Challenges Related to Confidentiality

Maintaining client confidentiality might be assumed in counseling; however, in actual practice, providing confidentiality may be more challenging than it initially appears. Certain restrictions apply to maintaining confidentiality in specific cases. For example, counselors working with a group, families, or minors cannot assure their clients’ absolute confidentiality. Understanding when confidentiality applies in the counseling profession is a challenging yet essential requirement for delivering ethical counseling services. These challenges could range from the straightforward (e.g., office administration issues such as case notes and client files, sharing information with other behavioral health professionals) to the more complicated (e.g., mandated reporting, court ordered disclosure, responding to subpoenas, exceptions to confidentiality).

For this Discussion, review the media, Clinical Mental Health Counseling: Confidentiality, and consider the ethical decision-making model for addressing challenges to confidentiality. Use the Case Study Analysis Worksheet located in the Learning Resources for week two. Review the confidentiality issues in the ACA Ethical Standards Casebook and consider how to address challenges in adhering to critical elements in counseling practice.

Post by Day 3 any insights gained about confidentiality or the challenges to confidentiality based upon the Faculty Interviews. Then, provide a brief description of two key confidentiality issues from this week’s case studies in the ACA Ethical Standards Casebook. Explain why you consider these issues to be critical elements in a counseling practice. Then, explain two challenges you might face as you adhere to these elements in day-to-day practice and explain how you might address them.

Be sure to use the Learning Resources and the current literature to support your response.

Respond by Day 5 and provide a different perspective on how you might address challenges to critical elements in day-to-day practice that your colleague discussed.

Required Resources

Note: To access this week's required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Readings

• Herlihy, B., & Corey, G. (2015). ACA ethical standards casebook (7th ed.). Alexandria, VA: American Counseling Association.
  • Chapter 1, “Client Rights and Informed Consent”  (pp. 143–153)
  • Chapter 3, “Confidentiality” (pp. 169–182)
• Remley, T. P., Jr., & Herlihy, B. (2016). Ethical, legal, and professional issues in counseling (5th ed.). Upper Saddle River, NJ: Pearson.
  • Chapter 5, “Confidentiality and Privileged Communication” (pp. 106–129)
• McHale, J. V. (2009). Patient confidentiality and mental health: Part 1. British Journal of Nursing (BJN), 18(15), 944–945.
  
  Retrieved from the Walden Library databases.

• McHale, J. V. (2009). Patient confidentiality and mental health. Part 2: Dilemmas of disclosure. British Journal of Nursing (BJN), 18(16), 996–997.
  
  Retrieved from the Walden Library databases.

• Simone, S., & Fulero, S. M. (2005). Tarasoff and the duty to protect. Journal of Aggression, Maltreatment & Trauma, 11(1/2), 145–168.
  
  Retrieved from the Walden Library databases.

Case Studies

• Herlihy, B., & Corey, G. (2015). ACA ethical standards casebook (7th ed.). Alexandria, VA: American Counseling Association.
  • “Case Study 1: Keep Kendra's Secret, or Not?” (pp. 147)
  • “Case Study 5: The Slap - How to Best Help Hope” (pp. 169)
  • “Case Study 6: A Supervisee Feels Betrayed” (pp. 179)

Media

• Laureate Education, Inc. (Executive Producer). (2012). Clinical mental health counseling: Confidentiality [Video]. Baltimore, MD: Author.
  
  
  
  Note: The approximate length of this media piece is 2 minutes.
   

  Accessible player --Downloads--Download Video w/CCDownload AudioDownload Transcript
• Laureate Education, Inc. (Executive Producer). (2012). Tarasoff. Baltimore, MD: Author.

Optional Resources

• Gray, B., Robinson, C., Seddon, D., & Roberts, A. (2008). “Confidentiality smokescreens” and carers for people with mental health problems: The perspectives of professionals. Health & Social Care in the Community, 16(4), 378–387.
  
  Retrieved from the Walden Library databases.

• Lorence, D. P. (2004). Confidentiality measures in mental health delivery settings: Report of US health information managers. Journal of Behavioral Health Services & Research, 31(2), 199–207.
  
  Retrieved from the Walden Library databases.

• McCurdy, K. G., & Murray, K. C. (2003, October). Confidentiality issues when minor children disclose family secrets in family counseling. The Family Journal, 11(4), 393–398. 
  
  Retrieved from the Walden Library databases.