Confidentiality in theConfidentiality in the School Setting School Setting

Presented by:Presented by:

Emma Morales, LCSWEmma Morales, LCSW

Myrna Reynoso-Torres, LCSWMyrna Reynoso-Torres, LCSW

Yolanda Vargas, LCSWYolanda Vargas, LCSW

Social Work in the Social Work in the School Setting School Setting Promotes Academic Promotes Academic Success!Success!

NASW Code of EthicsNASW Code of Ethics

VALUE: Importance of Human VALUE: Importance of Human RelationshipsRelationships

Social workers seek to strengthen Social workers seek to strengthen relationships among people in a relationships among people in a purposeful effort to promote, restore, purposeful effort to promote, restore, maintain, and enhance the well being maintain, and enhance the well being of individuals, families, social groups, of individuals, families, social groups, organizations, and communities. organizations, and communities.

Confidentiality Confidentiality

Confidentiality is fundamental to Confidentiality is fundamental to relationships with all clientsrelationships with all clients

The duty to maintain the privacy of The duty to maintain the privacy of information obtained in the course of information obtained in the course of the professional/client relationshipthe professional/client relationship

Confidential information may be Confidential information may be obtained from sources other than obtained from sources other than the client, such as the parent, or the client, such as the parent, or other professionalsother professionals

Confidentiality MattersConfidentiality MattersVideoVideo

Importance of Importance of ConfidentialityConfidentiality

It promotes trustIt promotes trust It creates a safe It creates a safe

counseling environmentcounseling environment

Not ConfidentialityNot Confidentiality

CONSENTCONSENT

Best practice suggests Best practice suggests that parents be involved in that parents be involved in the consent of students the consent of students receiving mental health receiving mental health services. Therefore, you services. Therefore, you should get parent consent should get parent consent for all LAUSD students. for all LAUSD students.

Informed ConsentInformed Consent

At the beginning, discuss the rules At the beginning, discuss the rules in the relationshipin the relationship– Service you will provideService you will provide– Confidentiality Confidentiality (child-therapist & parent-(child-therapist & parent-

therapist)therapist)

– Limitations to ConfidentialityLimitations to Confidentiality Confirm consent in writing and Confirm consent in writing and

review written document with review written document with parent and studentparent and student

Los Angeles Unified School District

School Mental Health

Consent Form

Our school is pleased to announce that we are offering individual, family, and

group counseling to students. Your child, ____________________________, has been

referred for this service in order to help him/her achieve greater success in his/her

educational, social, and emotional growth. Services may include home visits, phone

contacts, and referrals to additional resources. Services may also require collaboration

with school staff and community agencies.

In signing the bottom of this form, you as the parent or guardian are indicating

that you understand that information regarding your family will be held in confidence

with the exception of situations that may be harmful to the health and safety of others,

including yourself and your children. It is your right to accept, refuse, or stop services at

any time.

If you have any specific questions or need any further assistance, please call

_________________________ at _______________________.

***********************************************************************

_____ I accept services.

_____ I decline services.

_____ I would like to receive a list of referrals to community resources.

___________________________________ ______________________________ Child’s Name Child’s D.O.B. ___________________________________ ______________________________ Name of Parent/Guardian Address ___________________________________ ______________________________ Home Telephone Work/Cell Phone ___________________________________ ______________________________ Signature of Parent/Guardian Today’s Date

Confidentiality in the Confidentiality in the school settingschool setting

EVERYONEEVERYONE wants to know what’s wants to know what’s happening with the student.happening with the student.

Providing Confidential Providing Confidential InformationInformation

Can you share Can you share information with information with colleagues at the school?colleagues at the school?

YES, but it has to be:YES, but it has to be:

PURPOSEFULPURPOSEFUL BEST INTEREST OF THE CHILDBEST INTEREST OF THE CHILD

Before you share Before you share information information

THINKTHINK WHYWHY are you sharing the information? are you sharing the information?

WHATWHAT information are you sharing? information are you sharing?

WHOWHO are you sharing this information are you sharing this information with?with?

Can You Share Can You Share Information with Information with Outside Sources?Outside Sources?

Only if you have a signed release of Only if you have a signed release of information information This applies to DCFS workers, This applies to DCFS workers, outside community agencies (mental outside community agencies (mental health, medical, legal, etc…)health, medical, legal, etc…)If you are unsure…. consult with If you are unsure…. consult with your field instructoryour field instructor

Los Angeles Unified School District

School Mental Health Parent Authorization for Release/Exchange of Information

Date: _____________________ To Parent/Guardian (s) of : _____________________________ We are requesting your written authorization for release/exchange of information from the individual, agency, or institution indicated below. The information received shall be reviewed only by appropriate professionals in accordance with the Family Educational Rights and Privacy Act of 1974. TO: ________________________________ RE: ___________________________________ Name Pupil (Last name) (First name) ____________________________________ Date of Birth: _______/_______/_______ Agency, Institution, or Department Mo. Day Yr. ____________________________________ ___________________________________ Street Address Street Address ____________________________________ ____________________________________ City State Zip City State Zip I hereby give you permission to release/exchange the following information: _____ Medical/Health _____ Speech & Language _____ Educational

_____ Psychological/Mental Health _____ Other-Specify ____________________________ The information will be used to assist in determining the needs of the pupil.

