Confidentiality Flashcards
(29 cards)
A client is at high risk of suicide
Permitted exception to confidentiality
A client is gravely disabled
Permitted exception to confidentiality if a client is not able to care for him/herself. Example given is a client who appears to be a danger to himself or others and who has a mental or emotional condition. (Schizo, etc.) Breaking of confidentiality would be to those I would need to contact in order to get the client the help he/she needed.
Billing insurance
Permitted exception to confidentiality
Disclosures to parents of minor clients
Permitted exception to confidentiality
Disclosures to other mental health providers of client in order to prevent harm to patient
Permitted exception to confidentiality
Probation office knowing about therapy attendance
Permitted exception to confidentiality
Confidentiality
Legal and ethical requirement placed on the therapist that restrict the volunteering of information obtained in a therapeutic relationship.
Client discloses crimes previously committed
Must maintain confidentiality unless the crime is against a protected class (child, dependent adult or elder)
The client passes away. Can his/her records be accessed?
Confidentiality survives the death of a client or former client. There must be authorization from the personal representative or legal executor of the deceased client.
Who must sign authorization for disclosure?
When treating more than one person, each member competent to do so and 12+ years of age is required to sign an authorization prior to the disclosure of any information whatsoever to third parties pertaining to the therapy.
What does confidentiality look like in a group setting?
When treating clients in group therapy, the therapist has a responsibility to maintain confidentiality of all group members. Additionally, a therapist is ethically responsible to obtain agreement among all group members to respect the confidentiality of other group members.
What if a client commits an act of theft or violence against the therapist?
A therapist is not obligated to maintain confidentiality.
Mandated reporting of child abuse
Must be reported if a therapist has knowledge or reasonable suspicion of physical abuse, sexual abuse, willful cruelty or unjustified punishment, unlawful corporal punishment or injury or neglect.
Emotional abuse is an optional report.
Mandated reporting of dependent adult or elder abuse
Must be reported if a therapist has knowledge or reasonable suspicion of physical abuse, abandonment, isolation, neglect, financial abuse, or abduction of an elder or dependent adult who is a resident of California.
Tarasoff
A therapist has a legal duty to report to law enforcement when the client communicates “serious treat of physical violence against a reasonably identifiable victim or victims.”
Reporting to the intended victim is an option, not a requirement. Should consider the clinical situation before taking action to notify victim.
A court order or order from a judge
Client does not have right to confidentiality.
An order from a state board, commission or administrative agency (ex. BBS)
Client does not have right to confidentiality.
Request from coroner for info in the course of an investigation for the purposes of identify a decedent or locating next of kin or when investigating deaths that may involve public health concerns.
Client does not have right to confidentiality.
Search warrant for therapist’s office
Client does not have right to confidentiality.
What should a therapist do when client or credible third party communicates serious threat of physical violence to the person?
Trumps confidentiality.
1) victim must be easily identifiable
2) therapist must notify law enforcement local to the client
- share specifics of the threat and relevant info (DSM diagnosis, history of violence)
3) notify potential victim if possible (victim must be easily identifiable)
What if the threat is to a school?
Notify local police and school authorities.
What if the gut feeling is very strong that the client might do something to someone?
1) assessing for harm to others
- if past assessments have hinted at possible harm to others and the “gut feeling” strengthens to the point of concern then may be ok to contact police.
- do a complete assessment of threats which come off as vague
- assessment should include an understanding if the client has a history of violence?
Does HIV fall under the duty to warn?
No, it does not.
Duty to protect - danger to self
Meeting standard of care = assessing levels of risk and intervening accordingly.
Assess for:
1) plans
2) means - would want client to agree to get rid of means
3) hopelessness/history of suicide
