● In the context of couple, family, or group counseling, the counselor shall not reveal any individual client’s confidences to others without the prior written permission of that individual.
The NBCC 2023 Standards include the following directives: ● Counselors shall clearly identify in writing the primary client in the record. ● Counselors will also identify in the record those individuals who are receiving related professional services in connection with such client relationship.
Confidentiality Laws with Minors or Incapacitated Clients Federal and state laws mandate the reporting of suspected child abuse or neglect. Additionally, statutes require the protection of others who may not have the ability to protect themselves, such as elderly individuals or those who are residing in institutions. Counselors and therapists who work with these clients are mandated reporters and must study applicable state laws that detail procedures for reporting abuse, including the required time limits, representatives to contact and their phone numbers.
giving informed consent. As appropriate, the counselor shall collaborate with the parent(s) or legal guardian, discussing the role of counseling, the confidential nature of the counseling relationship, and the autonomy of the client as required by the NBCC Code of Ethics, State and Federal law, and other applicable ethical standards. When working with minors or incapacitated adults who are legally incapable of giving informed consent, the counselor shall consider the custody agreement, power of attorney document, or legal agreement that may impact the rights of a parent or legal guardian.
Counselors and therapists must provide informed consent to minor or incapacitated clients as well. They must also take care to discuss the rules of confidentiality at their clients’ developmental or cognitive levels. The language used must be appropriate so that clients will understand that there are times when parents, guardians, or other officials must be notified concerning the information that they share. The NBCC 2023 Code of Ethics contains the following standards in this area: ● Counselors working with minors, incapacitated adults, or other persons unable to give legal consent to release confidential and privileged information, shall protect the confidentiality of information received in the counseling relationship as specified by Federal and State laws, written policies, and applicable ethical standards. In all cases, the counselor shall discuss with the client and their legal representative the limits of confidentiality and the rules concerning the release of any information. ● Counselors respect and honor the inherent and legal rights of the parents and legal guardians of minors and incapacitated adults who are legally incapable of Duty to Warn The confidentiality requirement of nondisclosure does not apply when imminent danger to the client or others exists. This duty to warn was a result of the Tarasoff case in California and has been added to many states’’ laws across the nation. The laws may vary across the states concerning the therapist’s obligation to warn and include such terms as: ● Whether the practitioner “must” warn of imminent danger or “may” warn of imminent danger. ● What constitutes a serious, foreseeable, and imminent danger? ● Which individuals must be given a warning of imminent danger and when? ● What circumstances warrant the therapist’s obligation to warn of imminent danger? ● Must the practitioner need to have firsthand information of the danger, or can a credible source inform them? ● Who is a credible source? ● What is the practitioner’s assessment of danger conflicts with opinions from medical or law enforcement personnel? ● Is the practitioner legally accountable if they issue a warning and danger was not imminent? It is imperative that any counselor or therapist confronted with a potential duty to warn situation seeks legal consultation for the best course of action. The ACA’s general requirement that counselors keep information confidential does not apply when:
The practitioner should have expertise in working with these clients and should be competent in communication with them. A statement should be included in the plan of service that indicates (1) what was told to the client, and (2) that the practitioner took steps to inform them of disclosure in the following situations: ● If they report they are being abused; ● If they say they plan to hurt themselves; and ● If they say they plan to hurt others. If the practitioner believes any of the three indicators of harm are credible, the practitioner must follow the appropriate steps to report abuse or neglect and to warn others if the threat is deemed a serious one. The rules that govern the actions to take in these cases vary from state to state; therefore, the practitioners must follow the mandates within their jurisdictions of practice and licensure, as well as the code of ethics. Case studies and additional considerations will be covered in subsequent sections. ● Disclosure is required to protect clients or identified individuals from serious and foreseeable harm; ● Legal requirements demand that confidential information must be revealed; ● The counselor is in doubt as to the validity of the exception and must consult with other professionals; and when ● Additional considerations apply to address end-of-life and child welfare issues (ACA, 2014). The foregoing statements are addressed in detail in the ACA Code of Ethics, which must be studied in its entirety to understand the complexities of confidentiality between the client and the counselor. The NBCC 2023 Code of Ethics provides the following standards: ● Counselors shall take proactive measures to avoid harming their clients and avoid imposing personal values on those who receive their professional services. Counselors will seek to minimize unavoidable or unanticipated harm, and where possible seek to address unintentional harm. ● Counselors shall not share client information that is obtained through the counseling process without specific written consent by the client or legal guardian except when necessary to prevent serious and foreseeable harm to the client or others, or when otherwise mandated by federal or state law or regulation.
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Book Code: PCUS1525
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