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4.01 Maintaining Confidentiality Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship.
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Unit 4 Seminar
Key TermsConfidentialityPrivileged communicationPrivacy
4.01 Maintaining ConfidentialityPsychologists have a primary obligation and
take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship.
4.02 Discussing the Limits of Confidentiality(a) Psychologists discuss with persons
(including, to the extent feasible, persons who are legally incapable of giving informed consent and their legal representatives) and organizations with whom they establish a scientific or professional relationship (1) the relevant limits of confidentiality and (2) the foreseeable uses of the information generated through their psychological activities. (See also Standard 3.10, Informed Consent.)
(excerpt)
◦When clerical assistants handle confidential information
◦When counselor consults◦When counselor is being supervised◦When client has given consent◦When client poses danger to self or others◦When client discloses intention to commit a crime◦When counselor suspects abuse or neglect of a
child or vulnerable adult◦When a court orders counselor to make records
available
Identify clients who are likely to do physical harm to third parties
Protect third parties from clients judged potentially to be dangerous
Treat those clients who are dangerous to themselves
Failing to diagnose or predict dangerousness
Failing to warn potential victims of violent behavior
Failing to commit dangerous individuals Prematurely discharging dangerous
clients from a hospital
Get informed consent Plan ahead through consultation Develop contingency plans Obtain professional liability insurance Involve the client Obtain a detailed history Document in writing Implement procedures to warn
Take direct verbal warnings seriously Pay attention to previous suicide
attempts Identify clients suffering from depression Be alert for feelings of hopelessness and
helplessness Monitor severe anxiety and panic
attacks Determine whether individual has a plan
Identify clients who have a history of severe alcohol or drug abuse
Be alert to client behaviors (e.g. giving prized possessions away, finalizing business affairs, or revising wills)
Determine history of psychiatric treatment
Sufficient factual grounds for high risk of harm to third party
Third party is at risk of death or substantial bodily harm
Harm to the third party is not likely to be prevented unless counselor makes disclosure
Third party cannot reasonably be expected to foresee or comprehend high risk of harm to self
All limits to confidentiality should be discussed with the client at the outset of treatment
Therapists must be aware of state laws regarding their professional interactions with HIV-positive clients
Therapists need to keep current with regard to relevant medical information
Therapists need to know which sexual practices are safe
Abandoning a client Sexual misconduct Breaking confidentiality inappropriately Failing to respect a client's privacy Failing to protect others from a dangerous
client Practicing beyond one's competence Failing to honor a contract with a client Failing to provide for informed consent
Make use of informed consent procedures
Define clear contracts with clients Do not practice outside of your competence
Take steps to maintain your competence
Document carefully Know and follow state and local laws
Know and follow the codes of ethics Respect confidentiality Report any cases of suspected child abuse Carefully consider bartering arrangements Keep relationships with clients professional Avoid engaging in sexual relationships with
clients Treat your clients with respect Obtain parental consent when working
with minors
Make use of assessment procedures Make it a practice to consult with
colleagues Keep current client records Avoid promising clients anything you
cannot deliver Anchor your practice to a theory Abide by the policies of the institution
that employs you
Ethical decision-making model:1. Identify the problem or dilemma2. Identify the potential issues involved3. Apply the ethics codes4. Know the applicable laws and regulations5. Obtain consultation6. Consider possible and probable courses of action7. Explore the consequences of various decisions8. Decide on the course of action
Ethics Codes On Confidentiality In Psychotherapy and Counseling
By Jeffrey Barnett, Psy.D., and Ofer Zur, Ph.D. ◦ http://www.zurinstitute.com/ethicsofconfidentiality.html
Privacy and confidentiality in school counseling - Special issue: legal and ethical issues in school counseling
◦ http://findarticles.com/p/articles/mi_m0KOC/is_1_6/ai_93700936/
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