THIS INFORMATION IS TO BE SENT TO:

_____________________________________________________________________________ Name Position _____________________________________________________________________________ Address This authorization shall be valid until __________________________ unless revoked earlier. I request a copy of this authorization: _____ Yes _____ No Signature: _________________________________________ Date: _____________________ Parent/Legal Guardian Note: This information will become part of the pupil’s educational records and shall be made available, upon request, to the parent or pupil age 18 or older.

Can you share Can you share information with information with Parents?Parents? Yes- Only if it pertains to Limits of Yes- Only if it pertains to Limits of

ConfidentialityConfidentiality It is best to encourage the client It is best to encourage the client

to communicate with parent to communicate with parent about something parent might about something parent might need to knowneed to know

Limitations to Limitations to ConfidentialityConfidentiality

Abuse/NeglectAbuse/Neglect Danger to selfDanger to self Danger to OthersDanger to Others

““Tarasoff” Tarasoff”

TARASOFF - “Duty to Warn”TARASOFF - “Duty to Warn”

A California Supreme Court decision A California Supreme Court decision that held that a psychologist could that held that a psychologist could be held liable for failing to take be held liable for failing to take reasonable steps to protect the reasonable steps to protect the intended victim when a client intended victim when a client threatens violence. This decision threatens violence. This decision created the “duty to warn” a created the “duty to warn” a reasonably identifiable victim when reasonably identifiable victim when a client threatens violence.a client threatens violence.

NOTICE

I am a Social Work Intern.

Anything you share with me WILL NOT be shared with anyone else without your

permission, except in the following three situations:

I suspect that you are in DANGER OF

HARMING YOURSELF.

I suspect you INTEND TO HARM ANOTHER PERSON.

I suspect that YOU ARE VICTIM OF

ABUSE.

By law, I MUST REPORT these three situations. However, I will also be

available to help you through the process toward resolution.

ExceptionsExceptions

Students 12 years of Students 12 years of age or older that need age or older that need “sensitive services”“sensitive services”

What are sensitive What are sensitive services?services? Pregnancy, contraceptive and abortionPregnancy, contraceptive and abortion HIV testing and servicesHIV testing and services Medical care of an STDMedical care of an STD Rape servicesRape services

In cases of rape or sexual assault, In cases of rape or sexual assault, students can provide consent, but students can provide consent, but parents must be notified unless they parents must be notified unless they are the perpetrators.are the perpetrators.

Students age 12 or older Students age 12 or older can provide consent can provide consent themselves for mental themselves for mental health services if they meet health services if they meet twotwo criteria: criteria:

Student is deemed mature enough to make Student is deemed mature enough to make an informed decision an informed decision

ANDAND One of the two following apply:One of the two following apply:1.1. Without mental health services, student Without mental health services, student

would present a danger of serious physical would present a danger of serious physical or mental harm to self or others. or mental harm to self or others.

2.2. Student is an alleged victim of incest or Student is an alleged victim of incest or child abuse.child abuse.

How many times can you How many times can you meet with a student before meet with a student before getting parental consent?getting parental consent?

Once!Once! But only…………………………….But only…………………………….

To receive a consent form to take To receive a consent form to take homehome

For a crisis situationFor a crisis situation

What if parent refuses What if parent refuses consent?consent?

You You MAY NOTMAY NOT see the student see the student

Unless……Unless……

not receiving mental health not receiving mental health services would pose a significant services would pose a significant health or mental health risk to the health or mental health risk to the studentstudent

Your reasons for seeing the Your reasons for seeing the student must be documented.student must be documented.

VignetteVignette DCFS case manager is working DCFS case manager is working

with Tommy. The case manager with Tommy. The case manager asks the school mental health asks the school mental health professional about Tommy, professional about Tommy, whether he seems happy, is whether he seems happy, is making friends, etc. The case making friends, etc. The case manager then says she wants to manager then says she wants to talk to Tommy’s teacher to find talk to Tommy’s teacher to find out if he is out ill often.out if he is out ill often.

What do you do?What do you do?

Other Things to Other Things to Consider Regarding Consider Regarding ConfidentialityConfidentiality Leaving phone messagesLeaving phone messages Emailing Emailing Running into clients in a Running into clients in a

public settingpublic setting

CLIENT RECORDSCLIENT RECORDS

Progress NotesProgress Notes

Keep track of significant events/dates/peopleKeep track of significant events/dates/people These notes should remain general and neutralThese notes should remain general and neutral Document “as if” your records could be Document “as if” your records could be

subpoenaed in a court of law and read in front subpoenaed in a court of law and read in front of the clientof the client

Do not leave notes or charts where others can Do not leave notes or charts where others can see themsee them

Personal NotesPersonal Notes

Are designed to reflect your longer Are designed to reflect your longer thoughts, reflections and observationsthoughts, reflections and observations

Are to be kept separate from pupil recordsAre to be kept separate from pupil records Process recordings fall under this categoryProcess recordings fall under this category Personal notes remain personal as long as Personal notes remain personal as long as

they are not shared in a public forumthey are not shared in a public forum

In Conclusion……In Conclusion……Be mindful of what you say and what Be mindful of what you say and what you writeyou writeReview limits of confidentiality before Review limits of confidentiality before every individual and/or group sessionevery individual and/or group sessionGet signed consent and release of Get signed consent and release of information forms for every clientinformation forms for every client

QUESTIONS???QUESTIONS???