Eye on Ethics

Self-Disclosure in Clinical Social Work
By Frederic G. Reamer, PhD
Social Work Today
November/December 2006

Sondra, age 32, sought counseling to help her cope with her recent separation from her husband. The social worker, Martin, is 43 years old and divorced.

Sondra and Martin met weekly for approximately four months. At the end of one therapy session, as Sondra was about to leave the office, Martin asked her whether she had a busy weekend planned. Sondra replied that ever since her separation, she has not had much of a social life. Martin responded by saying, “Yeah, I know what you mean. Ever since my divorce about a year ago, I’ve had the same problem.” Sondra commented that she had not realized Martin was divorced. The two commiserated for several minutes and ended their conversation. Two weeks later, at the end of their counseling session, Martin asked Sondra whether she would like to have lunch with him to continue their discussion. The couple began a social relationship, which ultimately led to sexual intimacy. When this relationship fell apart roughly six months later, Sondra filed a complaint against Martin with the state licensing board and a negligence lawsuit alleging emotional harm.

Social workers in diverse clinical settings—such as family service agencies, community mental health centers, substance abuse treatment programs, domestic violence programs, child welfare agencies, healthcare programs, correctional facilities, schools, and independent practice—encounter circumstances where self-disclosure to clients is a complex issue. Practitioners who are in recovery themselves must decide whether to disclose this fact to clients they serve in a substance abuse treatment program. Social workers who provide psychotherapy services may need to decide what to disclose to clients about the serious illness that will keep the practitioners from the office for a substantial period of time. Social workers employed in hospice programs may be tempted to share with clients the nature of their own personal experiences with dying relatives. Social workers in child welfare agencies may need to decide what to say to clients who ask about the practitioners’ religion or experiences as parents.

Self-disclosure to clients raises numerous boundary issues involving potential or actual conflicts of interest in social workers’ relationships with clients. Not all forms of self-disclosure are problematic and unethical, but some are. For example, clinical social workers agree that they should not disclose detailed personal information to clients about their intimate marital or relationship histories and struggles. Such disclosures clearly would be unethical and potentially exploitative and clinically harmful. However, social workers may disagree about how much personal information clinicians should disclose to clients about their debilitating illness, substance abuse history, religious practices, sexual orientation, marital status, or plans to leave the agency.

It is critically important for social workers to understand the nature of self-disclosure issues and manage them in ways that protect clients. Social workers should be familiar with prevailing ethical standards and risk-management advice to prevent harm to clients and prevent ethics complaints and ethics-related lawsuits filed by clients (and, perhaps, other parties) who believe social workers’ self-disclosure violated the profession’s ethical standards and caused harm.

Types of Self-disclosure
Self-disclosure issues in social work arise in various settings and circumstances. Many of these issues in clinical relationships involve some form of intimacy. Research evidence demonstrates that practitioner sexual misconduct with clients often begins when clinicians disclose personal information to clients about their own troubled marriages or intimate relationships.

Sometimes social workers disclose personal information for other purposes—for example, to strengthen their therapeutic alliance and nonphysical connection with clients. However, self-disclosure for therapeutic benefit may not always be helpful to clients. Sometimes self-disclosure to clients is rooted in social workers’ own emotional and dependency needs, such as those stemming from practitioners’ childhood experiences; marital or relationship issues; aging; career frustration; or health, financial, or legal problems. Research on impaired mental health professionals suggests that troubled practitioners who become involved in inappropriate client relationships often disclose personal information to clients because doing so helps the practitioners cope with their own challenges.

Social workers occasionally disclose personal information to clients when such self-disclosure could produce tangible, material benefits or favors for the social worker beyond monetary payment for services rendered. For example, social workers sometimes provide services to clients who have expertise from which the professionals themselves may benefit. A social worker who has a nagging plumbing problem may disclose this information to, and seek advice from, a client who is a plumber. A social worker with chronic lower back pain may choose to disclose this fact to a client who is a physical therapist or orthopedic surgeon, hoping to obtain some practical advice. A social worker struggling to manage her deceased father’s complex estate may decide to share a complicated probate issue with a client who is a lawyer in an effort to resolve the problem.

Numerous self-disclosure issues arise because of social workers’ genuinely altruistic wish to help clients. Most clinical social workers are caring, dedicated, and honorable people who would never knowingly take advantage of clients. Ironically, however, social workers who are remarkably compassionate and caring may create boundary problems unwittingly by disclosing too much personal information to clients.

Some forms of self-disclosure are difficult to anticipate or prevent. For example, social workers may encounter clients unexpectedly in their place of worship, thereby disclosing personal information about their religious affiliation and practices. Or, social workers may encounter a client in the waiting room of an oncologist, thereby disclosing some degree of personal information about the social worker’s health status.

Ethical Considerations
To protect clients, social workers should be familiar with prevailing ethical standards in the profession that are relevant to self-disclosure and boundary issues. The National Association of Social Workers (NASW) Code of Ethics includes several important standards pertaining to conflicts of interest that can emerge when social workers disclose personal information to clients, whether for purposes of intimacy and emotional connectedness, personal benefit, altruism, or as a result of unexpected or unanticipated circumstances (standards 1.06[a-c]).

As noted above, social workers’ disclosure of personal information to clients is sometimes self-serving and is evidence of impairment, incompetence, or unethical conduct (for example, when social workers share their own emotional and relationship struggles with clients in an effort to engage in a sexual relationship with the client). Social workers must carefully adhere to several compelling standards in the NASW Code of Ethics that are relevant when they are concerned about a colleague’s impairment, incompetence, or unethical behavior (standards 2.09[a-b], 2.10[a-b], 2.11[a-d]). The NASW Code of Ethics also obligates social workers to pay close attention to issues in their own lives that may lead to inappropriate self-disclosure or boundary problems (standards 4.05[a-b]).

Social workers frequently find themselves in circumstances where self-disclosure is, or has the potential to become, an issue. Some forms of self-disclosure are benign and may be therapeutically useful in that they help clients connect with their social workers and view them as humans; other forms of self-disclosure are exploitative, self-serving, and harmful to clients. Social workers who disclose personal information inappropriately may injure clients and expose themselves to the risk of ethics complaints and negligence lawsuits.

To protect clients and themselves, social workers should be thoroughly familiar with current ethical standards pertaining to boundaries, dual relationships, and conflicts of interest. In addition, social workers should engage in a series of steps—principally involving consultation, supervision, and the review of relevant statutes, regulations, agency policies, ethics standards, and literature—when they consider disclosing personal information to clients.

Social workers’ primary obligation is to protect clients and avoid self-disclosure that has the potential to undermine clients’ clinical progress. They should always ask the question, “Whose needs are being met here?” when considering self-disclosure. In the final analysis, social workers must adhere to the maxim, “Do no harm.”

— 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.

For More Information
Reamer, F. G. (2001). Tangled Relationships: Managing Boundary Issues in the Human Services. New York: Columbia University Press.