Social work practice on multimedia platforms
DISCUSSION PAPER: SOCIAL WORK PRACTICE ON MULTIMEDIA PLATFORMS Social Work Students University of Newcastle Australia, NSW 2308 (Introduction) · (Remembering- this discussion paper will be distributed in the district to encourage staff to consider the opportunities and challenges a multimedia platform can offer) Challenges · (Literature review of challenges to social work practice over the web) · (Include examples of OOHC, child protection, or similar fields) Solutions · (Literature review of possible solutions to social work practice over the web) · (Include examples of OOHC, child protection, or similar fields) (Conclusion) · (Remembering- this discussion paper will be distributed in the district to encourage staff to consider the opportunities and challenges a multimedia platform can offer) Bibliography Social Work, Technology, and Ethical Practices: A Review and Evaluation of the National Association of Social Workers' Technology Standards Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=wshc20 Social Work in Health Care ISSN: 0098-1389 (Print) 1541-034X (Online) Journal homepage: https://www.tandfonline.com/loi/wshc20 Social Work, Technology, and Ethical Practices: A Review and Evaluation of the National Association of Social Workers’ Technology Standards Amy Lopez To cite this article: Amy Lopez (2014) Social Work, Technology, and Ethical Practices: A Review and Evaluation of the National Association of Social Workers’ Technology Standards, Social Work in Health Care, 53:9, 815-833, DOI: 10.1080/00981389.2014.943454 To link to this article: https://doi.org/10.1080/00981389.2014.943454 Published online: 16 Oct 2014. Submit your article to this journal Article views: 3322 View related articles View Crossmark data Citing articles: 11 View citing articles Social Work in Health Care, 53:815–833, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 0098-1389 print/1541-034X online DOI: 10.1080/00981389.2014.943454 Social Work, Technology, and Ethical Practices: A Review and Evaluation of the National Association of Social Workers’ Technology Standards AMY LOPEZ, PhD Graduate School of Social Work, University of Denver, Denver, Colorado, USA Information and communication technologies (ICTs) are becom- ing essential to social work practice by providing increased treat- ment possibilities and reducing barriers to service. While recogniz- ing the importance of ICTs in practice, social work practitioners have had concerns about ethical use. In response, NASW compiled the Standards for Technology and Social Work Practice. While the guidelines set the groundwork, they were not embedded in a process that would allow them to adapt to the swift pace of ICT changes. This article reviews the current Standards, evaluates how these have been implemented by practitioners, and offers suggestions for updates. KEYWORDS technology, ethical practices, NASW Technology Standards INTRODUCTION Through their Facebook and Twitter feeds, the National Association of Social Workers posed this question to their friends and followers: “What are your thoughts on online therapy and virtual clinical social work practice? Legal and ethical concerns? What technology would be best to facilitate social work practice online?” (National Association of Social Workers [NASW], November 4, 2011). While the responses from Facebook friends and Twitter followers Received April 1, 2014; accepted June 26, 2014. Address correspondence to Amy Lopez, PhD, University of Denver, Graduate School of Social Work, 2148 S. High Street, Denver, CO 80209. E-mail:
[email protected] 815 816 A. Lopez were mixed, those responding acknowledged the potential benefits of being able to provide services to remote or disenfranchised populations. Despite positive support, there were also several statements about concerns about ethical practices when using technology, such as maintaining confidentiality or concerns regarding social work clients who may not have the financial resources to participate in technology based activities. In addition to these comments, the friends and followers on the social media sites acknowledge they have been using technology based communications, but without much guidance as to how to proceed. Since NASW is communicating with a social media audience concerning relevant practice questions, one must assume that NASW believes that a siz- able portion of the audience who would respond to questions about “online therapy” and “virtual clinical practice” regularly use Facebook and Twitter. It is clear that there are two issues embedded in this example. The first issue is a social work practice issue. In other words, there are pressing needs to examine the principles that will guide social workers in their use and applica- tion of ICTs in the various fields of practice (i.e., in mental health, substance abuse, child welfare, administration, community organization). The second issue relates to the ubiquity of ICT use in American life. In other words, ICTs are in use in everywhere and in every field of practice, including professional organizations like NASW, despite legal and ethical issues. As ICT practices have increased over the past ten years, concerns have been raised by mental health professionals about their use in the therapeutic encounter. Several different mental health practice organizations have devel- oped Codes of Conduct related to the practice of “online therapy” (Recupero & Rainey, 2005; Ross, 2011). Social work responded to the need for guidance with Standards for Technology and Social Work Practice (NASW & ASWB. 2005). In this document, NASW and the Association for Social Work Boards (ASWB) developed eight specific standards to address issues related to the use of technology in the social work field. While these standards provided a foundation for ethical ICT practices and address many concerns, they are ambiguous, abstract, and increasingly out of