Hey guys!
Welcome to this video lesson on Confidentiality within the Counseling profession.
Counselors should understand that for a counseling relationship to work, it has to be built on trust.
Most of the time, your client is not going to hand you their trust on a silver platter.
Building trust takes time.
Sometimes we think of building trust as starting on a neutral ground ; neutral being this state
of mind where your client is unsure about whether or not they can trust you.
Well, this notion is probably too optimistic, depending on the situation.
The reality, often times, is that they don't trust you.
It's not that they aren't sure.
They straight up do not trust you.
So, instead of starting off at the level playing field of zero, you might be starting off somewhere
on the negative end.
Now this, obviously, can vary person-to-person, but quite often you will see that you are
having to work against the grain of distrust.
Giving them a platform of appropriate privacy and confidentiality, while also upholding
those terms of privacy and confidentiality, is the first step in building trust with your client.
You, the counselor, should always clearly communicate to the client the parameters of
confidentiality in a culturally competent manner.
There are seven things that are important to be familiar with when it comes to confidentiality.
1.
Respecting Client Rights As a counselor you should always have awareness
and sensitivity regarding cultural meanings of confidentiality and privacy.
Be considerate to respect differing views toward disclosure of information, and you
should always discuss with clients how, when, and with whom information is to be shared.
A counselor should never ask for private information from clients, unless it is beneficial to their
growth in the counseling process.
Be respectful or their privacy.
Never disclose information.
The only reason a counselor should ever disclose information is when appropriate consent is
given, or there is a sound legal or ethical justification.
Be very clear with your client about when it is appropriate for you, the counselor,
to disclose the information at initiation; as well as throughout the entire counseling process.
Being upfront, and clear with your client will help you, the counselor, to gain credibility.
2. Exceptions
So, we just talked about never disclosing
information, unless you have to.Well, the general requirement 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 must be revealed.
If you are unsure, never make the decision without seeking counsel from other professionals.
If you are considering being a counselor who provides services to terminally ill individuals
who are considering hastening their own deaths, then you need to know that your client has
the option to maintain confidentiality; depending on certain laws and their specific circumstances.
If a client let's you know that they have a disease commonly known to be both communicable
and life threatening, then you may be justified in disclosing information to identifiable third parties;
but only if the parties are known to be at serious and foreseeable risk of contracting the disease.
Before making a disclosure, always assess the intent of the client to inform the third party about their disease,
or to engage in any behaviors that may be harmful to an identifiable third party.
Laws may vary state to state, so make sure, whatever state you are in, that you are familiar
with the laws concerning disclosure about disease status.
The only other time that it is okay to disclose a client's private information is when a court
tells you that you have to.
If this happens, you should always seek to obtain written, informed consent from the
client, or take steps to prohibit the disclosure; if that doesn't work have it limited as narrowly
as possible, because of potential harm to the client or counseling relationship.
When you are trying to disclose the minimal amount,
clients are informed before confidential information is disclosed,
and are involved in the disclosure decision-making process.
3.
Information Shared With Others
The counselor should make every effort to
ensure that privacy and confidentiality of clients are maintained by subordinates, including
employees, supervisees, students, clerical assistants, and volunteers.
When services provided to the client involve participation by an interdisciplinary or treatment
team, the client should be informed of the team's existence and composition,
information being shared, and how that information is being shared.
Where you share information also matters.
Counselors should only discuss confidential information when they can ensure that the
setting is safe, and private.
Even if your client is not the one paying for your services, you should never release
information to the third party payer unless your client has authorized such disclosure.
If you are transmitting the confidential information of your client you should always take precautions
to ensure the security of the transmission.
If a client were to pass away the counselor must still protect the confidentiality of that deceased client,
and be consistent with legal requirements, as well as with the documented preferences of the client.
4.
Groups and Families
In group work, you need to clearly explain
the importance and parameters of confidentiality for that specific group.
In couples and family counseling, counselors must clearly define who is considered "the client"
and discuss expectations and limitations of confidentiality.
Counselors should always seek agreement, and should document, in writing, such agreement
among all involved parties regarding the confidentiality of information.
Often times the couple or family is considered the client if they decide not to specify who is the "client."
5.
Clients Lacking Capacity to Give Informed Consent
If you are counseling minor clients or adult clients who lack the capacity to give voluntary,
informed consent, you need to 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.
You need to inform parents and legal guardians about the role of counselors and the confidential
nature of the counseling relationship, consistent with current legal and custodial arrangements.
You must be sensitive to the cultural diversity of families and respect the inherent rights
and responsibilities of parents or guardians regarding the welfare of their children or
charges according to law.
Work to establish an appropriate, collaborative relationships
with parents or guardians to best serve clients.
Always seek permission from an appropriate third party to disclose information.
In such instances, counselors should inform clients consistent with their level of understanding
and take appropriate measures to safeguard client confidentiality.
6.
Records and Documentation
Counselors should only create and maintain
records and documentation that is necessary for rendering professional services.
You must ensure that records and documentation are kept in a medium that is secure and that
only authorized persons have access to them.
You are required to obtain permission from clients prior to recording sessions through electronic or other means.
If you plan on allowing anyone other than your client to observe the session, you must
first obtain permission from your client.
It is also important to provide reasonable access to records and copies of records when
requested by competent clients.
The only time you would limit your clients access to their records, or portions of their records,
is when there is compelling evidence that such access would cause harm to the client.
Counselors need to document the client's request and the rationale for withholding some or
all of the records in the files of clients.
In situations involving multiple clients, counselors 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.
If a client has requested access you, the counselor, should provide assistance and consultation
in interpreting counseling records.
If exceptions to confidentiality exist, you need to obtain written permission from your
client to disclose or transfer records to legitimate third parties, and steps should
be taken to ensure that receivers of counseling records are sensitive to their confidential nature.
You must store records following termination of services to ensure reasonable future access,
to ensure that you are in line with federal and state laws and statutes, and dispose of
client records and other sensitive materials in a manner that protects client confidentiality.
You need to 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.
You must also take reasonable precautions to protect your client confidentiality in
the event that you are terminated from practice, incapacity, or death.
Always appoint a records custodian when identified as appropriate.
7.
Case Consultation
When information is shared in a consulting
relationship it needs to be discussed for professional purposes only.
Written and oral reports present only data relevant to the purpose of the consultation,
and every effort needs to be made to protect client identity and to avoid undue invasion of privacy.
If and when you are consulting with colleagues, you must 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 with; unless they have obtained the prior
consent of the person or organization, or the disclosure cannot be avoided.
In such a case, disclose tinformation only to the extent necessary to achieve the purposes
of the consultation.
While upholding confidentiality is not the only avenue to build trust with you client,
it is an important one, and one that should never be breached.
You should familiarize yourself with the ACA Code of Ethics confidentiality section.
I hope this video was helpful.
To watch more of our counseling videos be sure to head over to our channel.
See you next time!