Technology Changes in Social Work

As a profession, Social Work originated in the 19th century.  This was before computers, internet, electronic based records, pagers, cell phones, fax machines, and e-mail.  There was no such thing as The Health Insurance Portability and Accountability Act (HIPAA), nor the Social Work code of Ethics.  During this time, the telephone was barely even mastered.  During these initial years, what social worker could have possibly predicted the range of electronic tools that are now considered essential in contemporary social work practice?

In less than 25 years, computers have become ever-present necessitates in nearly every walk of life across the globe.  Rapid change of any kind is never accomplished without hardships, and the rapid pace with which computers have been integrated with human culture has resulted in a number of problems and controversies. One of these controversies is whether or not computers should be used in the social work profession and if so, how should they be used.  As electronic tools in social work practice have flourished, the profession has had to create ethical guidelines to maintain the pace with these developments. The National Association of Social Workers (NASW) has had to evolve the ethical standards as deemed necessary with each and every change.  In 1996 The Health Insurance Portability and Accountability Act (HIPAA) was developed. HIPAA is the federal law that establishes standards for the privacy and security of health information, as well as standards for electronic data interchange (EDI) of health information, (Issues in Ethics, 1987). 

A new development in many helping professions is the sudden start of concurrent documentation.   Concurrent documentation in social work means that the worker collaborates with the consumers during the assessment process, service planning as well as intervention sessions in order to complete as much related documentation as possible and appropriate.  Some benefits to concurrent documentation are that it is believed to enhance the consumer and family involvement in the therapeutic process.  “If clients understand why this is important, and that they are an integral part of the process, they are more likely to participate in the practice and not feel upset by it,” (Bodek, 2007).  From a worker point of view, concurrent documentation can help staff more easily achieve performance standards and have time for other valuable activities.

While this method seems mostly beneficial, it has been said that concurrent documentation can create a barrier between the social worker and the consumer.  Some consumers have said that at times they feel a disconnect when trying to engage during sessions due to lack of eye contact by the social worker, (Hayes, 1999).

In this evolving world, the social work profession is not immune to its changes of its own kind.  Recently there has been a birth of various electronic modalities of treatment.  Telephone therapy or counseling sessions are offered to consumers.  In some clinical social work practices, telephone sessions are offered as an adjunct to a primarily face-to-face therapeutic relationship.  “A new analysis of phone therapy research by Northwestern University shows that when patients receive psychotherapy for depression over the phone, more than 90 percent continue with it,” (Coleman, 2002).  The researchers suggest that telephone therapy appeared to be just as effective at reducing depressive symptoms as face-to-face treatment. 

Another treatment modality is the emerging of internet, online or e-therapy.  This includes but is not limited to scheduled electronic chat sessions which consist of real time information exchanges, structured email exchanges, and group online chat sessions that are moderated by a therapist. “A growing number of controlled trials suggest that Internet therapy works well when (a) a proper diagnosis is made before the treatment starts, (b) a comprehensive treatment is provided, (c) the treatment is user friendly and not overly technically advanced, and (d) support and a clear deadline are provided for the duration of the treatment,” (Andersson, et al, 2009).  Additionally, online therapy provides accessibility to individuals who are disabled or housebound.

One disadvantage to web-based therapy is, first and foremost, the need for basic computer literacy skills and access to computer.  Not all consumers have the luxury of owning such technology that is readily available.  

Another disadvantage to web-based therapy is the lack of spontaneity, authenticity, immediacy and directness.  Therapists cannot respond to crisis situations as they can from traditional therapy, (Smith, 2000).   With web-based therapy, there is an increased risk of projection due to lack of non-verbal cues available in face to face sessions which can make it difficult for the therapist to show care and positive regard. With web-based therapy, there is the possibility of sudden unexpected termination of therapy due to technological difficulties experienced by the counselor and/or the client. This can be a potential risk to the consumer’s well-being.

Social work practice has changed dramatically since its earliest days.  In this profession, change is perpetual.  Once social workers can embrace the changes to come, the more enjoyable this line of work can be. 

References:

Coleman, M. (2002). Medicare telehealth provisions for the clinical social worker.  National Association of Social Workers, Clinical Social Work Practice Update. [Online].  Available at http://www.socialworkers.org/ 

Issues in Ethics.  Center for Applied Ethics.  IIE V1 N1. (Fall 1987)

Bodek, Hillel. (2007). Basic Standards for Clinical Documentation and Record Keeping.  The New York State Society for Clinical Social Work, Inc. 

Andersson, Gerhard; Carlbring, Per; Berger, Thomas; Almlöv ,Jonas; Cuijpers, Pim. (2009). What Makes Internet Therapy Work? Cognitive Behaviour Therapy. Vol. 38, Iss. sup1.

Hayes, BG (1999).  Where’s the data: Is Multimedia instruction effective in training counselors? Journal of Technology and Counseling. 1(1).

Smith, S.D. & Reynolds, C. (2002).  Cyber-Psychotherapy. Annals of the American psychotherapy Assoc. 5 23-30.

Snyder, D.K. (2000). Computer assisted judgment: Defining strengths and liabilities.  Psychological Assessment. 12(1), 52-60