Jan/Feb 2008

Defamation of Character
By Frederic G. Reamer, PhD
Social Work Today
Vol. 8 No. 1

Leora is a clinical social worker in the emergency department of a private hospital. One afternoon, a 15-year-old boy was rushed to the hospital following an apparent suicide attempt. The boy had consumed a large quantity of antidepressant medication and benzodiazepines and then cut his wrists. The boy’s mother, a single parent, was notified of her son’s medical emergency and rushed to the hospital.

At the hospital, the mother met with Leora, who tried to help her cope with the crisis. The mother insisted that she be allowed to be with her son during his emergency treatment. She had to be restrained by hospital staff when she tried to enter the room where her son was being treated.

During the episode, the mother expressed rage toward the boy’s father, with whom she was engaged in a bitter custody battle. According to the mother, the boy’s father was responsible for the boy’s emotional distress. The mother was also critical of the boy’s school counselor who, the mother said, should have shared more information with her about her son’s distress.

Sadly, the boy died in the hospital. Several months later, the mother filed a complaint against the hospital alleging that she was emotionally harmed by the way staffers, including Leora, treated her. In conjunction with her complaint, the mother requested a copy of the hospital’s medical record. When the mother reviewed the chart, she was stunned to read the following words in Leora’s clinical note: “Mother manifests symptoms of premorbid separation issues and narcissistic/hysterical tendencies. History of troubled marriage and conflicting relationships. Clearly has persistent unresolved issues around grief and loss.” The mother was enraged by those words and judgments. Shortly thereafter, the mother filed an ethics complaint and lawsuit against the hospital and Leora, including allegations of defamation of character.

Social workers must always be careful to treat clients respectfully and avoid using insulting or insensitive language with or about them. Social workers’ use of offensive language in their communications can be hurtful and undermine their efforts to help people in need. According to the National Association of Social Workers’ Code of Ethics, “Social workers should not use derogatory language in their written or verbal communications to or about clients. Social workers should use accurate and respectful language in all communications to and about clients” (standard 1.12).

In addition to the clinical and ethical repercussions that accompany social workers’ use of inappropriate language, practitioners also expose themselves to legal claims of defamation of character. Defamation occurs when individuals make false statements that injure the reputation of another party and expose him or her to public contempt, hatred, ridicule, or condemnation. Defamation can take two forms: libel and slander. Libel occurs when the communication is in written form—for example, in a social worker’s clinical note about a client that is read by other staffers, professional colleagues from other agencies who have access to the record, an employer, or a judge. Slander occurs when the communication is in oral form—for example, when a social worker testifies in a court of law during a custody dispute or termination of parental rights proceeding or presents information during a clinical case conference that will determine a client’s admission or termination from a program.

Social workers can be legally liable for defamation of character if they say or write something about a client that has three elements: the communication was untrue, the social worker knew or should have known that the statement was untrue, and the communication caused some injury to the client. Social workers’ defamatory statements about clients—for example, about their mental status, personality attributes, or behavior—can cause emotional distress or financial harm or damage someone’s reputation. Defamatory statements made by a social worker to a client’s employer—for example, about the client’s alleged substance abuse—may result in the employer’s decision to terminate the client’s job. Defamatory statements made by a social worker to a treatment program director about a client’s conduct may lead to the client’s termination from the treatment program. Defamatory statements made to a judge about a client’s parenting and disciplining techniques may lead to termination of parental rights.

Social workers can take several practical steps to avoid derogatory communications and defamation of character, including the following:

Avoid imprecise wording. Social workers should carefully word their notes and oral comments. They should avoid vague wording and the use of phrases such as “it seems,” “I believe,” or “it appears,” particularly in the absence of detailed, accurate supporting evidence. Certainly there are times when it is appropriate for social workers to express professional opinions—for example, when their opinion is relevant to a judge’s decision about termination of parental rights or child custody, a parole board’s decision about releasing an inmate from prison, or a program director’s decision about terminating a client from treatment. However, the social worker’s judgments about a client’s functioning or mental status should always be supported by facts.

Do not display bias. Social workers should use neutral language that avoids any hint of favoritism. This is particularly important when social workers express opinions during adversarial proceedings, such as divorces, custody disputes, negligence lawsuits, and criminal trials. Biased wording can be inflammatory, provocative, and harmful to clients and third parties. Clients and others who believe that social workers’ comments about them are biased may file an ethics complaint or lawsuit alleging defamation of character.

Avoid broad characterizations. Social workers should avoid phrases such as “poor outcome,” “good result,” “moderate compliance,” “drunk,” “aggressive,” and “combative” that are not supported by valid and detailed evidence. Without supporting factual information, social workers run the risk of being accused of making unsupported generalizations that are untrue and harmful. Social workers may need to use adjectival statements at times to describe clients’ status; when such statements are warranted, social workers should include the facts on which the opinion is based.

Document what you know, not what you think. Social workers should be sure to substantiate any written or oral opinions. Speculation about clients or others that is not based on factual information and is harmful can lead to defamation allegations.

Do not communicate impulsively. To avoid defamatory comments, social workers should think carefully before they write or speak. They should anticipate who may read or hear their comments and how those words may harm the client and be used against him or her. Social workers should edit their words carefully to ensure their accuracy and truthfulness.

Defamation of character in social work is rarely the result of practitioners’ deliberate attempt to harm someone. More often, it is the result of haste or inadequate training and education. To protect clients, third parties, and themselves, social workers must prepare written documents and make verbal comments carefully and precisely, mindful of the harm that defamatory statements can cause. Social workers should scrutinize their choice of words and edit carefully. In short, words matter.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work, Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, healthcare, criminal justice, and professional ethics.