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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 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!

Here'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!

Getting ready to get licensed? Here's a free practice question to give you a sense of what you might encounter on the ASWB exam:

A school social worker contacts a parent to set up a meeting after a child is referred by the principal because of frequent absences. The parent asks the social worker how much information will be shared with the school principal. How should the social worker respond FIRST?   

A. Tell the parent that since the social worker is a school employee, all information can be shared with other school staff.  

B. Explain that no information will ever be shared unless there is a release of information or it involves abuse or neglect.  

C. Discuss specific guidelines that have been developed with the school regarding confidential information policies.

D. Request the mother sign a release of information that will allow information to be shared freely with the principal.   

How would you answer?

Let's take the responses one at a time.

A. Info automatically shared. Not it. Social workers should not share all information with school staff, except in the unlikely instance that sharing information is a specific policy developed by the social worker and the school.

B. No info shared. Also not correct. In addition to mandated reporting, there may be times that some information will be released. This should be outlined in the social worker's policy.

C. Discuss policies. Could be it. The social worker should have a policy in place regarding confidentiality, and this should be shared with the parent.

One more to consider.

D. Get a release signed. Yes, but the question asked for what should be done FIRST. Before being asked to sign a release, the mother should be given more information about confidentiality and the pros and cons of signing a release.

To sum: School social workers need to develop specific policies regarding confidentiality and sharing information. These policies should be developed in conjunction with the school. Students and their parents should be made aware of these policies, which is the best first step in the process described in this question.

Worth repeating and remembering that if the question includes FIRST, BEST, NEXT, there's usually a reason for it being there. Those big capital letters generally signal the need for a little extra attention when choosing between two decent-seeming responses.

How'd you do?

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Here'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).

***

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Stay safe and good luck with the exam!

Some free social work licensing exam practice:

A family meets with a social worker following a teenage daughter's breakup with her boyfriend. The mother states that she really liked the boy and has felt very depressed since the breakup. The father has tried to contact the boy in hopes of repairing the relationship. According to a family systems theory-based approach, what is MOST LIKELY happening in this family?

A. The family has connected relationships.

B. It is an enmeshed family system.

C. It is a disengaged family system.

D. It is a separated family system.

What's your answer?

Do you know this material? If not, how do you get to a best, educated guess? Sometimes, common sense is your best guide. Common sense and some simple psych vocabulary.

In the vignette, the mother is depressed by the breakup. The father is meddling. The parents are pretty clearly overreaching. So what answer does that sound like?

Let's take the offerings one at a time:

A. Connected. A connected family enjoys time together but also have separate friendships and interests. This family appears too involved in one another's business to be truly connected.

B. Enmeshed. The mother's depression following the breakup, and the father's attempt to repair the relationship, are signs that this family is enmeshed. Mark this one as a good possibility.

C. Disengaged. Disengaged families have very little emotional connection, usually don't spend much time together, and aren't impacted by one another's activities. Not it.

D. Separated family systems don't have a lot of shared connections, though they do have a few activities they enjoy doing together. Again, not it.

So you have your answer. Enmeshed families do not respect one another's boundaries. They tend to focus on everyone else's business rather than self-care. The lack of privacy in enmeshed families often leads to conflict.

You might have narrowed this down to connected vs. enmeshed. If you'd never heard of the enmeshment, you might have been tempted to pick connected. But the word has probably entered your world at some point. If not, you know it now. You're ready for a question like this on the AWSB exam.

To get really ready, practice with SWTP's complete 170-question exams. There are thorough rationales, plus suggested study links, for every answer of every question. Sign up to get started.

Good luck on the exam!