Case 4.01 Maintaining Confidentiality: Disclosure

In the article, “Confidentiality: Concept analysis and clinical application”, author Winifred Ellenchild, examines confidentiality from both a theoretical perspective using concept analysis and through the use of a clinically based empirical investigation. The author compared the two approaches and discussed the features, credentials, costs, empirical referents, and implications for clinical practice. The results discussed in the article are those provided through a research project involving participants’ definitions of confidentiality and confidentiality issues.

Clearly, confidentiality is essential to the healing process. However, though it may appear to be a relatively easy concept, its application in the therapeutic atmosphere has proven to be quite complex (Younggren & Harris, p. 589). One issue that causes confusion for many professionals pertains to the differences between confidentiality and legal privilege. Quite often, ethical obligations overlap with the legal requirements. Frequently, the practitioner is not well informed about these particular limits on confidentiality and this lack of knowledge can place both the client and the helping professional at risk (Younggren & Harris, p.590, 598).

Psychologists are committed to increasing scientific and professional knowledge of behaviour and people's understanding of themselves and others and to the use of such knowledge to improve the condition of individuals, organisations, and society (APA, 2010). The PSI preamble (2010) states “the authority of psychologists derives from the scientific methods of investigation on which their knowledge is based, and the ethics which govern all their professional activity. They accept that codes of ethics are necessary to protect the interest of clients and prevent misuse of psychological knowledge. The Ethics Code provides a common set of principles and standards upon which psychologists build their professional and scientific work. The following is a rough and general summary of the principles that are addressed by the APA, PSI and BPS;

This paper is a response to a video discussing the issues of confidentiality, privilege, reporting, and duty to warn. This paper looks at these issues and their explanations in the American Counseling Association Code of Ethics as well as the Georgia State Board of Professional Counselor’s ethical guidelines and provides a commentary on the laws. It was found that these issues are not always black and white, but there is some debate on these issues. Confidentiality is both an ethical and a legal responsibility yet there are often times when the ethical demands clash with the legal demands. This paper explores some of those crashes and explains what I have learned from the video and the professional and stage guidelines concerning confidentiality and its implications and how I will apply what I have learned into future practice.

Remley and Herlihy (2016) defines confidentiality as an ethical concept which refers to the counselor 's obligation to respect the client 's privacy and in session discussion will be protected from disclosure without their consent (p.108). The receptionist never disclosed what was being discussed in wife A session; however, her inadvertent breach of confidentiality occurred the moment she divulged the fact that wife A is a patient at a mental health facility. An important premise to understanding the ethical principle of confidentiality is base that a counselor respects the client 's right to privacy (Remley & Herlihy, 2016; Quigley, 2007). Premise one states the "counselor honor the rights of clients to decide who knows what information about them and in what circumstances" (p.110).

Video presentation: The video clip was quite interesting I found it to be very educational as to the legal obligations of therapists in the mental health field. There were issues that were brought up that were quite important, such as therapists need to understand confidentiality, privileged information, and a therapists responsibility related to reporting suspected child abuse, elder abuse, and/or suicidal ideations, and possibly the most important of them all is a therapists duty to warn. The first case they were

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The ethical dilemma I wish to explore is The Duty to Warn. This refers to the duty of a counselor, therapist to breach one of the most important bonds between a client and a therapist; the law of confidentiality. The therapist has the right to break confidentiality without the fear of being brought up for legal action. If the therapist believes that the client poses a danger, or is a threat to himself, someone else, or society as a whole, the therapist must decide how serious of a threat the client may be, then if he decides it’s a serious issue, he must notify the person in danger, which would e the third party, or the police, or other people who may be in the

When it comes to confidentiality there are rules that one has to follow in order to abide by the person’s rights. Using caution when talking to others about the client who want to obtain information that they are not at liberty to have. An example of this would be someone claiming to be a patient’s friend wanting a room number in the hospital to go visit them. Confidentiality is a very delicate situation in the practicing field of professionals.

When mental health counselors work with various clients during their career, they need to practice confidentiality and privacy when conducting one-on-one, group, or any type of counseling services. Like any medical patient, mental health clinicians need to treat their clients with dignity and respect. It is extremely important for the mental health counselor working with his or her assigned caseload

Everyone is entitled to confidentiality unless they give permission for someone else to see their information or they can no longer make decisions on their own (for example, if they are confused or comatose). A federal law, Health Insurance Portability and Accountability Act applies to most health care physicians and its guideline, known as the Privacy Rule. The Privacy Rule sets specific rules regarding privacy, access, and disclosure of information. For example, HIPAA specifies the following:

In this paper, I will discuss the principles that permit disclosure of protected health information with or without the patient’s consent for each of the four categories, government agencies, legal agencies or representatives and research groups. I will also state whether I feel privacy safeguards are adequate to support those principles.

As a counsellor I have an obligation to follow professional standards and apply appropriate behaviour defined by mental health associations. The purpose of this is to prevent harm to clients as well as to define my own professional values.

Confidentiality is someone who is trusted with private or secrecy matter; confidential whisper or issue. (Credo Reference, 2001). Certain situations where the confidentiality between client and therapist, may need to be breached to ensure the safety of the client him/herself, the community or ourselves. Two important circumstances would be a client/child under 16 who has been abused or a client needs hospitalisation because they have been considering taking their own life or other concerning issues (Corey, 2009).

The second ethical issue occurred when the psychologist disclosed information about Mr. Hartwig’s to his psychiatrist without Mr. Hartwig’s consent. The psychologist motivations for contacting Mr. Hartwig’s psychiatrist appears to be ethical. He was attempting to establish a collaborative relationship with the psychiatrist in order to maximize the effectiveness of each for of treatment in order to best serve the client (APA, 2002). However, The APA guidelines on stipulate that while psychologist should attempt to establish a collaborative relationship they must request release from the client before disclosing confidential information (APA, 2002). The client shared the name of his psychiatrist, but there was no evidence that the client consented to an exchange of information between the two professionals. In addition to the psychologists’ obligation to obtain consent to disclose information to the psychiatrist; he was also ethically obligated to ensure that the client understands what he/she is giving consent for. Koocher and Keith-Spiegel, suggest elements that a release-of-information form should include; who the information is to be released to, and any limitations on the information to be released (2008). If the client consented to disclosure with the