Section B: Confidentiality And Privacy

Question 1

The cornerstone of the counseling relationship

Answer 1

Trust

Question 2

How counselors earn trust

Answer 2

Creating ongoing partnership, establishing and upholding appropriate boundaries, maintaining confidentiality

Question 3

B.1.a Multicultural/Diversity Considerations (respecting client rights)

Answer 3

Counselors maintain awareness and sensitivity regarding cultural meanings of confidentiality and privacy Counselors respect differing views toward disclosure of information. Counselors hold ongoing discussions with clients as to how, when, and with whom information is to be shared.

Question 4

B.1.b Respect for Privacy (respecting client rights)

Answer 4

Counselors respect the privacy of prospective and current clients. Counselors request private information from clients only when it is beneficial to the counseling process.

Question 5

B.1.c Respect for confidentiality (respecting client rights)

Answer 5

Counselors protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification.

Question 6

B.1.d Explanation of Limitations (respecting client rights)

Answer 6

At initiation and throughout the counseling process Counselors inform clients of the limitations of confidentiality and seek to identify situations in which confidentiality must be breached.

Question 7

B.2.a Serious and foreseeable harm and legal requirements (Exceptions)

Answer 7

The general requirements that Counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information use be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues.

Question 8

B.2.c Contagious, Life-Threatening Diseases (Exceptions)

Answer 8

When clients disclose that they have a disease commonly known to be both communicable and life threatening, Counselors may be justified in disclosing information to identifiable third parties, if the parties are known to be at serious and foreseeable risk of contracting the disease. Prior to making a disclosure, Counselors assess the intent of clients to inform the third parties about their is ease or to engage in any behaviors that may be harmful to an identifiable third party. Counselors adhere to relevant state laws concerning disclosure about disease status.

Question 9

B.2.d Court-Ordered Disclosure (exceptions)

Answer 9

When ordered by a court to release confidential or privileged information without a client’s permission, Counselors seek to obtain written, informed consent from the client or take steps to prohibit the disclosure or have it limited as narrowly as possible because of potential harm to the client or counseling relationship.

Question 10

B.2.e Minimal disclosure (exceptions)

Answer 10

To the extent possible, clients are informed before confidential information is disclosed and are involved in the disclosure decision-making process. When circumstances require the disclosure of confidential information, only essential information is revealed.

Question 11

B.3.a Subordinates (information shared with others)

Answer 11

Counselors make every effort to ensure that privacy and confidentiality of clients are maintained by subordinates, including employees, supervisees, students, clerical assistants, and volunteers

Question 12

B.3.b. Interdisciplinary Teams (information shared with others)

Answer 12

When services provided to the client involve participation by an interdisciplinary or treatment team, the client will be informed of the team’s existence and composition, information being shared, and the purposes of sharing such information.

Question 13

B.3.c Confidential settings (information shared with others)

Answer 13

Counselors discuss confidential information only in settings in which they can reasonably ensure client privacy.

Question 14

B.3.d Third-party Payers (information shared with others)

Answer 14

Counselor’s disclose information to third-party payers only when clients have authorized such disclosure.

Question 15

B.3.e Transmitting confidential information (information shared with others)

Answer 15

Counselors take precautions to ensure the confidentiality of all information transmitted through the use of any medium.

Question 16

B.3.f Deceased clients (information shared with others)

Answer 16

Counselors protect the confidentiality of deceased clients, consistent with legal requirements and documented preferences of the client.

Question 17

B.4.a Group work (Groups and families)

Answer 17

In group work, counselor’s clearly explain the importance and parameters of confidentiality for the specific group.

Question 18

B.4.b Couples and family counseling (groups and families)

Answer 18

In couples and family counseling, counselor’s clearly define who is considered “the client” and discuss expectations and limitations of confidentiality. Counselors seek agreement and document in writing such agreement among all involved parties regarding the confidentiality of information. In the absence of an agreement to the contrary, the couple or family is considered to be the client.

