July/August 2009 Issue

Tech-Savvy Social Work — Meeting the Digital Demand
By Christina Reardon
Social Work Today
Vol. 9 No. 4 P. 12

Discover how information technology can enhance social services data management, client tracking, and outcomes measurement. Consider the benefits and risks of communication technology in direct service to clients.

There’s no doubt about it: Information technology (IT) is becoming ubiquitous in American society. The signs of the tech takeover become more prevalent each day. A growing number of people are using the Internet to read newspapers, chat with friends, shop, and pay bills. The popularity of social networking sites such as MySpace and Facebook has skyrocketed. Everyone seems to be spending more time sending text messages with their cell phones or listening to their favorite tunes on iPods.

Using technology is not new in social work. But the great speed at which new technologies are popping up has set off debate among human services professionals about what role technology should play in their work. A growing number of social service and behavioral health organizations are turning to technology to tackle tasks such as data management, client tracking, and outcomes measurement. 

Using Technology Successfully in Information Management
Perhaps the highest level of IT acceptance in social work is in the area of information management. More human services organizations, especially larger ones, are turning to special hardware and software designed to help providers organize client data, measure provider performance, and determine clients’ eligibility for services.

Many technology companies are taking notice of this trend. Among the companies that produce applications specifically for social service providers are Cúram Software Ltd., Harmony Information Systems Inc., Sigmund Software, and Core Solutions Inc. Some people with previous experience in human services have founded companies such as Social Solutions Inc.

A primary reason why agencies approach Cúram Software for services is that they are seeking increased efficiency and productivity. Many organizations are being forced to use fewer resources to help more clients and realize that an uncoordinated approach focused on pen and paper is no longer sustainable, says Ronan Rooney, Cúram’s chief technology officer and cofounder.

“When you have four or five people working on a case and they’re all writing on bits of paper, that is so behind the times technologywise,” Rooney says.

IT also helps agencies better respond to the increasing demand for accountability and results-based services, says Steve Butz, president and founder of Social Solutions in Baltimore. Butz, a former caseworker, started the company in 2000 to market software that allows organizations to see which of their interventions are effective and which are not.

“There has been a real evolution of giving and philanthropy over the past 10 or 15 years in terms of people asking what kind of return they are getting for their investment,” Butz says. “High-performing organizations seek this type of software out because they want to account for outcomes.”

One organization that has switched to electronic data management is the Children’s Home Society of Florida, which provides foster care, adoption services, pregnancy counseling, and other programs to children and families. The agency developed its fosterTRACK program to help social workers manage the licensing process for foster parents. Another system is caseTRACK, which helps the agency organize and store data on the children and families it serves, including demographic information, diagnostic information, and outcome data.

Such a systematic approach to data collection is especially useful to the Children’s Home Society of Florida because it helps the organization cope with the high amount of employee turnover that traditionally occurs in the social services sector, says Andry Sweet, the society’s vice president of operations.

“It helps us keep a consistent record of what’s happening, so if another person has to come in, he or she could pick up where the other person left off,” Sweet says.
Child welfare officials in Jefferson County, CO, turned to the Swedish technology company Anoto Group for help with reducing the amount of time caseworkers spent entering data into the county’s data management system. Anoto, working with California-based PenData Solutions Inc., developed a digital pen and paper system for the county. Caseworkers use special pens, each of which has a camera inside that takes pictures of the caseworker notes. The caseworker can then dock the pen and download the information onto a computer for editing.

“Most of our staff report saving between three and five hours a week in terms of doing documentation,” says Barbara Weinstein, finance and data manager for Jefferson County’s Division of Children, Youth and Families. “That increases our face-to-face time with clients.”

Some human services professionals are using technology to help clients connect with one another. In late 2007, Stewart Gordon launched Foster Care Central, a social networking Web site for people in the foster care system. The site provides a meeting place for foster children, many of whom struggle with issues such as being shifted from home to home and aging out of the system. The site also allows foster parents and service providers to ask each other questions and share resources.

“As technology becomes easier for people to use and people grow up with it, it will become commonplace in social work,” Gordon says. “People will expect it.”

Considering Pitfalls of Technology in Direct Service
Some providers warn that widespread acceptance of new technology comes with pitfalls, especially when it comes to using technology in direct service to clients.

“This is not a black-and-white issue,” says Frederic G. Reamer, PhD, a professor in the School of Social Work at Rhode Island College in Providence. “There’s a lot of gray here, and there are multiple shades of gray here. I think social workers need to be very, very careful in how they approach [technology].”

Reamer says he agrees that there are many positive ways in which technology can be used in social work. For example, the Internet and videoconferencing can be invaluable tools for practitioners working with clients, such as those with agoraphobia, who don’t feel comfortable leaving their homes for treatment. Communication technology also makes it easier for social workers to reach clients in remote, rural areas.

But many social workers don’t consider the potential ethical pitfalls of relying too much on technology when dealing directly with clients. Technology can lead organizations and individual professionals into situations where they cross ethical boundaries or at least engage in questionable behavior, Reamer says. Consider the following situations:

• A social worker establishes a Web site to provide online counseling services. How can the worker be sure that clients are who they say they are? What are the licensing issues if the worker and his or her clients are in different states? What happens if the client is in another state and has a mental health emergency? Can the worker properly assess the client without being able to see the client’s nonverbal communications?

• A social worker decides to use his or her personal cell phone or e-mail account to communicate with a client. What message does that send to the client about the nature of the relationship?

