I am a recent MSW graduate student currently working as a medical case manager. My ultimate goal is to do clinical therapy. My agency provides the credentials I need to make this a reality: LCSW supervision and CEU opportunities. However, I am worried that I do not have enough clinical experience to make this transition. I am considering applying to fee for service therapy jobs to improve my clinical abilities, in addition to my current job. I wanted to gather other opinions about this idea. Has anyone been in similar situation? What have you done to gain clinical experience? Was it difficult to switch from case manager to therapist positions?
Some tips for gift giving and receiving:
Submitted by an LCSW working in an out-patient mental health setting:
My supervisor sent out a blast-e-mail to all staff inviting them to a house party in which she was selling a particular type of candle and accessories. She has also brought in the catalog and posted it in the workers' lunchroom so they could preview the product. I find this type of dual relationship highly awkward and inappropriate. Although she said in her e-mail that there was "no pressure" to attend, I know she will be very aware of who does NOT attend the party. I am definitely not going, but I want to report this supervisory violation to somebody! In the spirit of the Code of Ethics, I went to her first (the Code says to speak with colleague when possible when there is a conflict) I already told her that I found it irregular and she dismissed my concern. Am I overreacting?
what to do with haunting information
A client reported to me that he had participated in something that he was very ashamed of. He then said he had gotten high and ended up at some party at some house someplace in the inner city where the owner of the house had two little girls. The girls were in a back bedroom while the partying was going on and the father of the girls was parading guests back to the bedroom where they would be allowed to do whatever with the girls. The client had participated and admitted to starting oral sex on one of the girls. He said he became ill and stopped and left the home abruptly. He only has vague recollections of what happened after that till he woke up the next morning. He was extremely upset, remorseful, disgusted, and ashamed in my office. My dilemma is what do I do with this haunting information? He had no idea where the house was, how he got there, or who the offending father was. Assuming this "blackout" memory is true, what do I do? I don't think I have a legal obligation but my moral conscience is bothering me.
I am a social worker who went to graduate school with a person that I know for a fact did NOT graduate. Yet she calls herself a social worker and says she went to graduate school, giving the impression that she received her MSW. But she didn't. What should I do? Should I report it to someone?
This scenario is not really an ETHICAL dilemma but it is a PRACTICE dilemma and I would like some feedback. I have been seeing a woman in her 50s for about six months. The focus of the work has been around sub-clinical depression, work stress, and relationships (or lack thereof).
She has been divorced 10 years and is hoping for another relationship. When she came into a session right after Valentines Day, she asked: "Did you do anything special for Valentines Day?" Knowing that her loneliness is part of her depression, how should I have answered? Do you answer with the truth and risk making her feel worse? So you not answer and perhaps put a dent in the pretty good therapeutic relationship? Or turn it around and ask how she reacts to Valentines Day in her situation?
In discussing co-pays with a group of colleagues, one worker said that when a co-pay is very high (i.e. $50) and the client is obviously struggling with a very low income that she reduces the co-pay thereby taking less for herself. (There is no sliding scale option at our agency.)
However, when doing record-keeping she records the higher amount (which she didn't take and keeps the 'secret' amount between her and the client). The office still gets whatever insurance it should get for the session.
She is trying to do something "nice" for her client, but somehow it doesn't feel right.
The HR department of a private counseling agency contacted one of their therapists for a reference on one of her former clients. The agency was considering hiring this former client as a therapist. The client had only been seen by her twice. He had no experience as a therapist, but does have an online Masters degree in psychology.
The request puts the social worker in an uncomfortable position. She didn't think he was qualified for the position but she had other information that would certainly raise questions about his suitability for the position.
Is she able to breach confidentiality and talk about this client to her own HR department? If another agency had called her with the same request, she most decidedly could not without the client's permission. Is it different within your own agency? And how much can she reveal? Since social workers are "the conscience of the agency" should she advise HR that this request might be a breach of confidentiality and she is uncomfortable with the request? (They did not seem to think it is since it is "in-house".) Should she just answer "yes" or "no" with no further information or reveal all that she knows to protect the integrity of the services being provided to clients?
Submitted by an LCSW:
Recently a client asked that I look at a video she took of an argument she had with her spouse. She videoed the argument on her cell phone without her spouse's knowledge. I did look at it, and I could see him (but not her) and I could hear both of them.
Clinically speaking, the video provided insight into the nature of the problem, but my gut says I shouldn't have looked at it. It seems wrong to look at a video of someone who has no idea he's being videoed while arguing.
I help serve a community breakfast in an inner city neighborhood on the weekends. I often see clients there that I know don't really need the services of this totally donated breakfast. On one hand, I think they are taking food that could go to someone who really needs it and on the other hand, is it really that bad that they do? Should I tell the organizers of the breakfast? Should I say something to the clients? (I know them from another agency.) There are really no eligibility requirements that I know of to partake of the breakfast, except they are supposed to be from the surrounding neighborhood. It is not enforced though.
Ethical situation encountered by social workers are presented here. Feel free to comment.