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Privacy and Confidentiality in the Therapeutic Relationship

Section 4
Protecting Victims of Violent Patients while Protecting Confidentiality

Question 4 | Test | Table of Contents

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The correct answer, of course, is B, care is taken to determine the information's validity. The duty to warn, as I’ve just mentioned known as the Tarasoff Decision, overrides the client's right to give consent.

Answer C, the client was instructed earlier about the limits of confidentiality, is false because the duty to warn applies even if the client was not previously instructed about it. C describes what would be a good practice, but it's not required.

Answer B, however, is required. It would be destructive to violate a client's confidentiality and raise the anxiety of a presumed threatened third party on the basis of invalid information.

Let’s look at Answer D, the client has a serious and persistent mental illness, now this answer is incorrec because the duty to warn applies to persons with any diagnosis or even no diagnosis at all.

♦ Ethical Issues of Child Abuse and Confidentiality

Section 4 deals with the ethical issues and the conflict that arises related to child abuse and confidentiality.

Abuse of children, no doubt, is one of the greatest social maladies of our times. And current statistics, although staggering, may reflect only the surface of the problem as you are well aware.

Human services professionals -- including psychologists, social workers, marriage and family therapists, mental health counselors, teachers, and psychologists -- are required by law, as you know, to report suspected child mistreatment or child abuse.

Let’s begin this section with a question to stimulate your thinking.

- Rothstein, M. A. (2014). Tarasoff Duties after Newtown. Journal of Law, Medicine & Ethics, 42(1), 104-109.
- Administration for Children & Families. (august 2014). Confidentiality Toolkit. U.S. Department of Health & Human Services, 1-129.
Reviewed 2023

Peer-Reviewed Journal Article References:
Bersoff, D. N. (2014). Protecting victims of violent patients while protecting confidentiality. American Psychologist, 69(5), 461–467.

Hudgins, C., Rose, S., Fifield, P. Y., & Arnault, S. (2013). Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care. Families, Systems, & Health, 31(1), 9–19.

Karnani, S. R., & Zelman, D. C. (2019). Measurement of emotional blackmail in couple relationships in Hong Kong. Couple and Family Psychology: Research and Practice, 8(3), 165–180.

Mimran, M. (2020). Review of flirting with death: Psychoanalysts consider mortality [Review of the book Flirting with death: Psychoanalysts consider mortality, by C. Masur, Eds.]. Psychoanalytic Psychology, 37(3), 259–261.

Mrkva, K., Cole, J. C., & Van Boven, L. (2021). Attention increases environmental risk perception. Journal of Experimental Psychology: General, 150(1), 83–102.

Nielsen, B. A. (2015). Confidentiality and electronic health records: Keeping up with advances in technology and expectations for access. Clinical Practice in Pediatric Psychology, 3(2), 175–178.

QUESTION 4
You are about to finish a session with Helen the mother and Jodie the daughter. You feel Helen has pent up hostilities towards her daughter. You notice as Jodie reaches for her school bag to leave, her sleeve pulls up to reveal a cut and a large bruise on her arm. The first thing you should do would be:
a. contact Child Protective Services about the possibility of abuse
b. ask Helen how the injury happened
c. wait until the next session to discuss the situation
d. ask the child in private how the cut and bruise happened
To select and enter your answer go to Test.

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