Privacy and Confidentiality
The obligation of psychologists to protect clients from unauthorized disclosure of information revealed in the context of the professional relationship
What is confidentiality?
The Court appoints a psychologist to evaluate a patient in order to provide a defense attorney with information.
What is an example of an exception to privilege?
A minor of any age seeking services related to pregnancy or sexual assault, and someone seeking mental health care that is over 12 and mature enough to participate.
What are examples of persons that can consent to medical care?
A person who due to mental disorder is a danger to self, others, or is gravely disabled, or they are a danger to self-suicidal intent, or they have an inability to provide one's food, clothing, shelter.
What are examples of reasons for a 72-hour hold (5150; 5585)?
“Serious emotional damage”
What is something that you may but are not required to report?
Access may be denied when the psychologist believes that providing the information is reasonably likely to endanger the physical safety of the client or other person and the client is given the right to have the denial reviewed.
What is HIPPA's justification for denying a patient access to medical records?
A lawyer initiates a hearing to determine a patient's competence to stand trial.
A patient requests a proceeding to determine his or her sanity.
The Board of Prisons appoints a psychologist to examine a patient.
What are some examples that are not an exception to privilege?
a) not more than 6 months or fine not exceeding $1000
b) Multiple acts in violation or exploitation not more than 6 months or fine not exceeding $1000
c) Acts with two or more victims punishable by imprisonment in state prison for a period of 16 months, 2 or 3 years, fine not exceeding $10,000; or imprisonment not more than 1 year or fine not exceeding $1000 or both
d) two or more acts with a single victim when the offender has at least one prior conviction, 16 months prison, 2 or 3 years, fine not exceeding $10,000
What are the criminal liabilities (sexual misconduct) penalties for a psychologist?
After 72hrs they remain danger to self, others, or gravely disabled, and they have been advised of need and seek voluntary treatment but has refused.
When can a person can be certified for 14 days of intensive treatment?
This is similar to 5150 but applies to individuals who are impaired as a result of alcohol or drug use.
What is a 5230 hold?
This can be done when the information will be used for routine treatment, payment, and health care operations purposes.
When does HIPPA allow you to disclose information without a patient's consent?
Regarding privilege, the patient's therapist, when authorized by the patient.
Who is someone that cannot be the holder of privilege?
This is the length of time that must pass following termination of therapy before a psychologist can have sexual contact with a patient they provided therapy for.
What is 2 years following the termination of therapy?
A person is entitled to this within 4 days of the date of certification after a 14 day hold.
What is a certification review hearing?
California law protects physicians and surgeons from criminal/civil when they notify the spouse, sexual partners, or needle-sharing partners, but no legislation exists for psychotherapists for this specific instance.
What is HIV and the duty to protect?
A patient directly communicates to his psychologist an imminent threat of violence against his boss. The therapist opts to maintain the patient's confidentiality.
The patient's legal guardian, when the patient does not want the guardian to hold privilege.
The patient's representative.
An unemancipated minor.
Who are all people that can be a holder of privilege?
These are examples of age differences in which sexual abuse between minors must be reported.
What is, when a minor under 18 years when they have a reasonable suspicion that the activity was not consensual, even when the minor claims it was consensual and regardless of the partners age. When minor is under 14 years of age and partner is 14 years or older, when the minor is 14 years of age and partner is 24 years of age or older, when the minor is 15 years of age and the partner is 25 years of age or older?
This established a “duty to warn” the intended victim, in the rehearing it was changed to “duty to protect” the intended victim by warning them, the police, or other reasonably necessary steps. CA adopted immunity statue designed to protect therapists from monetary liability if patient communicates serious threat of physical violence.
What is the Tarasoff decision?
Someone other than the client is the dangerous party, someone other than family member reports the client has threatened to harm someone, there is no reasonably identifiable victim, or the client threatens suicide.
What are situations in which the duty to protect does not apply?
A father brings his six-year-old daughter to you for testing. The parents are divorced, and while they share legal custody, the father has primary physical custody. You diagnose the child with autism spectrum disorder. The girl's mother requests a copy of the testing report.
What is an example in which you should release a summary of the testing report, or the full report only if they insist?
It authorizes the disclosure of privileged information in a legal proceeding if the information is necessary to prevent the danger presented by the patient to himself or herself, others, or property.
It is to prevent not only ANY danger, but to PREVENT the patient from danger to self, other, or property
What does Evidence Code 1024 specifically authorize a mental health provider to do?
An emancipated minor seeking mental health treatment.
Who is someone under 18 that can consent to their own treatment?
This expanded the patient’s communication in a duty to protect, to include patient’s immediate family members.
What is Ewing v Goldstein (2004)?
This is an exception to therapist-patient privilege when client poses danger to self, others, property of others. Disclosure may be disclosed if the therapist, in good faith, believes the disclosure is necessary to prevent or lessen a serious and imminent threat of safety to foreseeable victim(s).
What is the Confidentiality of medical information act (CMIA)?