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How to Ethically Set Client Confidentiality Boundaries
Ethical Confidentiality Boundaries continuing education social worker CEUs

CEU Answer Booklet
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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Audio Transcript Questions The answer to Question 1 is found in Track 1 of the Course Content. The Answer to Question 2 is found in Track 2 of the Course Content… and so on. Select correct answer from below. Place letter on the blank line before the corresponding question. Do not add any spaces.
Important Note! Numbers below are links to that Section. If you close your browser (i.e. Explorer, Firefox, Chrome, etc..) your answers will not be retained. So write them down for future work sessions.

Questions:
1. What are three aspects regarding ethical boundaries related to ethics versus the law?
2. What are three confidentiality boundaries to consider when treating self-harming clients?
3. What are concepts of consulting colleagues in relation to a client’s confidentiality?
4. What are three controversies resulting from concerns about confidentiality boundaries?
5. What are five steps to consider in order to avoid risking breaking confidentiality boundaries?
6. What are three concepts regarding confidentiality boundaries related to very young children?
7. What are three strategies that you might be able to use in order to protect a client’s right to confidentiality if subpoenaed by the court?


Answers:
A. intent; parental disclosure; and hospitalization. 
B. fear of disclosure; loss of trust; and HIPAA hypocrisies.
C. maximizing communication; wary parents; and treatment in the classroom.
D. ethically improper; legally binding; and walking the tightrope.
E. client’s best interests; conflicts of interest; and proper consultation procedure
F. Consult Colleagues; Obtain Proper Supervision; Review; Obtain Legal Consultation; and Document Decision-Making Steps.
G. gaining client consent; negotiation; and seeking guidance from the court.

Course Content Manual Questions The Answer to Question 8 is found in Section 8 of the Course Content… and so on. Select correct answer from below. Place letter on the blank line before the corresponding question.
Important Note! Numbers below are links to that Section. If you close your browser (i.e. Explorer, Firefox, Chrome, etc..) your answers will not be retained. So write them down for future work sessions.

Questions:
8. According to the Codes of Ethics, what is a mental health professional’s responsibility in regards to confidentiality in group work?  
9. Clients need to be educated about confidentiality, privileged communication, and privacy to ensure trust in the therapeutic relationship. What is one of the best ways to accomplish this? 
10. According to APA’s first working group, what is the psychologist’s role in end-of-life decisions?
11. What are the nine arguments for continuous observation? 
12. According to Glass, what are the costs of rigidification of technique? 
13. What are ‘pseudoboundary violations’? 
14. Some conflicts of interest involve what lawyers call undue influence. What is undue influence? 
15. According to Reamer, what are the six elements of a sound risk management protocol to deal with boundary issues? 
16. What is the underlying motive behind gifts given to address a perceived imbalance in the professional relationship? 
17. What is important to consider before a constructive therapeutic response to client gift-giving can be identified?  

Answers
A.  Rigidification of technique can stifle creativity, impede the individualization of treatment, and obscure subtleties in context, timing, and cultural expectations that could be critical for optimal treatment.
B.  Undue influence occurs when a mental health professional inappropriately pressures or exercises authority over a susceptible client in a manner that benefits the mental health professional and may not be in the client's best interest.
C. The psychologist's role in such situations is to protect the client's rights, support significant others, not allow the affixation of a mental illness diagnosis if it is inappropriate, and help evaluate whether or not the client has decision-making capacity.
D. through the process of informed consent
E.  (1) Be alert to potential or actual conflicts of interest. (2) Inform clients and colleagues about potential or actual conflicts of interest; explore reasonable remedies. (3) Consult colleagues and supervisors, and relevant professional literature, regulations, policies, and ethical standards (codes of ethics) to identify pertinent boundary issues and constructive options. (4) Design a plan of action that addresses the boundary issues and protects the parties involved to the greatest extent possible. (5) Document all discussions, consultation, supervision, and other steps taken to address boundary issues. (6) Develop a strategy to monitor implementation of action plan.
F.  (1) Values life (2) Provides a 'holding space' (3) Can foster mutual respect (4) Can be therapeutic (5) Person feels 'special' (6) Emotional intimacy (7) Safety and protection (8) Supportive and (9) Intensive worker involvement
G.  Such a gift may help the client regain status that was temporarily lost during her increased sense of dependency during a major portion of her counseling.
H.  Some interventions which may be subjectively experienced by the patient as boundary violations are, in reality, solidly within the realm of ethical practice.
I.  Mental health professionals must clearly communicate to group members that confidentiality cannot be guaranteed in group work.
J.  the therapeutic implications of the gift alongside the ethical concerns


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