• A social worker sets up a profile on a social networking site such as Facebook or MySpace, where he or she discloses personal information such as hobbies and tastes in music. What happens if a client finds this profile? How might that change the client’s relationship with the social worker?

A 2009 research study by Janaki Santhiveeran, PhD, of California State University in Long Beach suggests that the increased use of electronic communications may be leading to ethical lapses. The study gathered qualitative and quantitative data from 66 e-therapy Web sites to see how well they complied with the National Association of Social Workers’ Code of Ethics. The study found a high level of compliance when it came to the duty to inform but a low level of compliance when it came to the duty to maintain professional boundaries. Mixed results were reported for the duty to maintain confidentiality and procedures to be used in emergencies.

These ethical concerns do not mean that social workers should swear off technology, Reamer says. Instead, social workers should ask themselves serious questions before starting to use technological tools such as e-mail and cell phones. They also should check out the Code of Ethics for information on the use of electronic communications, consult with lawyers who specialize in risk management in social work, and consider licensing issues if they intend to work with clients in other states.

“My succinct advice would be that we need to be very mindful of the potential risks. They are very real risks,” Reamer says. “As soon as you click ‘send,’ you lose control.”
One challenge for social workers who want to use technology ethically is that the Code of Ethics has not kept pace with the rate of change, says Goutham Menon, PhD, an associate professor of social work at the University of Texas at San Antonio. The existing guidelines are too general to adequately address issues such as licensing jurisdiction, he says.

“That is where we are falling short,” Menon says. “There are a lot of issues that have not been addressed. Those types of details need to be worked out.”

Social workers also must be careful to ensure that the efficiencies realized through using technology do not come at the cost of traditional skills, such as active listening and intuition, that are so valuable in assessing client situations, says JoAnn Del Sardo, LCSW, distance education site coordinator for the social work department at California State University at Long Beach. Using technological tools, such as online assessments designed to detect children at risk of abuse or neglect, should not replace one-on-one interactions with families, she says.

“My fear is that we’re going to get that checkbox mentality. The decision-making process could get out of whack if we rely too much on technology,” she says. “Right now, we have a good balance between the social workers who rely more on gut feelings and social workers who think more about using databases.”

Getting Used to IT
That balance may not last long. Several observers say technology will become more prevalent in social work practice over the next decade.

The economic crisis will likely speed up the trend because it will force human services organizations to find ways to become even more productive and efficient in light of the increasing number of people approaching them for help, Rooney says. The influx in demand for services also may convince funders to put more money into organizations’ IT operations. “It is going to force people to take notice of [IT] and take action,” he says.

The focus on accountability and results that has driven many organizations to embrace technology will likely become more intense as well. For example, President Obama has agreed to pump more government money into nonprofits but only those that show proven results. Many foundations and individual donors will continue to take the same approach, Butz says. “I definitely think there will be some pruning of the bushes when it comes to the nonprofit sector,” he says.

In the end, social work organizations that want to maintain the funders’ attention are going to have to become more comfortable with technology and how to use it to develop effective programs, says David Wallach, LMSW, director of IT at Abbott House. The Irvington, NY-based organization provides services to families in the New York City area and surrounding counties. Technology provides social workers a way to do great work—and to show others the results of that work, Wallach says.

“We see social work as something different, but it really is a business,” he says. “We can’t show [the government and other benefactors] our great work except through data. We have to be more comfortable with the data. We need to move forward with the reality that this is the way things are going to be, the way things are.”

— Christina Reardon is a freelance writer based in Harrisburg, PA, and an MSW candidate at Temple University.

Technology in Education
Social work practitioners aren’t the only ones feeling the effects of society’s increased dependence on IT. Technology is making its presence felt in social work schools as well.
The use of technology in social work education has grown immensely in recent years. Schools are increasingly offering distance education through videoconferencing and online classes. Students are more savvy about using software programs, communicating electronically, and using textbooks that include online content.

A primary benefit of such technology is that it allows schools to reach students in far-flung geographic areas who are too far away to come to campus, says JoAnn Del Sardo, LCSW, distance education site coordinator for the social work department at California State University at Long Beach. Del Sardo helps coordinate a weekly distance education class that brings students in southern and northern California together with an instructor in Long Beach.

“It really expands the experience because the regional issues that students are dealing with in southern California vs. northern California are different,” Del Sardo says. “It’s very conducive to graduate education.”

Technology also makes it easier for students to do research and stay connected with instructors, says Julie Miller-Cribbs, PhD, an associate professor in the School of Social Work at the University of Oklahoma. But she warns that schools need to make sure their use of technology is not threatening students’ ability to interact with one another—a must in a people-centered profession such as social work.

“You have to be careful to make sure the program you design has that balance,” she says. “You have to give and take both ways.”

And while most students are willing to accept technology in the classroom, it appears that at least some aren’t ready to learn more about how to use it in practice. Adrian Kok, PhD, an associate professor at the Graduate School of Social Work at Dominican University, recently developed a course about the use of IT in social work. But the course had to be cancelled when too few students at the school in River Forest, IL, signed up for it.

Kok says the lack of interest among students shows that they don’t see how learning about technology is applicable to developing clinical skills. He hopes those attitudes will begin to change soon.

“Technology is becoming a more important part of clients’ lives,” Kok says. “I think it is underappreciated. It is a force that people don’t recognize, but it is a force that is shaping practice.”

— CR