Question 19

B.5.a Responsibility to clients (clients lacking capacity to give informed consent)

Answer 19

When counseling minor clients or adult clients ho lack the capacity to give voluntary, informed consent, counselor’s protect the confidentiality of information received–in any medium–in the counseling relationship as specified by federal and state laws, written policies, and applicable ethical standards.

Question 20

B.5.b Responsibility to parents and legal guardians (clients lacking capacity to give informed consent)

Answer 20

Counselors inform parents and legal guardians about the role of counselor’s and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements. Counselors are sensitive to the cultural diversity of families and respect the inherent right and responsibilities of parents/guardians regarding the welfare of their children/charges according to law. Counselors work to establish as appropriate, collaborative relationships with parents/guardians to best serve clients.

Question 21

B.5.c Release of confidential information(clients lacking capacity to give informed consent)

Answer 21

When counseling minor clients or adult clients who lack the capacity to give voluntary consent to release confidential information, counselor’s seek permission from an appropriate third party to disclose information. In such instances, counselor’s inform clients consistent with their level of understanding and take appropriate measures to safeguard client confidentiality.

Question 22

B.6.a Creating and maintaining records and documentation (Records and documentation)

Answer 22

Counselors create and maintain records and documentation necessary for rendering professional services.

Question 23

B.6.b Confidentiality of records and documentation (records and documentation)

Answer 23

Counselors ensure that records and documentation kept in any medium are secure and that only authorized persons have access to them.

Question 24

B.6.c Permission to record (records and documentation)

Answer 24

Counselor’s obtain permission from clients prior to recording sessions through electronic or other means.

Question 25

B.6.D Permission to observe (records and documentation)

Answer 25

Counselor’s obtain permission from clients prior to allowing any person to observe counseling sessions, review session transcripts, or view recordings of sessions with supervisors, faculty, peers, or others within the training environment

Question 26

B.6.e Client access (records and documentation)

Answer 26

Counselor’s provide reasonable access to records and copies of records when requested by competent clients. Counselors limit the access of clients to their records, or portions of their records, only when there is compelling evidence that such access would cause harm to the client. Counselor’s document the request of clients and the rationale for withholding some or all of the records in the files of clients. In situations involving multiple clients, counselor’s provide individual clients with only those parts of records that relate directly to them and do not include confidential information related to any other client.

Question 27

B.6.f Assistance with records (records and documentation)

Answer 27

When clients request access to their records, counselor’s provide assistance and consultation in interpreting counseling records.

Question 28

B.6.g Disclosure or transfer (records and documentation)

Answer 28

Unless exceptions to confidentiality exist, counselor’s obtain written permission from clients to disclose or transfer records to legitimate third parties. Steps are taken to ensure that receivers of counseling records are sensitive to their confidential nature.

Question 29

B.6.h Storage and disposal after termination (records and documentation)

Answer 29

Counselors store records following termination of services to ensure reasonable future access, maintain records in accordance with federal and state laws and statutes such as licensure laws and policies governing records, and dispose of client records and other sensitive materials in a manner that protects client confidentiality. Counselors apply careful discretion and deliberation before destroying records that may be needed by a court of law, such as notes on child abuse, suicide, sexual harassment, or violence.

Question 30

B.6.i Reasonable precautions (records and documentation)

Answer 30

Counselors take reasonable precautions to protect client confidentiality in the event of the counselor’s termination of practice, incapacity, or death and appoint a records custodian when identified as appropriate

Question 31

B.7.a Case consultation - respect for privacy

Answer 31

Information shared in a consulting relationship is discussed for professional purposes only. Written and oral reports present only data germane to the repurposes of the consultation, and every effort is made to protect client identity and to avoid undue invasion of privacy.

Question 32

B.7.b Case consultation - disclosure of confidential information

Answer 32

When consulting with colleagues, counselor’s do not disclose confidential information that reasonably could lead to the identification of a client or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided. They disclose information only to the extent necessary to achieve the purposes of the consultation.