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Self-Determination and the Social Work Exam

self-determinationOur question-a-section trek through the NASW Code of Ethics continues. All aboard!

Next up, 1.02, Self-Determination. The section is quick:

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 kind of questions might emerge from this section? Lots of 'em. The section lends itself to questions which assess for social worker overreach, cape-wearing, and rescue-mindedness over simple client care. Which kind of gives away the answer to an item like this:

A client tells a social worker that she plans to take a psychedelic drug over the weekend in an effort to decrease her anxiety. What should the social worker do?

A. Explain the dangers of psychedelic drugs to the client.

B. Discuss the pros and cons of the plan.

C. Notify police about the planned illegal drug use.

D. Refer the client to a psychiatrist for anxiety medication.

How do you wind your way to the right answer here? Take it step by step. Eliminate the most eliminatable first. Call the cops (C)? Social workers and police would rarely be off the phone with each other if social workers made a reporting call every time a client discussed drug use. Also, confidentiality. The other three are more reasonable. Which one is right?  Referring to an MD doesn't directly address the drug-taking plan the client has introduced. Explaining dangers risks alienating the client. Answer B respects client self-determination while opening a discussion about the wisdom of the plan. It's the best of the offered answers. BTW, worth noting that the client isn't just making stuff up--recent research shows psychedelics can be useful in mental health treatment. But you didn't need to know that to answer the question correctly. You just had to remember section 1.02.

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