This paper presents a multi-part reflection on clinical social work practice, exploring professional ethics under the NASW Code of Ethics through a case involving a minor client's privacy and self-harm. It examines the emotional and societal impact of race and white privilege using documentary evidence, then addresses educational disparity in low-income communities and the social worker's advocacy role. Additional sections apply ethnographic interviewing to a cross-cultural family case, distinguish major depressive disorder from normal sadness, and review the emerging use of virtual reality technology in treating eating disorders, drawing on a systematic review by Clus et al. (2018).
According to the NASW Code of Ethics (2017), social workers must respect clients' right to privacy when interacting with them. To gain clients' trust, social workers should ensure clients are comfortable and able to share sensitive information when ready, with confidence that it will not be disclosed without their consent. Due to the sensitive nature of social work, practitioners are sometimes required to seek private information from clients; however, the information sought should be limited to what is necessary to fulfill professional responsibilities.
My client was a 15-year-old boy referred to the clinic with symptoms of depression and anxiety. Additionally, Liam had begun cutting himself. He informed me that he was gay and was struggling with this because of his fear of what would happen if his parents found out. The referral came from school after the school administrator noticed that Liam had become withdrawn and no longer wanted to participate in sporting activities as he had previously. Liam willingly shared information about his sexual orientation, but he was not ready to let his parents, peers, or teachers know, as he feared being victimized.
The school administrator requested a report on Liam's condition in order to better understand how to support him at school. The challenge was how to disclose relevant information without breaching Liam's privacy, particularly regarding his sexual orientation. Liam has the right to determine what information may be shared about his sexual orientation, behavioral challenges, religious beliefs, and political ideology. As his social worker, I did not have the right to disclose anything he had not consented to share. At the same time, I was obligated to disclose information that posed a threat to Liam's health and safety. Accordingly, I disclosed his self-cutting behavior to both the school administrator and his parents, but I did not disclose any information about his sexual orientation.
The emotions stirred up by this topic were shock and anger. It prompts one to ask why African Americans are treated differently from white Americans, given that there is no meaningful biological difference between the two groups. Society has made race an issue where it need not have been, judging individuals based solely on skin color and without any understanding of the person behind that appearance. One becomes angry knowing that African Americans must often work twice as hard to achieve what others attain with relative ease. African Americans are frequently stereotyped as criminals, lazy, or educationally deficient, making it difficult for them to access jobs and opportunities.
Skin color affects how others treat a person and how they react when that person approaches them. In the documentary Race — The Power of an Illusion (California Newsreel, 2003), one subject named Noah acknowledges that there is a measurable advantage to being white — an observation that holds true in everyday life. Noah notes that when he tries to help a woman on the street, he does not receive a suspicious glance, as if he might be trying to steal from or harm her. However, had he been Black, even with good intentions, the woman's first assumption might have been that he was a threat.
There is always something new to learn, and this documentary offered new perspectives on human similarity across racial lines. For an African American viewer, it can be both surprising and affirming to discover that genetic similarities do not follow the lines of skin color or geographic origin as neatly as assumed. This knowledge can shift one's perception: it becomes clear that there is nothing genetically significant about skin color that justifies differential treatment. Being African American simply means that one's ancestors migrated later, resulting in slower adaptation in terms of skin pigmentation. From this perspective, race is a social construct rather than a biological reality.
There are personal experiences that illustrate these dynamics. In high school, I once tried to help a lost girl find her way home. The girl herself had no concerns, but a stranger who witnessed the interaction assumed I had ill intentions, confronted me aggressively, and blocked me from continuing to give directions. I did not protest and allowed the stranger to listen to the girl directly. After the girl explained what I was doing, the stranger apologized — an incident that vividly illustrated how society projects criminality onto people of color.
As a social worker, one population that may be particularly challenging to serve is white clients who may initially resist assistance from an African American practitioner. Race plays a significant role in society, and African Americans are sometimes viewed as recipients rather than providers of support. Awareness of this dynamic is essential to effective practice.
There is a widespread disparity in the American education system. Public schools do not receive equal funding, which forces some schools to operate without the resources necessary for quality education. During a visit to a low-income community, I observed dilapidated buildings and a neglected environment that raised questions about why such conditions persist. Low-income areas are often inhabited by individuals struggling with poverty, substance use, and crime — people trying to escape the reality of difficult lives. Yet with proper structures and systems, such communities could thrive.
The schools in the community were particularly striking: graffiti covered interior and exterior walls, classrooms were dark with blocked windows, and there was a severe shortage of resources including textbooks, qualified teachers, and administrators. Students who wanted an education were compelled to attend these schools because zoning restrictions prevented them from enrolling elsewhere. The funding these schools receive is proportional to the area's income, creating a cycle in which under-resourced communities produce under-resourced schools with little hope of reform unless the broader economic conditions improve. In stark contrast, the neighboring community appeared prosperous — a disparity that seemed almost surreal in its proximity. The majority of residents in the low-income area were African Americans struggling to meet basic needs such as food, shelter, and clothing.
Community members shared stories of having their dreams thwarted by repeated discrimination until they lost hope entirely. The options available to them were limited, and systemic discrimination made it nearly impossible to seek opportunities in other areas. With schools lacking sufficient resources, children do not receive equitable educational opportunities, and many perform below their potential even when capable of more with adequate support. The result is an endless cycle of poverty and disparity.
To create meaningful change, a social worker should serve as an advocate for such communities at the local council and congressional levels. Without sufficient resources, conditions will not improve, and continued neglect will deepen existing inequalities. Children in these communities lack role models, looking instead to adults whose stories are marked by discrimination and disappointment. Through advocacy, a social worker can amplify community voices and coach residents on how to articulate their needs and push for necessary services. Community members can be educated about what their local government is obligated to provide, and social workers can connect them with NGOs capable of refurbishing schools, building infrastructure, and mentoring youth. At the legislative level, social workers can petition members of Congress to ensure that school funding is decoupled from local income levels so that all students receive adequate educational resources.
To assist Elena and her family, it is essential to first examine our own values and beliefs and consider how they might influence our perceptions of her. The more deeply held those beliefs are, the more difficult it becomes to remain open to differing perspectives. Therefore, the first step is to learn about Elena's culture and understand its influence on her life and parenting practices. As emphasized in the Child Welfare Fundamentals Study Guide (2018), social workers must be aware of their own privilege and power and recognize the impact these have on their practice. This means withholding judgment during interactions with Elena and actively working to set aside assumptions rooted in one's own cultural framework.
"Applying culturally competent interviewing to a family case"
"Clinical distinctions between depression and normal sadness"
"Systematic review of VR as an eating disorder intervention"
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