Chapter 6 Flashcards
Confidentiality
- rooted in a client’s right to privacy is at the core of effective therapy
- it is the therapist’s duty to protect private client communication
Privileged Communication
a legal concept that generally bars the disclosure of confidentiality communications in a legal proceeding
can vary state to state
Privacy
-the constitutional right of individuals to be left alone and to control their personal information
Protecting Confidentiality Rights Fishers 6 Steps
- respond ethically to legal requests for disclosure
- avoid the avoidable breaches of confidentiality
- talk about confidentiality
limits of confidentiality rights
- clerical assistance handle confidential infor
- counselor consults
- the counselor is being supervised
- the client has given consent
- client poses danger to self or others
- client discloses an intention to commit a crime
- therapist suspects child abuse or neglect
- court orders therapist records to be available
Privacy issues with telecommunication devices
- DO Not acknowledge clients receiving services or give out info to unknown callers
- verify that you are talking to your client and not someone else
- be aware that you do not know if your conversation is being recorded
- avoid making any comments that you do not what your client to hear of repeat in a legal proceeding
- be careful when taking confidential info over the phone
- avoid saying anything off the record
- do not let people hear messages in your office
- if talking to clients on a cell phone assume they are not in a private place
- realize your conversation may be listened to by an unauthorized individual
- make sure your access codes to voice mail are not disclosed
- be careful when sending text messages
HIPAA for Mental Health Providers
Health Insurance Portability and Accountability Act of 1996
-promote standardization of patient’s rights and control over their health care information
-was developed out of concern for electronically delivered info was not protected gaps in client confidentiality
- if you submit an electronic claim even just once you are considered a covered entity for HIPAA purposes
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privacy
licensed health care workers are expected to guard patients rights to privacy including payment matters, health info psy notes medical records
electronic transactions
create one national form of communication or language so health care providers can communicate with each other thru this common language
security requirements
prevent access to patients health care info must have ability to secure info
national identifiers requirements
health care providers have national identification # that identify them when they are conducting standard transactions
4 Standards of HIPAA
- privacy requirements
- electronic transcripts
- security requirements
- national identifiers requirements
Duty to protect Potential Victims
balancing client confidentiality and protecting the public major ethical challenge
Duty to Protect Potential Victims
identify clients that could do harm to a third party
protect third party
treat clients who are dangerous
Liability for Civil Damages
- you can be sued for civil damages if you fail to protect against dangerous acts from clients
- you can be held liable if you fail to diagnose or predict dangerous behavior
- failing to warn potential victims of violent behavior
- premature discharging dangerous clients from hospital
Tarasoff Case
- *Duty to Warn and Duty to Protect** Ca Supreme Court
- student killed a girl returning from Brazil police were informed
- Parents sued the therapist
- went to CA supreme court when it was ruled against in the lower court
Bradley Case
- *Duty not to negligently release a dangerous client**
- Wessner threatened to kill his wife and her lover because they were having an affair
- he told the therapist he had a weapon
- dropped off kids and killed the wife and lover
- Georgia Supreme Court ruled in favor of his children the physician failed to release information that the client was dangerous
Jablonski Case
- *Duty to commit a dangerous individual**
- wife brought in her husband 2x was fearful he was going to harm her
- hospital did not see a probable cause to commit him
- US ruled in favor of the victims daughter for failure to commit a dangerous individual
Hedlund Case
- *extends duty to warn anyone who might be near the intended victim and who might also be n danger**
- psychologist’s assistant did not warn the child of the victim and the child suffered psychological damages
- CA supreme court ruled in favor of the victim
Jaffee Case
- *communication between therapist and client is privileged information and is protected from forced disclosure in cases concerning the federal law**
- United states supreme court ruled
- victory for mental health care professionals and the confidentiality of their clients
- applies only in federal cases
School Counselors Liability for student suicide
- therapist must educate employees esp teachers about risk factors associated with adolescent students at risk for suicide
- must institute peer assistance programs to identify risk
- counselors have access to increased training and programs to help with adolescent suicide
- if the counselor is aware of student potential suicide they must inform parents
Eisel V Board of Education (1991)
- student counselors should take initiative in obtaining continuing education on suicide risks and students
- student was involved with satanism and said she was going to kill herself and her friends
- counselor failed to inform the parents
Disclosure of Client’s HIV Status
- Law is NOT clear pertaining to the duty to protect in cases pertaining to HIV status
- must know the specific law in your jurisdiction and seek consultation from a colleague
Disclosure of Clients HIV status
-from a legal perspective breaching confidentiality because of a client’s HIV status is NOT one of the exceptions to confidantality
Recommendations for Counseling patients with HIV
- discuss confidentiality before treatment
- must know the state laws regarding HIV + clients
- keep current on relevant medical information including safe sex practices
- open discussion on the dangers of unsafe sex practices and third parties
- in disclosing HIV information therapists need to follow guidelines to protect clients confidentiality
