).

Of the four offered responses, that's the best one: B, explore (gently).

Helpful? This is just a taste of how practice questions with thorough rationales can help you prep for the ASWB exam. Get started with SWTP's full-length, 170-question practice tests by signing up (we'll send you our free study guide when you create an account). There's nothing like realistic, real-time practice to get your ready for the big test. It worked for these people and countless others. You're next. Happy studying and good luck!

Categories :

Ethical Online Social Work

telehealthAmong the giant changes the pandemic has wrought, for many social workers, following CDC guidelines means no longer working face to face with clients. Along with all that's lost when not seeing someone in person, the non-verbal communication, the shared-in-room experience, what's also missing is perhaps a certainty about how to practice ethically. Online, virtual social work isn't just a one-for-one swap with face-to-face social work. There are new, vexing issues to tackle, most involving security, privacy, and confidentiality.

Here's a page of telehealth help from the NASW. And another from the CA NASW. And here's an Eye on Ethics article on the subject: Virtuous Virtual Social Work, which adds questions about boundaries and dual relationships to the virtual social work concerns pile.

Is it possible to practice telehealth ethically? Of course it is? It just takes a little extra care and learning up top.

Now, imagine what ASWB exam writers might come up with having read the above articles (which is just the sort of thing they might do as they're digging around for more question material). How would you write a question to assess a beginning social worker's competence and ethicality in the realm of telehealth? Something about informed consent? Something about HIPAA? Something about a client refusing telehealth sessions or insisting upon an insecure platform?

That's one way to tackle tricky subject on the licensing exam, as you're preparing and as you're taking the exam. Put yourself in the test-question writer's shoes. What might a question about any given topic look like? And, once you're sitting down for the real thing, ask yourself, "What is this question getting at? Why is it on the exam?"

The answer to that question may direct you to the correct answer to the question in front of you.

Can't come up with anything? Just like virtual meetings with clients, virtual study groups can be a big help. Challenge each other to come up with new questions. And, if you're really proud of what you come up with, send it in. Maybe we'll post it here.

Good luck with your ethical telehealth practice and good luck with the exam!

Categories :

ASWB Exam Practice: Client with COVID

maskedHere's a timely practice question.

A clinic social worker is seeing a client remotely who has recently tested positive for COVID-19 after experiencing respiratory symptoms, which are ongoing. He is still is working in a job that involves many other people. "But it's fine, I wear my mask and I'm almost always more than six feet apart from other people," the client explains. He says he will lose his income if he stops working. What is the social worker's obligation with regards to public health?

A. Report the client to the local health department.

B. Refer the client to the clinic's medical director.

C. Make sure the client is always staying six feet apart from others.

D. Review CDC guidelines for those infected with COVID-19 with the client.

Have you encountered anything like this yet? How did you respond? How would you respond? Which of the offered answers would you select on the social work licensing exam?

Let's take them one at a time:

A. Report to the health department. While the client may be endangering others, there is no duty to warn as there might be (in some states) for a client planning a violent crime. Sharing the client's diagnosis would be a breach of confidentiality.

B. Report to the clinic's medical director. This may not break the client's agreement with the clinic regarding confidentiality, it is that the best step to take regarding public health. The social worker should be able to address the issue directly. It may be helpful for the client to talk to the medical director, but there are interventions the social worker can be trying right away to help the situation.

C. Unless the social worker is going to work with the client and running interference, this is not practical.

D. The client is apparently ignoring CDC guidelines regarding COVID-19 infection. Reviewing those standards is a good first step. Referral to the clinic's MD could work to further encourage public-safety-minded adherence.

So there you have it. Can't break confidentiality, but have to do something.  That leaves referring or discussing. Like in many situations, the social worker should discuss (D, that is).

***

Do you have pandemic-related vignettes you'd like to see in this space as social work exam practice? Write us.

Ready to get started with full-length practice tests so you can pass the ASWB exam? Sign up to get started.

Stay safe and good luck with the exam!

Categories :

Search Our Blog