B.1.d. Explanation of Limitations At initiation and throughout the counseling process, counselors inform clients of the limitations of confidentiality and seek to identify situations in which confidentiality must be breached. B.2. Exceptions B.2.a. Serious and Foreseeable Harm and Legal Requirements 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 or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues. B.2.b. Confidentiality Regarding End-of-Life Decisions Counselors who provide services to terminally ill individuals who are considering hastening their own deaths have the option to maintain confidentiality, depending on applicable laws and the specific circumstances of the situation and after seeking consultation or supervision from appropriate professional and legal parties. * * Note: Euthanasia is not legal in Texas. See TAC Health and Human Services, Title 26, Rule §558.834 Hospice Counseling Services (Texas, 2021b). B.2.c. Contagious, Life-Threatening Diseases When clients disclose that 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 the parties are known to be at serious and foreseeable risk of contracting the disease. Prior to making a disclosure, counselors assess the intent of clients to inform the third parties about their disease or to engage in any behaviors that may be harmful to an identifiable third party. Counselors adhere to relevant state laws concerning disclosure about disease status. B.2.d. Court-Ordered Disclosure When ordered by a court to release confidential or privileged information without a client’s permission, counselors seek to obtain written, informed consent from the client or take steps to prohibit the disclosure or have it limited as narrowly as possible because of potential harm to
including employees, supervisees, students, clerical assistants, and volunteers. B.3.b. Interdisciplinary Teams When services provided to the client involve participation by an interdisciplinary or treatment team, the client will be informed of the team’s existence and composition, information being shared, and the purposes of sharing such information. B.3.c. Confidential Settings Counselors discuss confidential information only in settings in which they can reasonably ensure client privacy. B.3.d. Third-Party Payers Counselors disclose information to third-party payers only when clients have authorized such disclosure. B.5. Clients Lacking Capacity to Give Informed Consent B.5. a. Responsibility to Clients When counseling minor clients or adult clients who lack the capacity to give voluntary, informed consent, counselors protect the confidentiality of information received, in any medium, in the counseling relationship as specified by federal and state laws, written policies, and applicable ethical standards. B.6.e. Client Access Counselors provide reasonable access to records and copies of records when requested by competent clients. Counselors limit the access of clients to their records, or portions of their records, only when there is compelling evidence that such access would cause harm to the client. Counselors document the request of clients and the rationale for withholding some or all the records in the files of clients. In situations involving multiple clients, counselors provide individual clients with only those parts of records that relate directly to them and do not include confidential information related to any other client. B.7.b. Disclosure of Confidential Information When consulting with colleagues, counselors do not disclose confidential information that reasonably could lead to the identification of a client or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization, or the disclosure cannot be avoided. They disclose information only to the extent necessary to achieve the purposes of the consultation. Section D: Relationships with Other Professionals D.1.e. Confidentiality When counselors are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, they clarify role expectations and the parameters of confidentiality with their colleagues. association ethical codes, principles, or value statements. When discrepancies arise, the counselor should follow legal regulations and act within the framework of association code of ethics. Always consult the agency or institution supervisor or administrator or legal counsel in these cases and/or state regulatory representatives. Do not make these decisions alone, and consult only colleagues familiar with state law and the code of ethics for the appropriate association. The ACA Code of Ethics delineates confidentiality procedures that must be followed in group settings, with third-party payers or deceased clients, and when transmitting information. Many of these issues will also be covered in the discussion of HIPAA regulations.
the client or counseling relationship. B.3. Information Shared with Others B.3.a. Subordinates
Counselors make every effort to ensure that privacy and confidentiality of clients are maintained by subordinates,
Discussion The Texas Counseling Association views the ACA Code of Ethics as the foundation for ethical practice. You can see the congruency between the TAC rules for confidentiality and required reporting and the ACA Code of Ethics. The TAC provides specific rules for mandatory ethics regulations in contrast with the ACA Code of Ethics that is aspirational as the framework for ethical counseling practice. The ACA still requires adherence to the Code of Ethics for professional membership in the association, and all counselors have an obligation to report unethical behavior. If a discrepancy is noted between the ACA Code of Ethics and TAC regulations and statutes stated in any legal documents, Texas law always take precedence over any
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Book Code: PCTX1325
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