Self-determination is in the hands of the client unless it jeopardizes their well-being. As a clinician working in a juvenile hall placement program, self-determination is a key component to assist youth in accomplishing their goals and developing positive coping skills. As clinicians, sometimes we impose our values and beliefs on the client under the guise of “wanting the best for them.” However, our perspective of what’s best for them may not work in their family structure. For example, a teenager reports that he wants to drop out of school and obtain a GED. A social worker may question the client’s views and recommend the client to stay in school due to the social workers own values. The ASWB license exam tests your knowledge of the client’s rights of self-determination to ensure that your decision is ethical. However, there are scenarios where client self-determination may be limited such as a designated conservator/conservatee, danger to self and/or others, etc. An example of a conservatorship case is where the court may give a conservator rights to make decisions on the conversatee’s medical and financial matters. In this case, a social worker may speak with the conservator, the client, or both depending on the court order and services in place. An example of a danger to self is when a client is in your office and reports suicidal ideations, has the means, there is a plan, and the person lacks family support, the clinical social worker may have to submit for involuntary hospitalization if the client disagrees to voluntary hospitalization due to high-risk safety concerns. It is the clinician’s responsibility to understand the current situation and to try different interventions during the crisis before limiting the client’s self-determination. It is important to know the limitations to assist you on the social work exam and to become an effective LCSW. As a clinician remember to always meet the client where they are to build a positive rapport and understand their values and beliefs.
Antionette Moore LCSW