Continuing Education & Resources for Mental Health Professionals

Ethical Practice Model Adapted for
Multidisciplinary Settings

Protecting Confidentiality Rights: An Ethical Practice Model

(Adapted for Use in Agency & Multidisciplinary Settings)

Mary Alice Fisher, Ph.D.

I. PREPARE

            A. Understand Clients’ Rights and Your Ethical Responsibilities in Behalf of Those Rights

Rights of Agency/Organization That Hired You or Contracted for Your Services

Rights of Persons to Whom You Provide Therapy, Supervision, or Consultation

Rights of Others?

            B. Learn the State and Federal Laws that Can Affect Your Ability to Protect Confidentiality

            C. Learn the Agency/Organizational Policies that Can Affect Your Ability to Protect Confidentiality

            D. Clarify Your Personal Ethical Position About Confidentiality and its Limits in This Setting

                        Decide When/How You Will Limit Confidentiality Voluntarily

            E. Develop Plan for Ethical Response to Laws & Policies That Require You To Disclose “Involuntarily”

            F. Choose Reliable Ethics Consultants and Legal Consultants and Use as Needed

            G. Devise Informed Consent Forms that Reflect Your Real Intentions

            H. Prepare to Discuss Confidentiality and Its Limits in Understandable Language

 II. TELL PROSPECTIVE CLIENTS THE TRUTH  (Inform Their Consent)

            A. Inform All Prospective Clients and Consultees About Limits of Confidentiality

            B. Inform About Access to Information by Others in Setting (Other Staff; Supervisors, Teams, etc.)

            C. Inform About Foreseeable Uses & Potential for Future Disclosures of the Information to be Gathered

            D. Inform about Factors That Might Influence Willingness to Participate  (e.g., Risks/Benefits)

            E. Inform About Right to Decline to Participate & Consequences of Declining/Withdrawing

            F. Explain Any Roles or Potential Conflicts of Interest That Might Affect Confidentiality

            G. Obtain Consent From Informed Examinee (or Guardian) to Participate Under These Conditions         

 III. OBTAIN INFORMED CONSENT BEFORE DISCLOSING ANYTHING VOLUNTARILY

            A. Respect the Rule: Disclose Without Consent Only if Legally Unavoidable

            B. Inform About Content and Implications of a Potential Disclosure Before Disclosing

            C. Obtain and Document Consent Before Disclosing

 IV. RESPOND ETHICALLY IN LEGALLY-IMPOSED DISCLOSURE SITUATIONS

            A. Notify of any Pending Legal Demand for a Disclosure Without Subject’s Consent

            B. Respond According to Plan, Consistent with Policies in the Setting (from Step 1,E above)

            C. Limit Disclosure of Confidential Information to the Extent Legally Possible

 V. AVOID PREVENTABLE BREACHES OF CONFIDENTIALITY

            A. Avoid Making Unethical Exceptions to the Confidentiality Rule

            B. Establish and Maintain Protective Policies and Procedures; Train Staff & Technical Assistants

            C. Monitor Note Taking, Report Writing, and Record Keeping Practices

            E. Anticipate Legal Demands

            F. Protect Client Identity in Presentations, Consultations

 VI. TALK ABOUT CONFIDENTIALITY

            A. Model Ethical Assessment Practices; Confront Others’ Unethical Practices; Lobby for Protective Policies

            B. Provide Peer Consultation About Confidentiality Ethics in Organizational Settings

            C. Teach Ethical Practices to Students, Supervisees, Employees, Agency, Institution        

           Adapted From:  Fisher, M.A. (2008). Protecting Confidentiality Rights: The Need for an Ethical Practice Model. American Psychologist, 63 (1), 1-13.

(Article available in html at
http://www.CenterForEthicalPractice.org/Article-ProtectingConfidentialityRights.htm )

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