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As an addiction professional, I think the most important aspect of confidentiality is building trust and a rapport by ensuring the client that they can feel free to speak. If they are not discussing hurting themselves or someone else, treatment sessions are to be confidential.

Recently, our organization has been in hot water because a client overheard two employees discussing his HIV status. He left the treatment facility because he felt like he was going to be judged based on his positive status. The reason the direct care staffers knew his status is because someone on the treatment team is good friends with another direct care staffer. She told her friend and the friend passed the information to other direct care staff. That information should have never left the treatment team. Even with the same organization, not all persons are privileged to all client information. Below is my understanding of the differences between Privacy and confidentiality scopes.

Confidentiality is directed toward personal information that is shared with someone’s attorney, doctor, therapist, or any person that cannot be share client information to third parties without the consent.

Privacy is directed to the freedom from intrusion personal lives and this includes personal information. For example, medical examinations and their results or activities within the confines of your home. More personally, using a public bathroom or having an appoint at an office of a reproductive health provider or any action where you expect privacy. This includes hotel stays as well. When you check in at a hotel, you don’t expect the front desk to tell any stranger your room number

Privileged communication is the interaction between two parties in which the law recognizes a private, protected relationship. Whatever is communicated between the parties remains confidential, and the law cannot force what is disclosed between the two parties. Below are examples of privileged communication

  • Attorney and client.
  • Accountant and client.
  • Husband and wife.
  • Religious professional (priest, pastor, rabbi, etc.) and parishioner.
  • Doctor and patient.
  • Other health professionals and clients, including psychiatrists, psychologists, therapists, social workers, and professional counselors

Duty to warn refers to the responsibility of a counselor or therapist to inform third parties or police if a client makes a threat to themselves or another identifiable person. It is one of just a few instances where a therapist can break client confidentiality.

Duty to protect is the responsibility of any mental health professional to protect patients and others from foreseeable harm.

References

How and When Confidential Information Can Be Disclosed in Therapy. (2005, December 21). Retrieved from https://www.verywellmind.com/what-is-duty-to-warn-… Communication and How It Affects My Business. (2018, February 12). Retrieved from https://www.thebalancesmb.com/privileged-communica…

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