Before coming to your training, please do the following:
In this lesson, we will discuss the rules and the importance of confidentiality. You will be able to (1) explain why Deseret Employment staff and Church-service missionaries have the moral and legal responsibility to keep sensitive information confidential; (2) identify ways to create an environment of trust that maintains confidentiality; and (3) identify the circumstances when you can disclose confidential information. Remember that confidential information means sensitive information, which could be misused to cause damage or embarrassment to an individual or the Church.
From the following list, choose and complete one or more activities that best apply to your situation.
According to Elder Marvin J. Ashton, “It is better to be trusted than to be loved” (quoting David O. McKay, in “He Loveth That Which Is Right” [Brigham Young University fireside, Mar. 5, 1989], 4, speeches.byu.edu).
As a group, discuss the following questions:
Read or role-play the scenarios below. As you read them think about whether confidentiality was breached or not.
Julien is late to work again. There is a lot of work to get done, and the job coach trainer feels let down by Julien once again. Zane, an associate working with Julien, comes to the job coach trainer to ask about Julien. The job coach trainer replies: “He is late again. He is probably back into his addictions.”
Clara has not been working productively today. Her mind is somewhere else. The job coach trainer decides to approach her in her working area. As the job coach trainer approaches, she asks Clara if she is worried about her problems at home again.
Mateo asks to speak to you for a minute. You ask him to walk with you to another station. As you walk, Mateo tells you he is concerned about Monica, who is experiencing depression and having suicidal thoughts.
As a group, discuss the following:
Consider the readings for today’s lesson, your own personal experience, and your reasoning skills as you discuss with your group the following:
Write the answers on the board.
As a group, summarize the key points of the discussion into one to three sentences. Write these sentences on the board and record them individually in your learner's journal.
From the following list, choose and complete one or more activities that best apply to your situation.
Divide into two equal groups. First, your teams will compete in a game of hangman. The facilitator will create slips of paper that have phrases relating to confidentiality and place them in a jar. To play the game, a team member will randomly pull one of the slips of paper from the jar and will start playing hangman with his or her team members. If the team guesses the phrase, they will get one point. If they do not guess it correctly, the other team will have one chance to guess it. If the other team gets the phrase right, they get the point. If neither team guesses correctly, the slip of paper will go back to the jar. Once a team guesses the phrase correctly, they get to keep it. Each team will take turns pulling an expression from the jar. The team with the most points wins this part of the activity. Make sure all team members get a chance to play.
For the second part of the activity, each team will do the following for at least three of the phrases they guessed during hangman:
Each team will have 30 seconds per phrase to do these three things. Each of the three items is worth a point. The more examples a team gives about how to apply this at work, the more points the team gets. The team with the most points at the end of the activity wins.
Read the scenarios in Activity 2 under “Keeping Confidences Is a Moral and Legal Imperative.”
Then discuss the following as a group:
Role-play the scenarios, but change them so that the job coach trainer keeps confidentiality. Share with the rest of the group what you have learned from this activity. Take a minute or two to record impressions and feelings from this activity.
Divide into small groups. Each of you share your thoughts and insights from “Barriers and Bridges to Communication” (Ensign, Jan. 1985, 52). You could use the following questions to guide your discussion:
From the following list, choose and complete one or more activities that best apply to your situation.
Divide into pairs, and share your outline for the Code of Ethics for Deseret Employment Staff. Then consider your readings as you discuss and summarize the following:
Review the document found in Resource 1 of the “Lesson Resources” section. Then read the Authorization for Release of Confidential Information form found in Resource 2 of the “Lesson Resources” section.
Discuss the following questions:
Deseret Employment staff should keep copies of professional disclosure forms in their professional files.
Discuss the following questions:
Seek to identify a personal or business gap or need.
Spend a few minutes silently pondering what you've discussed during this lesson. Listen as the Holy Ghost helps you identify areas where you can improve. Record your impressions in your learner's journal under the question “What Lack I Yet?”
