Deck 7: The Professional Relationship: Limits, Dilemmas, and Problems

Question 1

The consumer rights revolution made it mandatory for social workers to:

A)Provide clients with resources
B)Give a time-line for treatment
C)Allow for sliding scale payments
D)All of the above

Answer 1

B

Question 2

Going to a social worker for help requires that the client believe that the professional will:

A)Perform professional functions competently
B)Be concerned about the problems the client brings to the situation
C)Solve all his problems for him
D)A and B

Answer 2

D

Question 3

An example of a conflict of interest would be a social worker's suggesting that a client shop at a business of which the social worker is part-owner.

Answer 3

True

Question 4

As a result of the consumer rights revolution, decisions and notes not previously shared with clients must be made available to them for inspection.

Question 5

Repeatedly hearing about the trauma that clients have experienced can result in PTSD in the social worker.

Question 6

Which of the following dual relationships between therapist and client should be avoided?

A)Investing money in the client's new business
B)Recommending a client's business to potential buyers
C)Dating a client
D)A and C
E)All of the above

Question 7

According to Maidment (2006), respectful and appropriate physical contact between the client and worker conveys a sense of connectedness unparalleled by verbal assurance and empathy.

Question 8

Gewirth's Principle of Generic Consistency states the social worker must always place the needs of the client above his own needs.

Question 9

A social worker who maintains overly rigid boundaries with clients may be seen as distant and cold.

Question 10

The most frequently reported ethical violation in social work practice is defrauding third party payers.

Question 11

With regards to the professional relationship, a social worker is to:

A)Promote the agency's interests.
B)Maintain boundaries so that the work does not interfere with the worker's private life.
C)Be honest.
D)All of the above

Question 12

Dual roles are always considered to be a conflict of interest.

Question 13

Touching the client is never appropriate in the therapeutic relationship.

Question 14

The 2008 NASW Code of Ethics allows for a therapist to engage in sexual relations with a former client two years after termination of therapy, provided the relationship would not be damaging to the former client.

Question 15

The professional role introduces a power imbalance; in the relationship the client has certain needs and the social worker has various powers.

Question 16

Which of the following is NOT a consequence for clients when they have a sexual relationship with their therapist?

A)Emptiness and isolation
B)Schizophrenia
C)Guilt
D)Impaired ability to trust

Question 17

Sexual misconduct with patients is the number one allegation for claims against social workers covered by the NASW Insurance Trust.

Question 18

Which of the following represents a conflict of interest?

A)The client and the worker use the same beauty shop and occasionally see each other there.
B)The social worker is selling Amway and she gets out her catalogs so that she can sell to the client at the end of every session.
C)The worker and client belong to the same church.
D)The worker accepts a cup of tea while making a home visit to a family which recently emigrated from Mexico.

Question 19

When a worker must make a diagnosis in order to obtain third-party payments, they tend to use "the least noxious diagnosis" because:

A)It allows the insurance company to see that the client really is in need of services.
B)It can protect the client's future employment prospects.
C)It limits the adverse impact on a client's self-esteem should they become aware of the diagnosis.
D)B and C
E)All of the above

Question 20

Engaging in a sexual relationship with a client is grounds for legal action in what number of states?

A)39 states
B)43 states
C)45 states
D)All 50 states

Question 21

Using Table 7.1 Frequency and Percentages of Incidents and Perceived Appropriateness of Behavior of Social Work Professionals, on page 131, give the class an opportunity to take this as an exam; have them list "yes" or "no" in regards to whether they feel it is appropriate or not.Do not have them put their names on the quiz.Have the students hand in their quizzes and then tally the numbers of yes and no responses per each question.Discuss the results.

Question 22

Discuss feelings related to using dishonesty when it is in the client's interest (such as presenting a wrong diagnosis so as to be able to provide services that the client is in need of that would otherwise not be available).

Question 23

Have students discuss their feelings about the limited personal privacy for a client (that the professional does not control the data provided by the client) and how, if at all, that impacts the therapeutic relationship.

Question 24

Are there any dual-role relationships in the vignette? If so, how many and between whom?

Question 25

What was Alex' responsibility to the hospital, himself, and Zoe when the admission call was initiated?

Question 26

Discuss the debate in the social work profession about sexual relations with
clients and why some social workers feel it is appropriate in specific instances.
Class Exercises:

Question 27

Using the list of reasons to lie to a client provided on the top of page 135-136, discuss with the class which ones they feel are ethical reasons for being dishonest and why they feel this way.

Question 28

Create five examples of dual-role relationships and explain why each one could constitute an ethical dilemma.

Question 29

What was the responsibility of the hospital's clinical director?

Question 30

Is therapist self-disclosure to a client ethical? Why or why not?
Discussion Topics:

Question 31

Which of the following is NOT true about sexual misconduct of social workers with clients?

A)It can cause the client emotional and mental harm.
B)If the insurance provider finds out, payment for treatment will stop.
C)The social worker's judgment may become impaired and the effectiveness of treatment compromised.
D)It is harmful to the reputation of the profession.

Question 32

Discuss the two opposing views of the social work profession in regards to Gewirth's principle of Generic Consistency.

Question 33

The advent of managed care of mental health services has:

A)Allowed for clients to receive a greater number of sessions from a therapist
B)Tended to undermine the professional authority and powers of clinicians by limiting their control over treatment choices
C)Allowed for less paperwork
D)Caused therapists to see themselves as having inadequate skills to interact effectively with clients

Question 34

Have the class divide into groups to answer the following questions based on the vignette below.
Alex is a licensed clinical social worker in Massachusetts.He is a forensic social worker in a state mental hospital, working solely with patients who have been deemed not guilty by reason of insanity (NGRI).Alex is informed by admissions that he will be receiving another NGRI patient; a 27-year-old Caucasian female named Zoe Taylor.He immediately recognizes the name as an old girlfriend of two years, with whom he had a sexual relationship that ended four years ago.Zoe has murdered her husband by shooting him point blank in the chest with a shotgun in front of her son.She shot him because he has been cheating on her with multiple partners.Because Alex was once involved with Zoe and still has unresolved feelings for her, he immediately sets up a transfer for Zoe to be held at the local county jail.Alex never informed his supervisor of his prior relationship with Zoe.Alex goes to see Zoe in the prison three days per week to discuss her case and to have sex.A prison guard walks in on Alex and Zoe in the act of intercourse and reports the behavior to Alex's supervisor at the hospital.Alex's supervisor is the clinical director of the hospital and Alex's best friend.He feels Alex made an error in judgment that can be dealt with in supervision, thus no report of sexually inappropriate behavior on the part of Alex was ever reported to NASW.

Question 35

Discuss what consequences could arise for a client if engaged in a sexual relationship with a therapist.

Question 36

Explain the argument by some social workers that a sexual relationship with a client in certain circumstances is beneficial to treatment.

Question 37

What was the responsibility of the prison guard who discovered Alex and Zoe engaging in intercourse?