therapist may have a legal obligation to inform parents but a moral obligation to protect the client’s privacy (Adam, 2012). In this case, if the parent initialed or signed consent to allow the teen to be in the treatment room alone with the therapist, there would be a case for allowing those conversations to remain confidential. On the other hand, the client is still legally a minor so depending upon the state of practice, there may be an obligation to inform the parent. States vary considerably on the age that requires consent of the parents concerning reproductive issues so the therapist would need to consult state law and other resources such as employer or agency policy. In some states the 17 year old’s communication would be protected by privacy and confidentiality law. The therapist was not obligated to accompany the client when confronting the parents about her situation. Because the parent immediately called the manager, it may be important to work on strengthening the lines of communication with the parents as well as a need to reset boundaries if this client continues to see this therapist in the future. Professionalism, Standard II: Legal and Ethical Requirements, Standard III: Confidentiality, and Standard V: Roles and Boundaries. information, is subject to the HIPAA Privacy rules and the therapist’s professional standards and code of ethics. The therapist is bound to safeguard all information from the medical record to preserve the patient’s privacy from exposure to anyone even office staff. The receptionist had no need or right to know anything about the client’s condition because she was not treating him or consulting on the case as a treating professional. Also her role as receptionist did not include the transmission of information to other healthcare professionals or insurance companies as that role is assigned to another staff member. Her role did not provide her with the right to access any information contained in the medical record. In this case, the client’s right to privacy and confidentiality concerning medical information was breach because only the therapist had the right to know that information. He had the ethical obligation to protect it from all others not directly involved in his care or financial/insurance reimbursement. Review Standard I on Professionalism and Standard III: Confidentiality. a responsibility to report it. They should contact their state board, and the certifying organization including NCBTMB, AMTA, or ABMP. Revocation A Certificant’s certification has been revoked and that person is no longer certified. A revocation may be: 1. Permanent, meaning that the person may not sit for a certification exam in the future. 2. Non-permanent, meaning that the person may sit for a certification exam again at some designated time in the future. The former Certificant may not: 1. Advertise using their credential or any NCBTMB logo 2. Use their certificate in any other way to promote their practice, or 3. In any way hold themselves out to be certified by NCBTMB.
in practice when they must balance the confidentiality, their fiduciary role, and client rights. The pregnant teenager, even as a minor has certain mandated privileges, according to state and federal law that entitle her to a variety of medical care services without the consent or even the knowledge of her parents (Adam, 2012). Here are some questions to consider: ● How does the therapist resolve conflicts between the parent’s values and rights and those of their minor child? ● What does it mean to respect the family’s values? ● What harm may come to the child as a result of disrupting a stable system of social support provided by the family? ● What does an individual do if he or she, as the therapist, has a conflict with the course of action chosen by a patient or a parent or, on the other hand, if the employer has a conflict with the course of action the therapist deems appropriate? (Adam, 2012) The therapist’s fiduciary responsibility consists of transparent competent care that is free of coercion. In this case, the professional duty to the client for confidentiality was in potential conflict with the duty to tell the parent the information given during treatment. Depending upon the conditions of the consent form, the Case study 9 A massage therapist and his receptionist were working in a small private massage and bodywork practice in an upscale community. The therapist recently began treating a major television celebrity who had a stained back due to an injury from playing golf. The receptionist asked if the client was Mr. ___, who was the star of a TV show and the therapist supplied his name and acknowledged he was the star of that show. The two discussed the fact that they were treating this star and began talking about the nature and severity of his injury. The receptionist asked how severe the injury was and how long he might continue sessions at the office. The therapist revealed that the diagnostic tests, including an MRI, indicated a moderate to severe injury that might require surgery so he would probably be visiting the office for a long duration. The two felt that it was permissible to discuss this client’s condition because there was no one else in the office to hear them. Analysis Regardless of whether or not there was anyone in the office, the therapist acted unethically and breached the confidentiality rights of the client in this case. All information related to the client’s medical file, including identifying Reporting misconduct Many states require a “duty to report” by their licensees. If therapists believe they have first-hand knowledge of another practitioner acting unethically or illegally, they have Sanctions for unethical behavior The following information is from the NCBTMB website and listed on the reference page (NCBMTB, 2016c): DISCIPLINARY ACTIONS Certificant violations of ethics & standards NCBTMB takes its role in serving the public’s trust very seriously. In accordance with the rules and procedures regarding ethical and professional disciplinary complaints, NCBTMB publishes sanctions imposed on certificants found to be in violation of the Code of Ethics and/or Standards of Practice.
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