What is the difference between confidentiality, privileged communication, and privacy?
A hallmark of psychological practice is the privacy and confidentiality that psychologists must observe to protect the well-being of their clients. This session will focus on the intricacies of maintaining confidentiality and when it is required by law to be disclosed.
1. Define confidentiality and its limitations and exceptions.
2. Examine situations where there may be a duty to warn or protect third parties.
3. Introduction to HIPAA
In most situations the law recognizes the psychologist(therapist)/patient relationship. There are exceptions. All states now have rules for reporting child abuse, most have rules for reporting elder abuse. The “Duty to Warn” (from Tarasoff) is often written into the practice act or rules of state psychology licensing boards but not in all jurisdictions. Indeed, there is no duty to warn in some jurisdictions. This is complicated, because if you follow the law a person could be harmed due to your lack of action. While there is no affirmative (must do) requirement to intervene in threat to others, you can assume that you will be found negligent if your patient is actively suicidal and you do nothing.
Privilege relates to the legal protection from being forced to break the expectation of confidentiality. Parents are the holder of privilege for minor children but many jurisdictions allow exceptions for some types of confidences.
Remember, like the attorney or priest, the confidentiality between psychologist and client is “sacred.” It is protected by law and tradition. However, unfortunately, some state laws increasingly infringe on that indispensable element. Thus, psychologists face increasing conflict among their professional ethics, their concern for clients, and their legal obligations.