Seek ways to close the gap or develop the required talent(s) to meet the need.
With the guidance of the Spirit, create your plan of how you will improve and close the gap(s) you have identified. You may use one or more of the exercises below, your own strategy, or a combination of both. Record this plan in your learner's journal under “What Must I Do?”
After a few minutes, those who are comfortable doing so can share their impressions with the group.
Seek understanding, and then share what you learned.
During the week, focus on implementing the plan you created. Record your impressions or lessons learned in your learner's journal under “Therefore, What?” You will be given time at the beginning of next week's lesson to share your experience with the group.
The following is an excerpt from the Code of Professional Ethics for Rehabilitation Counselors, “Section B: Confidentiality, Privileged Communication, and Privacy,” (2016), crccertification.com/code-of-ethics-4.
SECTION B: CONFIDENTIALITY, PRIVILEGED COMMUNICATION, AND PRIVACY
INTRODUCTION
Rehabilitation counselors recognize that trust is the cornerstone of the counseling relationship. Rehabilitation counselors aspire to earn the trust of current and prospective clients by creating an ongoing partnership, establishing and upholding appropriate boundaries, and maintaining confidentiality. Rehabilitation counselors communicate the legal and ethical parameters of confidentiality to their clients in a culturally competent manner.
B.1. RESPECTING CLIENT RIGHTS
a. RESPECT FOR PRIVACY. Rehabilitation counselors respect the privacy rights of clients. Rehabilitation counselors solicit private information from clients only when it is beneficial to the rehabilitation counseling process. Rehabilitation counselors make reasonable efforts to ensure that methods of sharing or transmitting information are secure.
b. PERMISSION TO RECORD. Rehabilitation counselors obtain permission from clients prior to recording sessions through electronic or other means.
c. PERMISSION TO OBSERVE. Rehabilitation counselors obtain permission from clients prior to observing sessions, reviewing session transcripts, and/or listening to or viewing recordings of sessions with supervisors, faculty, peers, or others within the training environment.
d. CULTURAL DIVERSITY CONSIDERATIONS. Rehabilitation counselors work to develop and maintain awareness of the cultural meanings of confidentiality and privacy. Rehabilitation counselors hold ongoing discussions with clients as to how, when, and with whom information is to be shared.
e. RESPECT FOR CONFIDENTIALITY. Rehabilitation counselors do not share confidential information without consent from clients or without sound legal or ethical justification. Rehabilitation counselors do not release confidential records without a signed authorization to release information, except allowed by law or required by court order.
f. EXPLANATION OF LIMITATIONS. At initiation and as needed throughout the counseling process, rehabilitation counselors inform clients of the limitations of confidentiality and seek to identify foreseeable situations in which confidentiality must be breached.
B.2. EXCEPTIONS
a. SERIOUS OR FORESEEABLE HARM AND LEGAL REQUIREMENTS. The general requirement that rehabilitation counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm, or when legal requirements demand that confidential information must be revealed. Rehabilitation counselors must be aware of and adhere to standards and laws that govern confidentiality. Rehabilitation counselors consult with other professionals when in doubt as to the validity of an exception.
b. CONTAGIOUS, LIFE-THREATENING DISEASES. When clients disclose they have a disease commonly known to be both communicable and life-threatening, rehabilitation counselors may be justified in disclosing information to identifiable third parties if they are known to be at demonstrable and high risk of contracting the disease. Prior to making a disclosure, rehabilitation counselors confirm the diagnosis and assess the intent of clients to inform the third parties about the disease or to engage in any behaviors that may be harmful to identifiable third parties. Rehabilitation counselors must be aware of and adhere to standards and laws concerning disclosure about disease status.
c. COURT-ORDERED DISCLOSURE. When subpoenaed to release confidential or privileged information without permission from clients or their legal representatives, rehabilitation counselors obtain written informed consent from clients, take steps to prohibit the disclosure, or have it limited as narrowly as possible due to potential harm to clients or the counseling relationship. Whenever reasonable, rehabilitation counselors obtain a court directive to clarify the nature and extent of the response to a subpoena. When release of raw assessment data is requested, refer to Standard G.2.b.
d. MINIMAL DISCLOSURE. When circumstances require the disclosure of confidential information, rehabilitation counselors clarify the nature of information being requested and make reasonable efforts to ensure only necessary information is revealed.
