Unit 4 Seminar

Key Terms  Confidentiality  Privileged communication  Privacy

4.01 Maintaining Confidentiality Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship.

4.02 Discussing the Limits of Confidentiality (a) Psychologists discuss with persons (including, to the extent feasible, persons who are legally incapable of giving informed consent and their legal representatives) and organizations with whom they establish a scientific or professional relationship (1) the relevant limits of confidentiality and (2) the foreseeable uses of the information generated through their psychological activities. (See also Standard 3.10, Informed Consent.) (excerpt)

◦ When clerical assistants handle confidential information ◦ When counselor consults ◦ When counselor is being supervised ◦ When client has given consent ◦ When client poses danger to self or others ◦ When client discloses intention to commit a crime ◦ When counselor suspects abuse or neglect of a child or vulnerable adult ◦ When a court orders counselor to make records available

 Identify clients who are likely to do physical harm to third parties  Protect third parties from clients judged potentially to be dangerous  Treat those clients who are dangerous to themselves

 Failing to diagnose or predict dangerousness  Failing to warn potential victims of violent behavior  Failing to commit dangerous individuals  Prematurely discharging dangerous clients from a hospital

 Get informed consent  Plan ahead through consultation  Develop contingency plans  Obtain professional liability insurance  Involve the client  Obtain a detailed history  Document in writing  Implement procedures to warn

 Take direct verbal warnings seriously  Pay attention to previous suicide attempts  Identify clients suffering from depression  Be alert for feelings of hopelessness and helplessness  Monitor severe anxiety and panic attacks  Determine whether individual has a plan

 Identify clients who have a history of severe alcohol or drug abuse  Be alert to client behaviors (e.g. giving prized possessions away, finalizing business affairs, or revising wills)  Determine history of psychiatric treatment

 Sufficient factual grounds for high risk of harm to third party  Third party is at risk of death or substantial bodily harm  Harm to the third party is not likely to be prevented unless counselor makes disclosure  Third party cannot reasonably be expected to foresee or comprehend high risk of harm to self

 All limits to confidentiality should be discussed with the client at the outset of treatment  Therapists must be aware of state laws regarding their professional interactions with HIV-positive clients  Therapists need to keep current with regard to relevant medical information  Therapists need to know which sexual practices are safe

 Abandoning a client  Sexual misconduct  Breaking confidentiality inappropriately  Failing to respect a client's privacy  Failing to protect others from a dangerous client  Practicing beyond one's competence  Failing to honor a contract with a client  Failing to provide for informed consent

 Make use of informed consent procedures  Define clear contracts with clients  Do not practice outside of your competence  Take steps to maintain your competence  Document carefully  Know and follow state and local laws

 Know and follow the codes of ethics  Respect confidentiality  Report any cases of suspected child abuse  Carefully consider bartering arrangements  Keep relationships with clients professional  Avoid engaging in sexual relationships with clients  Treat your clients with respect  Obtain parental consent when working with minors

 Make use of assessment procedures  Make it a practice to consult with colleagues  Keep current client records  Avoid promising clients anything you cannot deliver  Anchor your practice to a theory  Abide by the policies of the institution that employs you

 Ethical decision-making model: 1. Identify the problem or dilemma 2. Identify the potential issues involved 3. Apply the ethics codes 4. Know the applicable laws and regulations 5. Obtain consultation 6. Consider possible and probable courses of action 7. Explore the consequences of various decisions 8. Decide on the course of action

Ethics Codes On Confidentiality In Psychotherapy and Counseling By Jeffrey Barnett, Psy.D., and Ofer Zur, Ph.D. ◦ Privacy and confidentiality in school counseling - Special issue: legal and ethical issues in school counseling ◦ / / Documents posted in Doc Sharing