Client Access to Records

When was the last time you read--really read--the NASW Code of Ethics? If it was within the last week or so, maybe every word of the section below looks familiar. For everyone else, here's a refresher:

1.08 Access to Records

(a) Social workers should provide clients with reasonable access to records concerning the clients. Social workers who are concerned that clients’ access to their records could cause serious misunderstanding or harm to the client should provide assistance in interpreting the records and consultation with the client regarding the records. Social workers should limit clients’ access to their records, or portions of their records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to the client. Both clients’ requests and the rationale for withholding some or all of the record should be documented in clients’ files.

(b) When providing clients with access to their records, social workers should take steps to protect the confidentiality of other individuals identified or discussed in such records.

This is a good section for exam writers. The Code guidelines may run contrary to the instincts of most social workers. "Show a client her chart? Don't want to!" But the Code says you're supposed to. So when a question looks like this:

Detail, detail, detail...a client asks to see their chart...detail, detail...What should the social worker do?

The correct answer is the one that grants access while avioding "serious misunderstanding or harm." Which may be a close call. But that's what lots of social work, and lots and lots of the social work licensing exam, are about. 

Know it, answer it, pass it. Good luck!