Confidentiality And Informed Consent: Case Study
Confidentiality and Informed Consent
Cher Keen
PSY/305
August 3, 2015
Dr. Daniel Williams
Confidentiality and Informed Consent
Confidentiality in all fields of work is vital. It gives the client the comfort of knowing that their personal information will remain private and safeguarded. Confidentiality guidelines within counseling sessions can make the experience with a client more productive. A breach in confidentiality can compromise the trust between the Practitioner and the client, and lead to poor treatment results, termination of treatment and legal issues.
Therapist-Client Relationship
According to “The Therapeutic Alliance” (2015), “The establishment …show more content…
of a good relationship is necessary early in therapy. Clients tend to emphasize the importance of therapist warmth and emotional involvement, whilst therapists judge the quality of the relationship on clients’ active participation.” However, there are certain circumstances that may warrant a therapist to breach confidentiality. The most common circumstances include when a client is considered to be a threat to himself/herself or others, which will prompt the therapist to make specific parties aware of the potential danger of the client. Over the years, therapist have watched their ability to protect confidentiality slowly diminish by the increased right to use information in client records, such as child abuse reporting and court involvement. Some therapists also offer clinical services to clients that are potentially violent, which may present a challenge to their confidentiality. In this case, it may warrant the duty to protect third parties and create a breach in confidentiality to execute that duty.
Tarasoff v.
the Board of Regents of the University of California
There was a case in 1976, in which the Supreme Court of California stated that mental health professionals have the duty to warn and to protect persons from potential harm by a patient. “Being able to protect potential victims from harm and protecting clients from self-harm have become ethical obligations in social work practice” (Granich, 2015). The case of Tarasoff v. Regents of the University of California, involves a man named Prosenjit Poddar. He was a graduate student at the University of California, Berkeley where he earned his degree in September 1967. He also met a student named Tatiana Tarasoff during his time at Berkeley, and they began to see each other on a regular basis. Poddar started to develop feelings for Tarasoff and mistook a simple kiss that Tarasoff gave him on New Year’s Eve as the beginning of a serious relationship. However, Tarasoff did not have the same feelings for Poddar, so she told him that she had no intentions of entering into a relationship with him. She also mentioned that she had other male friends. The rejection contributed to Poddar’s feelings of resentment, and he began to stalk her as he plotted revenge. Poddar also began to experience severe emotional behavior that lead to depression. He started to neglect his studies, and his mental health began to shift. Tarasoff traveled to South America during the summer of 1969, while Poddar sought out a psychology. Poddar began counseling sessions with Dr. Moore, a psychologist at Berkeley, due to his mental instability. During one of his counseling sessions, he told Dr. Moore that he wanted to kill Tarasoff. Dr. Moore did not feel comfortable about his intent to kill Tarasoff, so he made a request to have the campus police detain Poddar. Dr. Moore was convinced that Poddar was suffering from acute paranoid schizophrenia. He also suggested having Poddar committed for evaluation as a dangerous person. Poddar was immediately
detained but released shortly after since he seemed to appear rational.
Later in the fall, Tarasoff returned from South America, and Poddar had discontinued seeing his psychologist. Tarasoff and her relatives were not aware of any potential threats regarding Poddar. Unfortunately, Poddar carried out his intent to kill Tarasoff and attacked her violently. Tarasoff’s parents motioned to sue Dr. Moore and employees at the University for failing to inform them of Poddar’s threat. Poddar was convicted of second-degree murder, but his conviction was later appealed because the jury was incompetently instructed. Poddar was released under the agreement to return to his homeland of India, and a second trial did not occur. “There are many concerns about the implications of the Tarasoff case, especially around the confidentiality of the client-social worker relationship and violent clients avoiding treatment” (Granich, 2015). According to the California Supreme Court, mental health professional have the responsibility of protecting victims from violent acts by the hands of their patients. This decision has become widely influential and has been embraced by other states within the U.S.
The Process of Informed Consent and Refusal
Providing patients with the chance to make an informed decision about their participation in treatment expresses a level of respect and responsibility. Informed consent is not only ethical but very integral to the therapist-client relationship. The client’s decision to seek and follow through with treatment is voluntary, informed and rational. The voluntary aspect of consent addresses the client’s participation efforts based on not being coerced or persuaded by a mental health professionals. The informed aspect of consent provides clients with detailed information of the nature and extent of their therapy, associated fees, the potential involvement of third parties, and confidentiality limitations. The rational aspect of consent addresses the client’s ability discern and evaluate the relevance of the information offered by the mental health professional to make a rational decision about agreeing or refusing the services provided.
