Maintaining Client-Centered Practice in a Computer-Centered World: The Place for Technology in Social Work Practice

Challenges, Opportunities, and Future Steps

The Helen Rehr Center for Social Work Practice recently held a two-day colloquium in New York entitled “Social Work Practice in the Digital Age.” The goal of the colloquium was to address the challenges, opportunities, and future steps for social workers as they integrate technological innovations in health care and social services into their professional work. Seasoned practitioners, educators, and administrators from various settings attended the colloquium and identified relevant themes including implications for direct practice, advocacy for greater interdisciplinary collaboration in software design, and reassessment of social work education. A summary of the discussion follows, but further investigation is required. As such, the Helen Rehr Center seeks to engage a larger circle of social workers in similar thoughtful discussions on this subject and supports a request for papers to be published in a special issue of the Journal of Social Work in Health Care.

Challenges and Opportunities of Digital Technology in Direct Practice

Traditionally, social workers have valued holistic care related to the person-in-environment paradigm and the bidirectional relationship of person and environment on micro, mezzo, and macro levels. Yet, as technological innovations have permeated health and social services, the ways that practitioners and clients interact with each another and the surrounding environment are experiencing significant changes and presenting formidable challenges.

The Challenges
Practitioners must learn how to incorporate a new tool into the fragile client-practitioner relationship. With some form of digital media present, there suddenly is an "other" in the room, which can easily become a distraction. Practitioners must be aware of how this tool might hinder their attention to the multidimensional exchange in the room. Other challenges include compromises to confidentiality and concerns over clients being given remote access to their records and experiencing distress due to the increased potential for misinterpreting the context of the record. Additionally, critical non-verbal aspects of the therapeutic work can be lost with the decrease in face-to-face interactions. Ill-defined use of technological tools compromises the dignity and worth of the person as there is great risk of replacing the unique individual with a piece of machinery.

The use of digital technology can also compromise the boundaries that have been essential to the efficacy of therapeutic work as practitioners become more accessible through e-mail and cell phones. There is also the potential for clients to access details of the practitioners’ personal life via social media platforms such as Facebook, Twitter, and LinkedIn. Lastly, the increased use of online platforms such as Skype, blogs, e-mail, and Instant Messenger, while convenient, lack the protocols necessary to safeguard ethical considerations. Practitioners need to take great care to protect records and be mindful of how information is disseminated across interfaces.

The Opportunities
Nevertheless, the technological boom has also brought a wealth of opportunities. With portable technologies and wireless access cards, field practitioners can bring greater resources to clients who are digitally disenfranchised. Social workers in the field are better able to connect their clients with community resources that might not otherwise have been as readily available. Software programs and protocols have also been developed to make client records more organized, concise, and available. Technology facilitates interdisciplinary collaboration and sharing of information between providers to ensure accurate communication related to client needs.

Interdisciplinary Collaboration in Software Design

Due to the evolving nature of technology and the collaboration that it facilitates, social workers must be involved in program development and software design related to electronic record keeping. If social workers are not involved, a wealth of critical information may be omitted from the record to the detriment of the client and legitimacy of the social work profession. The process of software development highlights the delicate dance among the competing agendas of other disciplines, funders, and regulatory bodies. Social workers must advocate the importance of the unique social work perspective and ensure that it is adequately represented during decision-making as well as in the electronic record.

In meeting such agendas, practitioners who are accustomed to the traditional focus of process in social work may be concerned about the development of protocols and software that give priority to outcome measurements. Some practitioners welcome the increased measurement of quantitative outcomes, particularly if it serves as a complement to qualitative data rather than as a substitute. This approach can bolster the integrity of the social work profession and clients alike since the hard work and value of what is being done may be more concretely conveyed.

Social work practitioners have an opportunity to be acknowledged by the health care industry and others for their work which was once unquantifiable and to relate it to the achievement of larger agency goals in cost-benefit analyses. Additionally, social workers may gain valuable insight and best practices from increased collaboration with professionals in other areas of health care and social services.

Technology and Social Work Education

These rapid technological developments need to be integrated into the curricula of social work schools to prepare students for efficient and effective engagement with clients in a changing climate. Currently little can be found in the curricula standards of the Council of Social Work Education. Regardless, Schools of Social Work must develop coursework that reflects the changed practice environment and help students integrate historical and client information and core social work values with emerging technological platforms. Also required is an examination of how technology is being used in social work education; in class projects and assignments and the increasing number of online courses offerings.

Social work supervisors and managers must ensure that skills related to the utilization of digital recording is adequately integrated into the continuing training and development of current practitioners. Students and current social workers must hone their critical thinking, writing, and technical skills to navigate computer systems and transcribe sessions and notes in ways that are both fruitful and concise. They must also learn how to interpret information contained in digital records and take care not to focus on the machine while losing the dignity and worth of the unique, complex client.

In Summary: Testing The Core Social Work Values and Ethics

It is clear that ethical standards and values of the profession are being tested by technological developments with the potential of losing the client among digital data and the increased use of electronic communications between social worker and client. While the integration of technology poses challenges, it also provides opportunities. Social workers are better able to quantify outcomes, view progress,and legitimize their work by providing the profession more transparency. Technological developments have allowed social workers to become more mobile bringing access to resources to clients who are otherwise digitally disenfranchised and enhancing communication between social worker and client and social worker and supervisor. With further investigation and protocols in place that ensure confidentiality and client/social worker boundaries, various platforms such as Skype, Instant Messaging, Blogs, and e-mail can have benefits related to therapeutic outcomes.

Prepared by the Task Force on Social Work Practice in the Digital Age of the Helen Rehr Center for Social Work Practice 8.1.13

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