NASW Practice Snapshot:
From Consumer To Provider

Office of Social Work Specialty Practice

Social workers have worked for years to improve opportunities for individuals with mental illnesses, including opportunities to obtain jobs in fields of their choice. Not surprisingly, as advances in mental health treatments and knowledge evolve, former and current consumers of social work services are increasingly pursuing careers in the field that has done so much to serve them, and in which they have personal experience to guide their work. However, as former and current consumers seek jobs where they would have access to personal information about individuals who were previously their peers, this raises legitimate questions and concerns for social workers who now find these former consumers to be their peers. Providing solid answers to the questions that providers are expressing would be beyond the scope of this “Snapshot,” but it can begin raising some of the concerns and dispensing ideas and guidance for social workers to contemplate and discuss.

ACCESS TO CONFIDENTIAL INFORMATION:

Maintaining the confidentiality of information is always important, and sharing an individual's confidential information with someone who used to be their peer may feel disconcerting. Every hiring agency, however, has a responsibility to screen all applicants, and to determine their capability of maintaining the confidentiality of information before hiring them or providing such information to them. Likewise, if you are in a position to share or grant access to private information, it is your responsibility to assess the person's likelihood to use it appropriately. If you suspect they may not, it is your obligation to reserve access and to raise the issue with your supervisor and colleagues. If an individual has been assigned to your organization, office, or team, you still have a responsibility to appraise their ability to use confidential information appropriately, and to raise concerns with your supervisor and colleagues. Section 3.09 of the NASW Code of Ethics states, “Social workers should not allow an employing organization's policies, procedures, regulations, or administrative orders to interfere with their ethical practice of social work” (NASW, 1999).

EDUCATION, PROFESSIONAL, AND PERSONAL EXPERIENCE:

Personal experience can help an individual work with people who undergo problems similar to their own. Many would even argue that no amount of “book learning” or experience in the field can provide the same knowledge that can be learned as a consumer. Experience as a consumer, however, also cannot replace information learned by studying the trials, successes, and failures of others, and the clinical experience from working in the field as a service provider. Each consumer and situation is unique, and a provider who has only learned from personal experience may be ill-prepared to work with a client who does not present a similar history and problems. Learning to cope with a wide array of problems and professional responsibilities in implementing the most appropriate approaches can only be properly learned through a combination of education and professional experience.

An example to understand how different experiences prepare a person to handle situations differently is when a provider must react to harsh words from consumers. Part of our knowledge as professionals involves understanding that clients say things to us that they are uncomfortable saying to others and, in the process, may say or do things that are hurtful. A consumer can respond to another consumer inappropriately with the worst consequences in most cases being that they need to seek services elsewhere. A social worker who responds inappropriately has much more serious potential consequences. Learning to hear, refract, and appropriately address harsh words is a skill providers learn by adopting new techniques, analyzing approaches others have used, and by experiencing verbal criticism while upholding a professional obligation to respond appropriately. A consumer who takes a role as a provider but does not have this educational and professional experience may be ill-prepared to respond appropriately when confronted by consumers in an inappropriate manner.

This issue emphasizes the value of having clearly defined qualifications for each position in an agency. To ensure the highest quality services to consumers, guidelines can direct what tasks each individual is qualified to perform. Peer Support Specialist programs, for example, usually require that trainees take a course to learn about providing therapeutic support, and such programs can prepare individuals for certain roles. The important points to consider when giving responsibilities to a consumer-provider are the same as with any other provider: what combination of experience and education does a person have; what references do they provide that indicate how they have handled situations in the past; and what have they demonstrated to be their abilities when handling new and stressful situations? Any job applicant or individual seeking a promotion would be judged on the same factors. Consumers need to have opportunities to work in provider roles, and their personal experience will be invaluable when assessing them for a position. But if evidence suggests that any applicant might not be a good candidate for a position working with certain consumers, then one must carefully consider hiring them for the position.

Again there are no simple answers to questions that arise as consumers begin working in the field alongside social workers. Some individuals will come through social work schools, and we will never know they were once consumers, and others will be Peer Support Specialists, and we may know of their past experience as consumers before they start work. Remember though, that certain rules of professional practice and development apply to any employee, regardless of their background. Consumers should have opportunities to choose their field of work, but it is critical that we remember our obligations to protect both the consumers we work for and ourselves.

For more information or discussion, join the online discussion forum in the Mental Health Specialty Practice Section. Also read the NASW Code of Ethics .

REFERENCES:

National Association of Social Workers. (1999). Code of ethics of the National

Association of Social Workers. Washington , DC : NASW Press.

NASW, April 2005