environment that will encourage participation and protect student disclosure of information. These should include strategies to address nonjudgement and appropriate speech, respect of all members, brainstorming skills and listening skills, equal time to speak, and issues surrounding social media including requiring social media/tech free zones. Above all, every attempt to obtain a commitment from participants to keep the sessions confidential is critical. Know the unique needs of the students to identify those who will benefit from the group process and those who could potentially be harmed. Plan topics and strategies to monitor, redirect, or terminate sessions that become nonproductive or negative. Remember, there is no way to guarantee confidentiality with any client, but especially with minors, and statements made in the group may be taken out of context, misrepresented, or expanded if they are shared throughout the school, home, or community. Be prepared to handle those situations and share any potential repercussions with supervisors or administrators so they are prepared. The ASCA (2022) provides the following standards for ethical practice to address some potential conflicts when conducting groups related to informed consent, confidentiality, disclosure, and protecting students: A.7. Group Work School counselors: a. Offer culturally sustaining small-group counseling services based on individual student, school, and community needs; student data; a referral process; and/ or other relevant data. Case Study 1: Confidentiality Sue is a seven-year-old who began having social and academic problems in school. Her parents decided to consult a licensed NCC counselor with a specialty in working with children. The counselor met with Sue and her parents and began counseling sessions with Sue. The counselor learned that Sue’s grandmother had recently passed away and her parents were having marital difficulties and had began a trial separation. The counselor conducted a family and developmental history, reviewed school records, and found that Sue had recently been referred to the school psychologist for a battery of cognitive processing tests, along with emotional and behavioral assessments, to determine eligibility for special education classes. A few weeks into counseling, the counselor received an official request form from the school administrator and signed by the parents for “all information that might inform special education eligibility process.” The counselor discussed the request with the parents and obtained a signed consent from the parents to release information and communicate with the school. She responded only in general terms, noting that she was counseling Sue for issues related to a family matter that were being addressed and Sue was making progress based on the counselor’s ongoing assessments. Discussion Did the counselor act appropriately? The counselor decided that an in-depth discussion of the family issues and stressors that may have led to Sue’s difficulty at school was not relevant to the special education eligibility or planning
b. Provide equitable access to participation in groups, including alleviating physical, language, and other obstacles. c. Assess student needs to determine if participating in the group is appropriate for the student. d. Inform parents/guardians of student participation in and the purpose of the small group. e. Facilitate short-term groups to address students’ academic achievement, postsecondary and career exploration, and social/emotional well-being. f. Use data to inform group topics, establish well-defined expectations and measure the outcomes of group participation. g. Reflect on group outcomes and determine adjustments that may improve future group interventions. h. Communicate the aspiration of confidentiality as a group norm, while recognizing and working from the protective posture that confidentiality for students in small groups cannot be guaranteed. i. Select topics for groups with the clear understanding that some topics are not suitable for groups in schools (e.g., incest survivorship, eating disorders, dating violence) and accordingly take precautions to protect members from harm as a result of interactions with the group. j. Facilitate culturally sustaining groups from the framework of evidence-based or research-based practices. k. Practice within their competence level and develop professional competence through training and supervision. a. Provide necessary follow-up and/or referrals to additional resources for group members. process. The school’s global, general request should have been narrowed to request only information pertinent to the eligibility process. Sue’s response followed the “minimum necessary rule” (see subsequent discussion). The counselor responded in general terms, protecting the student’s confidentiality, and was not obligated to disclose more records due to the lack of court mandate or any duty to warn. The counselor’s decision was also informed by the fact that the school psychologist was conducting a battery of tests that would yield specific information to assist in the eligibility and planning process. The counselor’s notes were not essential for the eligibility process, and there was no serious psychological impairment noted by the counselor in Sue’s case. A review of the Texas statute defers to HIPAA Privacy Rule on Minimum Necessary Requirement (HHS, 2016a); 45 CFR 164.502(b), 164.514(d), indicate the counselor was correct in responding in limited, general terms to the school’s global request for “all information” and sharing only minimal information. The ACA provides additional support in this case. According to the ACA Code of Ethics (2014): B.2.e. Minimal Disclosure To the extent possible, clients are informed before confidential information is disclosed and are involved in the disclosure decision-making process. When circumstances require the disclosure of confidential information, only essential information is revealed.
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Book Code: PCTX1325
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