Section B
Confidentiality and Privacy
Introduction
Counselors recognize that trust is a cornerstone of the counseling relationship. Counselors aspire to earn the trust of clients by creating an ongoing partnership, establishing and upholding appropriate boundaries, and maintaining confidentiality. Counselors communicate the parameters of confidentiality in a culturally competent manner.
B.1. Respecting Client Rights
B.1.a. Respect for Privacy and Confidentiality
Counselors respect the privacy of prospective and current clients. Counselors request private information from clients only when it is beneficial to the counseling process. Counselors protect confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification.
B.1.b. Multicultural/Diversity Considerations
Counselors maintain awareness and sensitivity regarding cultural meanings of confidentiality and privacy. Counselors respect differing views toward disclosure of information. Counselors hold ongoing discussions with clients as to how, when, and with whom information is to be shared.
B.1.c. Explanation of Limitations
At initiation and throughout the counseling process, counselors inform clients of the limitations of confidentiality and 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 identify 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.
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.
B.2.c. 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 the client or counseling relationship. See Section I. Forensic Practice.
B.2.d. 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.
B.3. Information Shared With Others
B.3.a. Colleagues and Co-Workers
Counselors take steps to ensure that privacy and confidentiality of clients are maintained by colleagues and co-workers, including employees, supervisees, students, clerical assistants, and volunteers.
B.3.b. Confidential Settings
Counselors discuss confidential information only in settings in which they can reasonably ensure client privacy.
B.3.c. Third-Party Payers
Counselors disclose information to third-party payers only when clients have authorized such disclosure or when otherwise permissible by law.
B.3.d. Transmitting Confidential Information
Counselors take appropriate steps to ensure the confidentiality of all information transmitted through the use of any medium.
B.3.e. Deceased Clients
Counselors protect the confidentiality of deceased clients, consistent with legal requirements and the documented preferences of the client and seek legal consultation before releasing records of deceased clients as needed.
B.4. Groups and Families
B.4.a. Group Work
In group work, counselors clearly explain the importance and parameters of confidentiality for the specific group.
B.4.b. Couple, Relationship, and Family Counseling
In couple, relationship, and family counseling, counselors clearly define who is considered “the client” and discuss expectations and limitations of confidentiality. Counselors seek agreement and document in writing such agreement among all involved parties regarding the confidentiality of information. In the absence of an agreement to the contrary, the parties in the relationship are considered to be the client.
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 as specified by federal and state laws, written policies, and applicable ethical standards.
B.5.b. Responsibility to Parents and Legal Guardians
Counselors inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements. Counselors work to establish, as appropriate, collaborative relationships with parents/guardians to best serve clients.
B.5.c. Release of Confidential Information
When counseling minor clients or adult clients who lack the capacity to give voluntary consent to release confidential information, counselors seek permission from an appropriate third party to disclose information and document such permission. In such instances, counselors inform clients consistent with their level of understanding and take appropriate measures to safeguard client confidentiality.
B.5.d. Accessing Records
Counselors only access records of their own clients or with an appropriate need to know and do not access records of any clients without such a need or without appropriately obtained permission.
B.6. Records and Documentation
B.6.a. Creating and Maintaining Confidential Records and Documentation
Counselors create and maintain records and documentation necessary for rendering professional services. Counselors ensure that records and documentation kept in any medium are secure and that only authorized persons have access to them.
B.6.b. Permission to Record
Counselors obtain permission from clients prior to recording sessions.
B.6.c. Permission to Observe
Counselors obtain permission from clients prior to allowing any person to observe counseling sessions, review session transcripts, or view recordings of sessions with supervisors, faculty, peers, or others.
B.6.d. Client Access
Counselors provide reasonable access to records and copies of records when requested by competent clients or authorized designee(s). 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 of 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.6.e. Assistance With Records
When clients request access to their records, counselors provide assistance and consultation in interpreting counseling records.
B.6.f. Disclosure or Transfer
Unless exceptions to confidentiality exist, counselors obtain written permission from clients to disclose or transfer records to legitimate third parties. Counselors inform recipients that counseling records are confidential.
B.6.g. Storage and Disposal After Termination
Counselors store records following termination of services to ensure reasonable future access, maintain records in accordance with federal and state laws and statutes such as licensure laws and policies governing records, and dispose of client records and other sensitive materials in a manner that protects client confidentiality.
B.6.h. Destruction of Records
Before destroying records, counselors consider relevant regulations, laws, and statutes of limitations that may be needed in the future, such as notes on child abuse/neglect, suicide, sexual harassment, or violence.
B.6.i. Reasonable Precautions
Counselors take reasonable precautions to protect client confidentiality in the event of the counselor’s termination of practice, incapacity, or death and appoint a records custodian. Counselors establish a professional will to address potential need for client access to records to which the counselor is unable to respond.
B. 7. Confidentiality in Consultation
B.7.a. Disclosure of Confidential Information
When consulting with colleagues, counselors do not disclose confidential information that could reasonably 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.