Confidentiality is considered one of the foundational principles of social work practice. The ethical, legal and professional responsibility to safeguard client information from unauthorized disclosures is often challenged by cases that pose unique situations in which the practitioner has to make ethical confidentiality practice decisions utilizing available resources. The resources are utilized at the discretion of the practitioner. Research on the utilization of resources is virtually non-existent. This study examines the influence of macro level resource options on confidentiality practices in social work.
A survey instrument adapted from Millstein’s (2000) Confidentiality in Direct Social-Work Practice: Inevitable Challenges and Ethical Dilemmas research was developed and administered to Licensed Clinical Social Workers (LCSWs) to assess the number and type of macro level resources that are utilized to resolve confidentiality ethical dilemmas. The sampling frame included all active licensees in the state of Florida (N=9,636) from which 1350 LCSWs were randomly selected to participate in the study. The response rate for the survey was 15% (n=203). Logistic regression, independent sample t-tests and chi-square analyses were utilized to analyze the data. The findings suggest that practitioner and organizational characteristics do not influence the number of resource options that are utilized to resolve confidentiality ethical dilemmas, however macro level resources tend to be utilized more frequently than micro level resources. Significant practitioner differences were found related to the type of resources utilized. The findings suggest that in general, non-whites tended to use macro level resources to resolve confidentiality ethical dilemmas more frequently than whites however gender, practice setting and years of post-master’s experience does not appear to influence the use of macro level resources.
Limitations of the design and implementation are discussed to guide future research and implications for social work practice and education are also presented.
