37. Records

Question 1

What to Document:

Answer 1

A SW is legally required to document the treatment plan, goals, consents, and releases of a client

Question 2

What to Release:

Answer 2

Clients have access to their records, unless there is something very upsetting in special circumstances, then those records would not have to be released

Question 3

Who Owns the Record:

Answer 3

The agency owns the records; clients have a right to view their records (depends on jurisdiction and state) and timeline

Destroying records also depends on jurisdiction and state, including for how long to keep them. SW should refer to local jurisdiction in maintaining records

Question 4

Parents Access to Minors’ Records:

Answer 4

Parents have access to child’s records, unless it is detrimental to client’s mental health and impacts the SW and child’s relationship

Question 5

If a Patient Dies:

Answer 5

The person who has access to clients records after they die is only their Power of Attorney