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Section 36
Confidentiality and Risk Avoidance Procedure

Question 36 | Test | Table of Contents

In this section, we will present the "Confidentiality and Risk Avoidance Procedure" your supervisee might consider in order to avoid breaking ethical confidentiality boundaries. This confidentiality procedure includes five steps: Obtain Proper Supervision; Consult Colleagues; Review; Obtain Legal Consultation; and Document Decision-Making Steps.

The 5-Step Confidentiality and Risk Avoidance Procedure

Step 1. Obtain Proper Supervision
I instruct the supervisee once they end the supervision experience, that does not end their need to be supervised. The first step in the Confidentiality Risk Avoidance Procedure is obtaining proper supervision. Supervisors may help supervisee’s decide how best to handle private, confidential, and privileged information concerning minors.

Moreover, supervisees who are sued or named in an ethics complaint can help demonstrate their competent decision-making skills by showing that they sought supervision.

Step 2. Consult Colleagues
The second step in the Confidentiality Risk Avoidance Procedure is consulting colleagues. If your supervisee is uncertain about the handling of private, confidential, and privileged information concerning minors, he or she might consider consulting colleagues who have specialized knowledge or expertise in this subject area.

Supervisees employed in settings that sponsor institutional ethics committees (committees that provide staff with a forum for consultation on difficult ethics cases) should take advantage of this form of consultation. Moreover, supervisees named in ethics complaints and lawsuits can help demonstrate their competent decision making by showing that they sought consultation.

Step 3. Review
In addition to obtaining proper supervision and consulting colleagues, the third step in the Confidentiality and Risk Avoidance Procedure is review. This includes reviewing ethical standards, relevant regulations, laws, and policies, and relevant literature. In regards to ethical standards, your supervisee might consider reviewing with the client the nature of confidentiality and the limitations of client's’ right to confidentiality.

When considering the matter from a legal standpoint, your supervisee might want to consult federal, state, and local laws and their rulings on the sharing of health records. Remember, State laws supercede federal, so to save time, I consult State laws first. If State laws are not clear on the situation, I then consult federal laws, most especially the HIPAA guidelines which can normally clarify most situations.

However, if neither of these levels give specific guidelines, as a last resort, consult the regulations set up by your own agency. To give a quick overview, most states have strict laws and regulations governing the handling of minors' confidential health and mental health records. State laws and regulations vary with respect to obligations to disclose confidential information when there is reason to believe that minors are engaging in self-harming behaviors threaten to harm others, or have a contagious or sexually transmitted disease.

All states require mental health professionals to report suspected abuse or neglect of children. Mental health professionals should consult local statutes, regulations, and child welfare officials to determine whether they are obligated to disclose confidential information to parents, guardians, and child welfare officials, even without the minor client's consent; permitted - but not obligated - to disclose confidential information to parents, guardians, or child welfare officials without the minor's consent; and not permitted to disclose confidential information to parents, guardians, or child welfare officials without the minor client's consent.

You might consider reviewing relevant professional literature with your supervisee, especially pertaining to the proper handling of private, confidential, and privileged information. Reviewing such literature can provide you and your supervisee with useful guidance and also provide compelling evidence that you made a conscientious effort to comply with current standards.

Step 4. Obtain Legal Consultation
The fourth step in the Confidentiality Risk Avoidance Procedure is obtaining legal consultation, if necessary. If you are completely unsure about your ethical and legal duties concerning confidential and privileged information, you may want to consult with a lawyer for an interpretation of relevant statutes, regulations, and case law. By seeking legal advice, you may enhance your ability to argue that you made a "good faith" effort to practice ethically.

Step 5. Document Decision-Making Steps
In addition to obtaining proper supervision, consulting colleagues, reviewing, and obtaining legal consultation, the fifth and final step in the Confidentiality and Risk Avoidance Procedure is documenting decision-making steps. Thorough documentation of the steps taken to handle confidential and privileged information can help protect your supervisee should he or she be named in ethics complaints and lawsuits. Documentation demonstrates your supervisee’s conscientious attempt to handle private, confidential, and privileged information responsibly.

In this section, we presented the Confidentiality and Risk Avoidance Procedure you might consider in order to avoid breaking confidentiality boundaries. This confidentiality procedure includes five steps: Obtain Proper Supervision; Consult Colleagues; Review; Obtain Legal Consultation; and Document Decision-Making Steps.
Reviewed 2023

Peer-Reviewed Journal Article References:
Chenneville, T., & Gabbidon, K. (2020). HIV, confidentiality, and duty to protect: Considerations for psychotherapists in the age of treatment as prevention. Psychotherapy, 57(1), 7–14.

Schatten, H. T., Gaudiano, B. A., Primack, J. M., Arias, S. A., Armey, M. F., Miller, I. W., Epstein-Lubow, G., & Weinstock, L. M. (2020). Monitoring, assessing, and responding to suicide risk in clinical research. Journal of Abnormal Psychology, 129(1), 64–69.

Thompson, S. M. (2020). Responding to inappropriate client sexual behaviors: Perspectives on effective supervision. Journal of Psychotherapy Integration, 30(1), 122–129.

Watkins, C. E., Jr. (2018). The generic model of psychotherapy supervision: An analogized research-informing meta-theory. Journal of Psychotherapy Integration, 28(4), 521–536.

QUESTION 36
What are the 5-Step Confidentiality and Risk Avoidance Procedure?  To select and enter your answer go to Test.


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