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Clinical Supervision: Models, Role, Legal & Ethical, Cultural Competency, & Transference
In this section, we will present the "Confidentiality and Risk Avoidance Procedure" your supervisee might consider in order to avoid breaking ethical confidentiality boundaries. This confidentiality procedure includes five steps: Obtain Proper Supervision; Consult Colleagues; Review; Obtain Legal Consultation; and Document Decision-Making Steps.
The 5-Step Confidentiality and Risk Avoidance Procedure
Step 1. Obtain Proper Supervision
Moreover, supervisees who are sued or named in an ethics complaint can help demonstrate their competent decision-making skills by showing that they sought supervision.
Step 2. Consult Colleagues
Supervisees employed in settings that sponsor institutional ethics committees (committees that provide staff with a forum for consultation on difficult ethics cases) should take advantage of this form of consultation. Moreover, supervisees named in ethics complaints and lawsuits can help demonstrate their competent decision making by showing that they sought consultation.
Step 3. Review
When considering the matter from a legal standpoint, your supervisee might want to consult federal, state, and local laws and their rulings on the sharing of health records. Remember, State laws supercede federal, so to save time, I consult State laws first. If State laws are not clear on the situation, I then consult federal laws, most especially the HIPAA guidelines which can normally clarify most situations.
However, if neither of these levels give specific guidelines, as a last resort, consult the regulations set up by your own agency. To give a quick overview, most states have strict laws and regulations governing the handling of minors' confidential health and mental health records. State laws and regulations vary with respect to obligations to disclose confidential information when there is reason to believe that minors are engaging in self-harming behaviors threaten to harm others, or have a contagious or sexually transmitted disease.
All states require mental health professionals to report suspected abuse or neglect of children. Mental health professionals should consult local statutes, regulations, and child welfare officials to determine whether they are obligated to disclose confidential information to parents, guardians, and child welfare officials, even without the minor client's consent; permitted - but not obligated - to disclose confidential information to parents, guardians, or child welfare officials without the minor's consent; and not permitted to disclose confidential information to parents, guardians, or child welfare officials without the minor client's consent.
You might consider reviewing relevant professional literature with your supervisee, especially pertaining to the proper handling of private, confidential, and privileged information. Reviewing such literature can provide you and your supervisee with useful guidance and also provide compelling evidence that you made a conscientious effort to comply with current standards.
Step 4. Obtain Legal Consultation
Step 5. Document Decision-Making Steps
In this section, we presented the Confidentiality and Risk Avoidance Procedure you might consider in order to avoid breaking confidentiality boundaries. This confidentiality procedure includes five steps: Obtain Proper Supervision; Consult Colleagues; Review; Obtain Legal Consultation; and Document Decision-Making Steps.
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