The Counseling Relationship
Confidentiality, Privileged Communication & Privacy
Grab Bag
Case Studies
100

Counselors act to avoid harming their clients and they are aware of their own values and avoid imposing their values.

What is A.4. Avoiding Harm and Imposing Values

100

Counselors obtain permission from clients prior to observing counseling sessions, reviewing transcripts or viewing recordings of sessions within the training environment.

What is B.6.c. Permission to Observe

100

Avoidance of doing harm, which includes refraining from actions that risk hurting clients.

What is Nonmaleficence

100

Eric has been working at the St Luke’s counseling center for 5 years. He had decided to open his own practice, which will open in few weeks. Eric is distributing his new business cards to his currents clients so that they can continue treatment with him in his new private practice.

What is C.3.d. Recruiting Through Employment 

Counselors do not use their places of employment or institutional affiliation to recruit clients, supervisors, or consultees for their private practices.

200

You discover that your client is seeing another counselor/therapist.

What is request a Release of Information for the other counselor.

Inform the other therapist that you are also working with the client and build a collaborative relationship with that professional so you are not working against each other, and the client is not able to split the two professionals.

200

When subpoenaed to release confidential or privileged information without a client's permission, counselors obtain written, informed consent from the client or take steps to prohibit the disclosure or have it limited as narrowly as possible.

What is B.2.c. Court Ordered Disclosure

200

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.

What is duty to protect

200

Jessica is a clinician at Hope Treatment Center. Her contract will expire in 3 months. She is searching for employment elsewhere and needs some recommendations and testimonies that would help her move on to the next job assignment. Jessica has asked some of her currents clients to write testimonies that would she will send with her employment applications. 

Is this okay? Why or why not?

What is C.3.b. Testimonials 

Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue influence. Counselors discuss with clients the implications of and obtain permission for the use of any testimonial.

300

Counselors screen prospective group members and to the extent possible, make sure that their goals and needs are compatible with the group format.

What is A.8.a Screening

300

To the extent possible, clients are informed before confidential information is disclosed and are involved in the disclosure decision-making process

What is B.2.d Minimal Disclosure

300

What a counselor should do when in doubt about their obligations regarding confidentiality or privileged communications.

What is consultation

300

Two years ago you provided 12 sessions of couples counseling with a client and his wife. There was live supervision during 4 of the 12 sessions. The couple is now divorcing and both of their attorneys have subpoenaed you and the supervisor to testify at the child custody and divorce hearings. How do you respond?

What is don't respond. 

You do not have to respond to a subpoena unless it comes from a judge.

400

Clients have the freedom to choose whether or not to enter into a counseling relationship and they need adequate information about the counseling process and the counselor.

What is A.2.a. Informed Consent

400

When clients disclose they have a disease commonly known to be both communicable and life threatening, counselors may be justified in disclosing information to identifiable third parties, if there is a risk to them of contracting the disease.

What is B.2.b. Contagious, Life-Threatening Diseases

400

Legislation passed by Congress to promote standardization and efficiency in the health care industry and to give patients more rights and control over their health information.

What is the Health Insurance Portability and Accountability Act (HIPAA)

400

Your 50-year-old client was recently killed in an automobile accident. As an LPCC in private practice, you had been seeing her regarding conflicts with her parents and siblings. Her relationship with them was quite contentious, and she had confided very personal information about each family member. Her family approaches you two weeks after the funeral and demands her counseling records. What do you do?

What is protect the confidentiality - even if the client is deceased, be consistent with legal requirements and agency policies by not breaking confidentiality.

500

Counselors understand the challenges of accepting gifts and understand that in some cultures, gifts are token of respect and showing gratitude.

What is A.10.e. Receiving Gifts

500

Counselors do not disclose confidential information that reasonably could lead to the identification of a research participant unless they have obtained the prior consent of the person.

What is B.7.d. Disclosure of Research Information

500

Self-care is..... 

an ethical mandate

500

Kristen is a new, single mother working with her client Jenny who recently got pregnant and is contemplating an abortion. When she talks about this, Kristen avoids eye contact, makes disapproving statements, and continues to provide information about single parent support and abortion services.

What is A.4.b. Personal Values 

Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.