Scope and Limits of Confidentiality


Discussion: Scope and Limits of Confidentiality

Group services require some unique ethical considerations. For example, confidentiality presents a number of challenges when working with therapy groups. To be effective, therapy group members need to feel that the therapeutic environment is safe and supportive. Imagine how you might feel if you shared private information in a therapy session and later found out that the information was disclosed outside of the therapy group, or even posted on the Internet. Unfortunately, confidentiality in this form cannot be guaranteed. Savvy pre-group screening, however, may help to identify those who might be at risk for inappropriately disclosing information. A proper pre-group orientation might further help members understand the importance of confidentiality, provide examples of inappropriate disclosure, and explain how to maintain privacy, and the consequences of not doing so.
Another important aspect of confidentiality involves case notes. With an individual client, confidentiality is fairly straightforward. You have a file for the client, and all the information that pertains to the client stays in the file. Unfortunately, the interactive nature of group therapy complicates matters. What if information about Client X is written in Client Y’s file? Should Client X have access to that information? What if Client Y wants information from his file sent to an outside source (e.g., his primary care physician), and the file contains information about Client X? These are examples of potential ethical conflicts and professional practice dilemmas that need to be considered well before group therapy begins.
For this Discussion, review the media titled “Audio Therapist: Clients and Confidentiality” (Students with last names beginning with A-M, select client 1. Students with last names beginning with N-Z, select client 2). Think about how you might respond to the client on the phone. Consider the legalities and ethics of confidentiality and its limits. Use your own words in clear terms, as though you are speaking directly to a client.
With these thoughts in mind:
Post by Day 4 a brief description of the client in the scenario you were assigned. Provide your exact response to the caller. Include how you would inform the 17-year-old client or the family member of the geriatric client about confidentiality and its limits. Be specific and use the Learning Resources and current literature to support your response on confidentiality.
Be sure to support your postings and responses with specific references to the Learning Resources.
Read a selection of your colleagues’ postings.

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