the jurisdiction. Some courts will deny privilege to allow every piece of information to be reviewed to make the best possible custody decision. Some courts will strictly adhere to rulings of privilege. The courts will have to resolve any conflicts that may result based on these two positions and the circumstances of each case. ● In cases of custody disputes, the mental health of one or both parents and the effects that this may have on the child may come into question. The court will decide based on the particular evidence regarding the mental health of the parents or the child. Again, states vary on their positions of privilege in these cases depending on the severity of the mental health issues of the parents or child. Today, states recognize privilege in the relationships of clients and mental health practitioners. Counselors and therapists should consult state statutes or case law in the state of their licensure and/or jurisdiction of practice to be familiar with the concept of privilege in their state. Case Study: Court Access to Records J. D. is a licensed MFT who found herself in an ethical dilemma when faced with a court order to release certain client records from her files. J. D. refused to release treatment notes as ordered by the courts as part of a custody dispute involving a young client. She believed that there were two exceptions to the confidentiality and client privilege, including knowledge of child abuse or if the client threatens suicide or homicide. J. D. stated that the notes were sometimes just phrases of her interpretations, thoughts, and topics to refresh her memory and would not be understood by anyone but herself. She believed that it was unethical to disclose her notes and decided to provide only a general summary. The attorney brought the summary to the judge who issued an order for the complete set of notes, but J. D. decided to defy the court order. J. D. was arrested and fined $2,000 on a contempt charge, which cost her $900 in bail in lieu of being incarcerated. In the end, J. D. decided to disclose the notes to the court. Analysis J. D.’s personal views and her misinterpretation of the AAMFT’s Code of Ethics point to a lack of understanding in many areas. Here are the key features: ● If J.D. had referred to the Code, she would know that she was wrong to defy the courts in this case. ● She made a mistake by not seeking assistance from other professionals or her administrator when faced with a situation as serious as a court order in a child custody the Privacy Rule to implement the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Privacy Rule standards address the use and disclosure of individuals’ health information called “protected health information” by organizations under the Privacy Rule called “covered entities.” According to the Privacy Rule, as well as all of the Administrative Simplification rules, the term “covered entities” applies to health plans, health care clearinghouses, and to any healthcare provider who transmits health information in electronic form in connection with services or transactions. HIPAA also includes standards for individuals’ privacy rights to understand and control how their health information is used. A major goal of the Privacy Rule is to ensure that
case. In fact, she viewed her own opinion, not based on sound decisions following the code, as more significant than the opinion of the court. ● She was not focusing on the best interest of her client by delaying the case and refusing to turn over her notes to inform the court’s decision. The delay added to the stress and fear felt by her young client, who was unable to give consent or waive the obligation of confidentiality to disclose the notes. ● If a subpoena duces tecum, or subpoena for production of evidence, is issued that requests all files documents, notes, reports, photographs, and recordings in any form, it is clear that case notes are part of that request. The subpoena in this case would have a release signed by the parent in cases with a minor child. ● A court order is issued as the result of a hearing before a judge and demands a set of records be disclosed and delivered to the court representative, unless there is an appeal to a higher court. It is the court, not the practitioner, which will ultimately decide what qualifies as protected information. If the therapist is ordered to testify and the client requests that the therapist should not disclose privileged information, the therapist may explain to the court the possible harm to the therapeutic relationship if a disclosure is made. If the judge requires the therapist to testify, they should disclose only the information related to the request. Under court order, the counselor or therapist is not in violation of privacy rules or privilege because they are complying with the judge’s order. The court order is defense against any charge of ethical wrongdoing if the counselor is later sued over a breach of confidentiality. Self-Assessment Question 6 A dual relationship exists when a mental health practitioner: a. Is counseling a person that they have a physical or emotional relationship with outside of the office. b. Is in a counseling relationship at the same time that they are in a relationship with the client outside of counseling. c. Is receiving a benefit that may be monetary, sexual, or service related but does not harm the client. d. Enters into a relationship with the probability of an ethical violation. individuals’ health information is properly protected while allowing sharing of health information to provide high- quality health care and to protect public health. Therapists and counselors must adhere to directives of the HIPAA Privacy Rules that apply to all healthcare providers. The rule permits the use of information, while protecting the privacy of people who seek care and treatment. Psychotherapy notes are treated in a different way from other records under the HIPAA Privacy Rule. According to HIPAA: “Psychotherapy notes” means notes recorded, in any medium, by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring,
Summary of the Health Insurance Portability Accountability Act (HIPAA) Privacy Rule The Standards for Privacy of Individually Identifiable Health Information established a set of national standards for the protection of certain health information. The U.S. HH) issued
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