References
Granich, S. (2015). Duty to Warn, Duty to Protect. Retrieved from http://www.socialworker.com/feature-articles/ethics- articles/Duty_to_Warn,_Duty_to_Protect/
The Therapeutic Alliance. (2015). Retrieved from http://www.supportingsafetherapy.org/therapists/therapeutic-relationship/the- therapeutic-alliance
Cher Keen
PSY/305
August 3, 2015
Dr. Daniel Williams
Confidentiality and Informed Consent
Confidentiality in all fields of work is vital. It gives the client the comfort of knowing that their personal information will remain private and safeguarded. Confidentiality guidelines within counseling sessions can make the experience with a client more productive. A breach in confidentiality can compromise the trust between the Practitioner and the client, and lead to poor treatment results, termination of treatment and legal issues.
Therapist-Client Relationship
According to “The Therapeutic Alliance” (2015), “The establishment …show more content…
of a good relationship is necessary early in therapy. Clients tend to emphasize the importance of therapist warmth and emotional involvement, whilst therapists judge the quality of the relationship on clients’ active participation.” However, there are certain circumstances that may warrant a therapist to breach confidentiality. The most common circumstances include when a client is considered to be a threat to himself/herself or others, which will prompt the therapist to make specific parties aware of the potential danger of the client. Over the years, therapist have watched their ability to protect confidentiality slowly diminish by the increased right to use information in client records, such as child abuse reporting and court involvement. Some therapists also offer clinical services to clients that are potentially violent, which may present a challenge to their confidentiality. In this case, it may warrant the duty to protect third parties and create a breach in confidentiality to execute that duty.
Tarasoff v.
the Board of Regents of the University of California
There was a case in 1976, in which the Supreme Court of California stated that mental health professionals have the duty to warn and to protect persons from potential harm by a patient. “Being able to protect potential victims from harm and protecting clients from self-harm have become ethical obligations in social work practice” (Granich, 2015). The case of Tarasoff v. Regents of the University of California, involves a man named Prosenjit Poddar. He was a graduate student at the University of California, Berkeley where he earned his degree in September 1967. He also met a student named Tatiana Tarasoff during his time at Berkeley, and they began to see each other on a regular basis. Poddar started to develop feelings for Tarasoff and mistook a simple kiss that Tarasoff gave him on New Year’s Eve as the beginning of a serious relationship. However, Tarasoff did not have the same feelings for Poddar, so she told him that she had no intentions of entering into a relationship with him. She also mentioned that she had other male friends. The rejection contributed to Poddar’s feelings of resentment, and he began to stalk her as he plotted revenge. Poddar also began to experience severe emotional behavior that lead to depression. He started to neglect his studies, and his mental health began to shift. Tarasoff traveled to South America during the summer of 1969, while Poddar sought out a psychology. Poddar began counseling sessions with Dr. Moore, a psychologist at Berkeley, due to his mental instability. During one of his counseling sessions, he told Dr. Moore that he wanted to kill Tarasoff. Dr. Moore did not feel comfortable about his intent to kill Tarasoff, so he made a request to have the campus police detain Poddar. Dr. Moore was convinced that Poddar was suffering from acute paranoid schizophrenia. He also suggested having Poddar committed for evaluation as a dangerous person. Poddar was immediately
detained but released shortly after since he seemed to appear rational.
Later in the fall, Tarasoff returned from South America, and Poddar had discontinued seeing his psychologist. Tarasoff and her relatives were not aware of any potential threats regarding Poddar. Unfortunately, Poddar carried out his intent to kill Tarasoff and attacked her violently. Tarasoff’s parents motioned to sue Dr. Moore and employees at the University for failing to inform them of Poddar’s threat. Poddar was convicted of second-degree murder, but his conviction was later appealed because the jury was incompetently instructed. Poddar was released under the agreement to return to his homeland of India, and a second trial did not occur. “There are many concerns about the implications of the Tarasoff case, especially around the confidentiality of the client-social worker relationship and violent clients avoiding treatment” (Granich, 2015). According to the California Supreme Court, mental health professional have the responsibility of protecting victims from violent acts by the hands of their patients. This decision has become widely influential and has been embraced by other states within the U.S.
The Process of Informed Consent and Refusal
Providing patients with the chance to make an informed decision about their participation in treatment expresses a level of respect and responsibility. Informed consent is not only ethical but very integral to the therapist-client relationship. The client’s decision to seek and follow through with treatment is voluntary, informed and rational. The voluntary aspect of consent addresses the client’s participation efforts based on not being coerced or persuaded by a mental health professionals. The informed aspect of consent provides clients with detailed information of the nature and extent of their therapy, associated fees, the potential involvement of third parties, and confidentiality limitations. The rational aspect of consent addresses the client’s ability discern and evaluate the relevance of the information offered by the mental health professional to make a rational decision about agreeing or refusing the services provided.
References
Granich, S. (2015). Duty to Warn, Duty to Protect. Retrieved from http://www.socialworker.com/feature-articles/ethics- articles/Duty_to_Warn,_Duty_to_Protect/
The Therapeutic Alliance. (2015). Retrieved from http://www.supportingsafetherapy.org/therapists/therapeutic-relationship/the- therapeutic-alliance