Foster Family Agencies: Peace Between the Silos

Foster family agencies with both social workers and therapists in their organization may experience a silo effect. The work they both conduct with youth can put them at odds with each other. While each role has value in helping improve the youth in the foster care system, they need to find an understanding of each other’s perspectives.

This issue of silos in foster family agencies comes into play in the area of confidentiality. Recently I worked with a foster family agency on law and ethics issues. The agency had a contract with a local county to provide mental health services for their foster youth. This meant each foster youth had a social worker and a therapist assigned to them at the agency. The therapists conducting mental health services were bound by client confidentiality unless issues of suicide, homicide, or child abuse arose. But the social workers did not understand or appreciate the therapist’s ethical duties.

When a youth at the foster family agency disclosed to their therapist they brought drugs to their school, the therapist was bound by confidentiality to not discuss this behavior with the youth’s social worker. The social worker was upset the therapist did not share this information. In their mind, had they known, they would inform the county social worker to evaluate potential placement change. The social worker also believed they should inform the school so they could intervene and confiscate the drugs from the youth. 

I explained to the social workers and therapists confidentiality has different meanings for each discipline. Social workers and therapists cannot reciprocate the youth’s privacy. We discussed how the foster youth’s disclosure did not meet any requirements for breaking confidentiality. If the therapist discussed it with the social worker, they would violate the law, because no threat of suicide, homicide, or youth abuse was evident. However, had the youth brought a knife to school and threatened to harm another youth or teacher, this would be grounds for notifying the school. But drug possession didn’t meet the bar of breaching confidentiality. 

Afterward, the social workers in the meeting appreciated the dilemma therapists have in hearing about risky behaviors but not being able to act on them. It creates more collaboration and cooperation between the two departments and a reduction of the silo effect between them. When foster family agencies have these two sectors (social work and therapy) in their organization, a better understanding of their counterparts’ responsibilities leads to integrated care.