18 Tips for Maintaining Confidentiality

Confidentiality – the ethical duty of counselors to protect a client’s identity, identifying characteristics, and private communications.

Confidentiality is the heart of healthy therapeutic relationships. Counselors are expected to keep confidentiality and to abide by the ethical laws and standards to protect their clients and make sure that they are doing their jobs to the best of their abilities. This all starts with trust in the relationship. If clients know and are reminded of your confidentiality obligations, this will help them feel comfortable and disclose information in the counseling setting. However, there are times where confidentiality is challenged, and if the client is not aware of the precautions, this can harm the entire relationship and all of the work that has been done. Therefore, this blog post is about the basic knowledge that counselors should consider before, after and during their counseling sessions. Below is a list of 18 tips as a summary of what you should know when dealing with confidentiality.

Top 18:

1. Recognize that trust is a cornerstone of the counseling relationship, Therefore, create an ongoing partnership, establish and uphold appropriate boundaries, provide settings that ensure client privacy and maintain confidentiality in a culturally competent manner.

2. At the initiation and throughout the counseling process, counselors inform clients, with competence, voluntariness and knowledge, of the limitations of confidentiality and seek to identify situations in which confidentiality must be breached; advise them about the consequences if they decide to refuse services after hearing that.

3. Explain the limits of confidentiality in developmentally appropriate terms through multiple methods such as student handbooks, school counselor department websites, school counseling brochures, classroom curriculum and/or verbal notification to individual students.

4. Promote awareness of school counselors’ ethical standards and legal mandates regarding confidentiality, as well as the rationale and procedures for disclosure of student data and information to school staff.

5. Be mindful of confidentiality guidelines (state, federal and school board policy) when utilizing paper or electronic evaluative or assessment instruments/programs and take precautions to ensure the confidentiality of all information transmitted through the use of any medium. For example, when sharing a student’s highly sensitive information (e.g., a student’s suicidal ideation) go through personal contact such as a phone call or visit and not less-secure means such as a notation in the educational record or an e-mail. You could also advocate for acceptable encryption standards to be utilized for stored data and currently acceptable algorithms to be utilized for data in transit.

6. Keep information confidential unless legal requirements demand that confidential information be revealed or a breach is required to prevent serious and foreseeable harm to the student.

7. If required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, clarify your role expectations and the parameters of confidentiality with your colleagues.

8. Recognize that your primary ethical obligation for confidentiality is to the students, but balance that obligation with an understanding of parents’/guardians’ legal and inherent rights to be the guiding voice in their children’s lives the need to balance students’ ethical rights to make choices, their capacity to give consent or assent, and parental or familial legal rights and responsibilities to make decisions on their child’s behalf.

9. Inform parents/guardians of the confidential nature of the school counseling relationship and respect the confidentiality of parents/guardians as appropriate and in accordance with the student’s best interests.

10. In group counseling, communicate the aspiration of confidentiality as a group norm, to the students and their parents, while also recognizing that confidentiality for minors in schools cannot be guaranteed.

11. Information obtained about research participants during the course of research is confidential. Procedures need to be implemented to protect confidentiality, such as asking for permission to record or observe the client.

12. When providing services to terminally ill individuals who are considering hastening their own deaths, have the option to maintain confidentiality, depending on applicable laws and the specific circumstances of the situation and after seeking consultation or supervision from appropriate professional and legal parties.

13. Ensure that privacy and confidentiality of clients are maintained by subordinates, including employees, supervisees, students, clerical assistants, and volunteers by disclosing information only to the extent necessary to achieve the purposes of the consultation. For example, do not disclose confidential information that could lead to the identification of a client or other person or organization unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided.

14. Provide reasonable access to records and copies of records when requested by competent clients, but limit the access of clients to their records, or portions of their records, only when there is compelling evidence that such access would cause harm to the client. Also document the request of clients and the rationale for withholding some or all of the records in the files.

15. In situations involving multiple clients, provide individual clients with only those parts of records that relate directly to them and do not include confidential information related to any other client.

16. Keeping information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm, so consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues.

17. When clients disclose that they have a life threatening disease, counselors may be justified in disclosing information to identifiable third parties, if the parties are known to be at serious and foreseeable risk of contracting the disease. Prior to making a disclosure, counselors assess the intent of clients to inform the third parties about their disease or to engage in any behaviors that may be harmful to an identifiable third party.

18. Protect the confidentiality of deceased clients, consistent with legal requirements and the documented preferences of the client.

These aspects of confidentiality are essential to maintaining a healthy and trustworthy therapeutic relationship. Allow them to help you when in doubt.

- Counselor's Circle