Results from a National Study of Social Workers Sanctioned by State Licensing Boards

Boland-Prom, Kim W., Social Work

Information about unprofessional conduct of social workers--including ethics complaints, malpractice claims, and regulatory board sanctions--is useful to state regulators, policymakers, educators, managers, and members of the profession. Published studies about the unprofessional conduct of social workers come primarily from two sources--ethics complaints (for example, Berlinger, 1989; Strom-Gottfried, 1999, 2000) made through NASW, and malpractice claims made through the NASW Insurance Trust (Reamer, 1995). Many state regulatory boards publish fists of sanctioned social workers, and a few occasionally publish reports of trends in their cases. Although the federal government tracks sanctioned health professionals from various disciplines, including social workers, descriptive statistics about disciplined social workers across the nation are limited. This article synthesizes the actions of state regulatory boards against social workers for unprofessional conduct. It adds to the published literature by providing information about sanctioned certified and licensed social workers and their unprofessional behavior and provides information about the policies and practices of state regulatory boards.

LITERATURE REVIEW

This section reviews the available social work literature on complaints and sanctions against social workers. The literature has been divided into ethics complaints, malpractice claims, a study of social workers sanctioned by one state regulatory board, and the U.S. Department of Health and Human Services (HHS) National Practitioner Data Bank reports on sanctioned social workers.

Ethics Sanctions

Five studies have been published about ethics sanctions against NASW members and reviewed by the association's Ethics Committee. The published studies report cases covering the time frame 1956 to 1997. The variety of ethics issues and their categorical labels reflect the different ethics codes in effect over time, evolving policies related to the types of ethics complaints accepted for review, and the development of social work practice standards, most notably as they relate to professional boundaries. McCann and Cutler (1979) reviewed NASW ethics cases (N = 154) sanctioned from 1956 to 1977. The cases were described as related to personnel issues, including firing and breach of contract (48.7 percent), unethical policies (7.2 percent), client dissatisfaction (7.2 percent), confidentiality (6.5 percent), and sexual practices (5.2 percent). Only 13 percent of these complaints were actually filed by consumers. Berlinger (1989) reviewed NASW ethics cases (N = 292) for the period 1979 to 1985. The author noted that half of the cases were filed in jurisdictions that did not have regulatory boards for social workers. The sanctions after hearings were primarily related to ethical responsibilities to organizations, the profession or society (28 percent), or colleagues (27 percent). Sexual misconduct was the third category, with 8 percent of the cases. These results are similar to adjudicated complaints in the previous decades.

NASW (1995) issued a report of a randomized sample (N = 300) of complaints adjudicated from 1982 to 1992. The types of complaints reviewed during this period were significantly different from the previous decades, with more cases related to practice with clients. Sexual activities with clients was the largest category (29.2 percent), followed by conflict of interest with clients (16.9 percent); termination of services (16.4 percent); exploitation of professional relationships (16.4 percent); and dishonesty, fraud, or misrepresentation (14.3 percent).

Strom-Gottfried (1999, 2000) reviewed ethics complaints (N = 894) that both overlapped the time frame of the previous study and extended the study by five years from 1986 to 1997. The majority of cases were categorized as boundary violations (56.1 percent). The largest type of boundary violations were sexual relationships with clients, former clients, or their significant other and sexual relationships during supervision. Strom-Gottfried (1999, 2000) also identified cases that fell into a category of boundary violations, including social violations and behavior such as providing alcohol or drugs to clients.

Malpractice Cases

Reamer (1995) reported on malpractice claims made through the NASW Insurance Trust for the period of 1969 to 1990, and reportedly 10 percent of insured NASW members had malpractice claims. The most frequent categories were incorrect treatment (18.6 percent), sexual impropriety (18.5 percent), confidentiality and privacy violations (8.7 percent), diagnostic failure (5.7 percent), and suicide of patient (5.1 percent). Although second in frequency, sexual contact with clients represented the largest financial awards.

Regulatory Board Complaints

In a study that compared complaints against bachelor- and master's-level social workers, Daley and Doughty (2007) reviewed cases (N = 500) adjudicated by the Texas Board of Social Work Examiners from 1995 to 2003. The most frequent complaints against social workers were poor practice, boundary issues, dishonesty, confidentiality issues, and conflicts of interest. Comparisons were made of the types of complaints made against social workers at three levels: bachelor-level social workers (BSWs), master's-level social workers (MSWs), and licensed clinical social workers (LCSWs). The social workers at the BSW level had a higher rate of complaints for poor practice than social workers with graduate degrees. Social workers certified after their master's degrees had higher rates of violations for dishonesty when compared with social workers at the BSW level. LCSWs had higher rates of complaints for boundary and confidentiality issues than those with a bachelor's degree in social work.

National Practitioner Data Bank

HHS maintains the National Practitioner Data Bank and publishes annual reports through the Healthcare Integrity and Protection Data Bank. The Health Care Quality Improvement Act of 1986, Title IV of P.L. 99-660, required regulators to report actions against practitioners starting on August 21, 1996. The stated purpose of the regulations was to protect against fraud and abuse within the health care delivery and health insurance systems. Beginning in 1999, the data bank collected information on health care practitioners sanctioned by certifying and regulatory boards, civil judgments, criminal convictions, injunctions, and actions by state and federal health care programs.

In the 2001 HHS report, information was reported on 52,540 individuals from various professions and 834 organizations. In the 2005 HHS annual report on 2004 data, the number of individuals in the database climbed to 80,026, and complaints against organizations rose to 2,313. Based on the cumulative numbers, the majority (more than 70 percent) of complaints were against nurses and physicians. Complaints (from 1996 to 2002) were reported against "psychology-related …

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Publication information: Article title: Results from a National Study of Social Workers Sanctioned by State Licensing Boards. Contributors: Boland-Prom, Kim W. - Author. Journal title: Social Work. Volume: 54. Issue: 4 Publication date: October 2009. Page number: 351+. © 2009 National Association of Social Workers. COPYRIGHT 2009 Gale Group.

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