B.3. INFORMATION SHARED WITH OTHERS
a. WORK ENVIRONMENT. Rehabilitation counselors avoid casual conversation about clients in the work environment and make reasonable efforts to ensure that privacy and confidentiality of clients’ information and records are maintained by employees, supervisees, students, clerical assistants, and volunteers.
b. INTERDISCIPLINARY TEAMS. When services provided to clients involve the sharing of their information among team members, clients are advised of this fact during the professional disclosure process and are informed of the team’s existence and composition.
c. OTHER SERVICE PROVIDERS. When rehabilitation counselors learn that clients have an ongoing professional relationship with another rehabilitation counselor or treating professional, they obtain a signed authorization prior to releasing information to other professionals. File review, second-opinion services, and other indirect services are not considered an ongoing professional relationship.
d. CLIENT ASSISTANTS. Clients have the right to decide who can be present as client assistants (e.g., interpreter, personal care assistant, advocates). When clients choose to have assistants present, clients are informed that rehabilitation counselors cannot guarantee that assistants will maintain confidentiality. Rehabilitation counselors impress upon assistants the importance of maintaining confidentiality. If the presence of a client assistant is detrimental to services, the rehabilitation counselor discusses the concern with the client. If the concern is not resolved, the rehabilitation counselor may consider termination and referral.
e. CONFIDENTIAL SETTINGS. Rehabilitation counselors are attentive to the type of service they are providing and whether confidential information is typically discussed. If confidential information is likely to be discussed, rehabilitation counselors choose settings in which they can reasonably ensure the privacy of clients. Prior to providing services in community or other settings where confidentiality cannot be maintained, rehabilitation counselors discuss with clients the risk to maintaining confidentiality.
f. THIRD-PARTY PAYERS. Rehabilitation counselors disclose information to third-party payers only when clients have authorized such disclosure, unless otherwise required by law.
g. DECEASED CLIENTS. Rehabilitation counselors protect the confidentiality of deceased clients, consistent with laws, organizational policies, and documented preferences of clients.
B.4. GROUPS AND FAMILIES
a. GROUP WORK. In group work, whether in-person or using electronic formats, rehabilitation counselors clearly explain the role and responsibility of each participant. Rehabilitation counselors state their expectation that all members maintain confidentiality for each individual and the group as a whole. Rehabilitation counselors also advise group members of the limitations of confidentiality and that confidentiality by other group members cannot be guaranteed.
b. COUPLES AND FAMILY COUNSELING. In couples and family counseling, rehabilitation counselors clearly define who the clients are and discuss expectations and limitations of confidentiality. Rehabilitation counselors seek agreement concerning each individual’s right to confidentiality and document in writing such agreement among all involved parties having the capacity to give consent. Rehabilitation counselors clearly define whether they share or do not share information with family members that is privately, individually communicated to rehabilitation counselors.