date. This article outlines the standards as they are now, provides studies related to how these stan- dards have been implemented, and provides suggestions for revisions of the guidelines based on new and emerging technologies. FEDERAL AND STATE LAWS REGULATIONS OF ONLINE SOCIAL WORK PRACTICES While there are laws and policies that provide some guidance about mental health treatment and social work services in general, there are no specific Social Work, Technology, and Ethical Practices 817 federal laws directly related to the provision of online treatment services (Cwiek, Rafiq, Qamar, Tobey, & Merrell, 2007). Although bills have been introduced requesting both funding and corroboration of states regarding licensing rules, there is not currently a statute that addresses national or international provision of medical or mental health services online (U.S. Department of Health and Human Services, Health Services and Resource Administration, 2013). The provision of online services has received sup- port from the Centers for Medicare and Medicaid Services, allowing for reimbursement of psychiatric telehealth, including mental health therapy, for Medicare and Medicaid patients (Centers for Medicare and Medicaid, 2013). Although some therapy practices have some federal guidelines, for the most part, each state is responsible for creating and enforcing laws and regulations related to the provision of social work services and psy- chotherapy practices, including online therapies (Beahrs & Gutheil, 2001). The first of the states to address online therapy practices was California. Under the Telemedicine Development Act of 1996, a health care practitioner was permitted to provide medical services using interactive audio, video, or data communications without person-to-person contact with the patient (CA Assembly Bill 116, 1996). However, it was not until 2003 that mental health practitioners, including, psychologists, marriage and family therapists, and clinical social worker were included as eligible providers of telehealth services (Centers for Technology and e-Health, 2013). Only 10 other states also regulate technology based medical practices, but the levels of regulation vary greatly by state (U.S. Department of Health and Human Services, Health Resources and Service Administration [HRSA], 2013). When issues are of importance, but not yet addressed by state or federal policies, practice organizations may choose to address such issues in their Codes of Ethics. As state and federal policies vary in terms of regulations of the practice of online therapy, practice organizations are addressing the issue (Recupero & Rainey, 2005; Santhiveeran, 2009). The NASW and ASWB determined the need to acknowledge the use of technology within social work practices. The NASW/ASWB Standards for Technology and Social Work Practice (2005) were created as a set of ethical guidelines and recommen- dations on how the social work profession should proceed in this new area. While these suggestions outlined in the Standards for Technology and Social Work practice offer guidelines and recommendations for practice, at this time, that is all they are—recommendations. As the NASW Code of Ethics states, “A code of ethics cannot guarantee ethical behavior. Moreover, a code of ethics cannot resolve all ethical issues or disputes or capture the richness and complexity involved in striving to make responsible choices” (NASW, 2008). As such, although ethical online social workers are expected 818 A. Lopez to follow these standards of treatment, at this time, there is really no way to enforce them. Reviews of e-therapy sites and surveys of online counselors demonstrate that while some practitioners are attempting to follow ethical guidelines, there are those who are not (Finn & Barak, 2010; Santhiveeran, 2009, Shaw & Shaw, 2006). Despite the fact that there is little way to enforce these standards, they do offer guidelines to those who want to implement these practices in an ethical and appropriate manner. Evaluation of the Technology Practice Standards In the development of these guidelines, several issues were raised as con- cerns including possible technology failures, data security and management, and credibility of those representing themselves as social workers. In addi- tion, because through the Internet, social workers can have an international client base, there were concerns about legal and cultural issues when prac- titioners are able to do their work worldwide (NASW & ASWB., 2005). Each of these concerns is addressed in a specific standard to provide guidance and recommendations. The goals of these standards are “to maintain and improve the quality of technology-related services provided by social work- ers, to serve as a guide to social workers incorporating technology into their services” (NASW & ASWB., 2005, p. 8). Through their eight areas of interest, the NASW/ASWB have attempted to outline responsible practice of social work in a digital age. While some of the areas of concern are already areas may be addressed by state laws regulating psychotherapy, some of the other standards remain primarily recommendations for ethi- cal practice. By evaluating each standard individually, it can be determined which standards have been useful, which need to be revised and which may be covered, or should be, under stricter guidelines, such as state or federal law. STANDARD ONE: ETHICS AND VALUES “Social workers providing services via the telephone or other electronic means shall act ethically, ensure professional competence, protect clients, and uphold the values of the profession” (NASW & ASWB., 2005, p. 4). This standard simply reinforces that social workers engaged in online practices should follow all guidelines already in place through the NASW Code of Ethics (NASW, 2008). This first standard sets the foundation for the rest of the expectations and asserts that the values of social work practice. Although