Self-Determination

You are working with an inpatient cancer patient who tells you he is interested in ceasing aggressive medical treatment and starting palliative care.  You’ve had experience with patients dying and also with those who choose to end treatment.  However, in your opinion, he is considering hospice earlier than most other patients usually do, when his chance of survivorship is quite high, and it “feels wrong” to you.

Think of similar situations where you feel conflicted, or outright may not agree, with a client’s desires or actions—a pregnant woman who is considering different plans of parenting, adoption, or abortion.  A domestic violence survivor going back to the abusive partner to give him/her another shot.  A graduate student who tells you about some dishonest paper writing or exam cheating.

Social workers encounter plenty of circumstances with clients that raise personal issues for themselves.  In those, it can be hard (but even more important) to stay professional and recall the ethical guidelines.

The NASW Code of Ethics says explicitly (emphasis my own): “Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals.” This is section 1.02, Self-Determination.

Sometimes it seems like a client’s own decision will result in a chance of harm coming to themselves or others, and we know that promoting a client’s wellbeing is another important part of the code of ethics (section 1.01).  

But when can you limit clients’ own decisions?  The following sentence in the self-determination section of the code states: “Social workers may limit clients' right to self-determination when, in the social workers' professional judgment, clients' actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.”  Those qualifiers need to be present in order for a social worker to step in.  Thus:

In real life counseling as well as on the ASWB exam (and California Law & Ethics exam), right/best answers in the self-determination category might look like 1) you helping clients explore the pros and cons of various paths, 2) assisting them in making a decision for themselves, and 3) generally respecting their own decisions – excepting issues involving mandated reporting, duty to warn, suicidal ideation with a plan & means to a plan, etc.  

Good luck studying!

Behind the Scene Annoyances

Here are some logistical, helpful steps to re-applying for the California Law & Ethics exam.  What follows is a behind-the-scenes view of me completing those steps, aka a list of annoyances.

• I got an unexpected notification that I had another piece of mail in my PO Box
• Wondered if there was any possibility that the mail was from the BBS saying that there was a mistake and I did not in fact fail by one question.  Computer error maybe? 
• Went to pick up the mail
• Cursed Chase Bank when I realized they trolled me with junk mail once again
• (Seriously, are they reading this blog?  And laughing?)

• I paid for all of my online courses
• …the day before NASW-CA sent out an email with the extra special 20% off coupon code
• Felt frustrated by that, too

• Went on a walk to the post office to mail my completed packet to BBS
• Passed CA smog test car shops that promise “Pass or free retest”
• Thought about the 3 courses I paid for plus the $100 check in the BBS envelope
• Sighed longingly

• Waited in a long line at the post office
• Realized I was standing near an awesome actor in line
• Made conversation with him about everything we have in common
• Let him borrow my pen, asked for baby’s first picture with a celebrity in exchange
• Took a picture
• Realized I may have been the annoying one in this situation.  Sorry, Danny Pudi.

Danny Pudi, my lego-faced baby, and me (excited, not annoyed, right here).

Here’s how this is relevant: I find I can re-focus on test prep better after taking a little break and releasing my annoyances via a mini vent session.  Maybe you’ve had a test fail or frustrating experience and need a similar mental health break before restarting fresh.  Thanks for listening!  Now back to studying.

Next Steps

If you failed your BBS California Law & Ethics exam, here is information about what to do next. 

First, you need to take additional courses before you can re-take the Law & Ethics exam.  Specifically, you need 12 hours worth of California law and ethics courses.

You can take courses in person or do it more quickly, and on your own time, online.  I chose to do mine through the NASW-California chapter online.  I selected four courses, which added up to the total 12 hours.

I even got to do one course for free!  Here is a course on the NASW Code of Ethics, worth 2 CEUs (continuing education hours), at no charge.

I paused for a minute, wondering if this course on the national code would count specifically toward the California requirement, but the course details specify that it is eligible to be used towards the 18 hours on law and ethics that California ASWs need to accrue, as well as the biannual 6 hours for California LCSWs renewing their license, so I think we’re OK.

Image Credit Pixabay

The letter informing me that I failed didn’t give a lot of instruction on where to find the application to re-apply for the exam—it just directed me to the general BBS website.  I had to click around for a while before I found it under Forms and Publications.  Let me save you some time -- here is the Request for Re-Examination.

You’ll need to fill out the application, write a check for $100, and include printed certificates of completion for the courses in the packet.  I also scanned a copy of the application to keep for my own records.

I sent my packet to the BBS with a tracking number and return receipt, so I can verify that they received it, and then I plan to monitor my checking account to see when they cash my check.

BBS recently updated their site with processing times – minimum of 30 business days for Request for Re-Examination.  There is also a mandated 90-day waiting period between exams.  That puts me at taking the exam no earlier than mid- or late-May.

When I get approval, I’ll sign up for a test spot online, go back to the PSI location, reflect on the benefits of taking this exam, and do it again! (…and pass!)