B.5. RESPONSIBILITY TO CLIENTS LACKING CAPACITY TO CONSENT
a. RESPONSIBILITY TO CLIENTS. When counseling minors or persons who are unable to give voluntary consent, rehabilitation counselors protect the confidentiality of information received in the counseling relationship, in any format, as specified by law, written policies, and applicable ethical standards.
b. RESPONSIBILITY TO LEGAL GUARDIANS AND PARENTS. Rehabilitation counselors inform legal guardians, including parents who are legal guardians, about the role of rehabilitation counselors and the confidential nature of the services provided. Rehabilitation counselors are sensitive to the cultural diversity of families and work to establish, as appropriate, collaborative relationships with legal guardians to best serve clients.
c. RELEASE OF CONFIDENTIAL INFORMATION. When working with minors or persons who lack the capacity to give voluntary informed consent to the release of confidential information, rehabilitation counselors obtain written permission from legal guardians or legal power of attorney to disclose the information. In cases where there is no legal guardian or legal power of attorney, rehabilitation counselors engage in an ethical decision-making process to determine appropriate action. In such instances, rehabilitation counselors inform clients consistent with their level of understanding and take culturally appropriate measures to safeguard client confidentiality.
B.6. RECORDS AND DOCUMENTATION
a. REQUIREMENT OF RECORDS AND DOCUMENTATION. Rehabilitation counselors include sufficient and timely documentation in the records of their clients to facilitate the delivery and continuity of needed services. Rehabilitation counselors make reasonable efforts to ensure that documentation in records accurately reflects progress and services provided to clients. If errors are made in records, rehabilitation counselors take steps to properly note the correction of such errors according to organizational policies.
b. CONFIDENTIALITY OF RECORDS AND DOCUMENTATION. Rehabilitation counselors make reasonable efforts to ensure that records and documentation, in any format, are kept in a secure location and that only authorized persons have access to the records.
c. CLIENT ACCESS. Rehabilitation counselors provide reasonable access to records and copies of records when requested by clients or their legal representatives, unless prohibited by law. In situations involving multiple clients, rehabilitation counselors 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. When records may be sensitive, confusing, or detrimental to clients, rehabilitation counselors have a responsibility to exercise judgment regarding the timing and manner in which the information is shared and to educate clients regarding such information. When rehabilitation counselors are in possession of records from other sources, they refer clients back to the original sources to obtain copies of those records.
d. DISCLOSURE OR TRANSFER. Unless exceptions to confidentiality exist, rehabilitation counselors obtain written permission from clients to disclose or transfer records to legitimate third parties. Rehabilitation counselors make reasonable efforts to ensure that recipients of records are sensitive to their confidential nature.
e. STORAGE AND DISPOSAL AFTER TERMINATION. Rehabilitation counselors store records of their clients following termination of services to ensure reasonable future access. Rehabilitation counselors maintain records in accordance with organizational policies and laws, including licensure laws and policies governing records. Rehabilitation counselors dispose of records and other sensitive materials in a manner that protects client confidentiality. Rehabilitation counselors apply careful discretion and deliberation before destroying records that may be needed by a court of law (e.g., notes on child abuse, suicide, sexual harassment, or violence).
f. REASONABLE PRECAUTIONS. Rehabilitation counselors take reasonable precautions to protect the confidentiality of clients in the event of disaster or termination of practice, incapacity, or death of the rehabilitation counselor. Rehabilitation counselors appoint a records custodian when appropriate.
B.7. CASE CONSULTATION
a. DISCLOSURE OF CONFIDENTIAL INFORMATION. When consulting with colleagues, rehabilitation counselors do not disclose confidential information that reasonably could lead to the identification of clients or other persons or organizations with whom they have a confidential relationship, unless they have obtained the prior written consent of the persons or organizations or when the disclosure cannot be avoided. They disclose information only to the extent necessary to achieve the purpose of the consultation.
b. RESPECT FOR PRIVACY. Rehabilitation counselors share information in a consulting relationship for professional purposes only with persons directly involved with the case. Written and oral reports presented by rehabilitation counselors contain only data germane to the purpose of the consultation, and every effort is made to protect the identity of clients and to avoid undue invasion of privacy.
c. CONFIDENTIALITY IN CONSULTATION. Rehabilitation counselors seeking consultation obtain agreement among the parties involved concerning each individual’s right to confidentiality, the obligation of each individual to preserve confidential information, and the limits of confidentiality of information shared by others.