Unit 4 Seminar

Key TermsConfidentialityPrivileged communicationPrivacy

4.01 Maintaining ConfidentialityPsychologists 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 dilemma2. Identify the potential issues involved3. Apply the ethics codes4. Know the applicable laws and regulations5. Obtain consultation6. Consider possible and probable courses of action7. Explore the consequences of various decisions8. Decide on the course of action

Ethics Codes On Confidentiality In Psychotherapy and Counseling

By Jeffrey Barnett, Psy.D., and Ofer Zur, Ph.D. ◦ http://www.zurinstitute.com/ethicsofconfidentiality.html

Privacy and confidentiality in school counseling - Special issue: legal and ethical issues in school counseling

◦ http://findarticles.com/p/articles/mi_m0KOC/is_1_6/ai_93700936/

Documents posted in Doc Sharing