Confidentiality in the School Setting Presented by: Emma Morales, LCSW Myrna Reynoso-Torres, LCSW Yolanda Vargas, LCSW

Social Work in the School Setting Promotes Academic Success!

NASW Code of Ethics VALUE: Importance of Human Relationships VALUE: Importance of Human Relationships Social workers seek to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the well­being of individuals, families, social groups, organizations, and communities. Social workers seek to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the well­being of individuals, families, social groups, organizations, and communities.

Confidentiality Confidentiality is fundamental to relationships with all clients Confidentiality is fundamental to relationships with all clients The duty to maintain the privacy of information obtained in the course of the professional/client relationship The duty to maintain the privacy of information obtained in the course of the professional/client relationship Confidential information may be obtained from sources other than the client, such as the parent, or other professionals Confidential information may be obtained from sources other than the client, such as the parent, or other professionals

Confidentiality Matters Video

Importance of Confidentiality It promotes trust It promotes trust It creates a safe counseling environment It creates a safe counseling environment

Not Confidentiality

CONSENT Best practice suggests that parents be involved in the consent of students receiving mental health services. Therefore, you should get parent consent for all LAUSD students.

Informed Consent At the beginning, discuss the rules in the relationship At the beginning, discuss the rules in the relationship –Service you will provide –Confidentiality (child-therapist & parent-therapist) –Limitations to Confidentiality Confirm consent in writing and review written document with parent and student Confirm consent in writing and review written document with parent and student

Confidentiality in the school setting EVERYONE wants to know what’s happening with the student. EVERYONE wants to know what’s happening with the student.

Providing Confidential Information

Can you share information with colleagues at the school? YES, but it has to be: YES, but it has to be: PURPOSEFUL PURPOSEFUL BEST INTEREST OF THE CHILD BEST INTEREST OF THE CHILD

Before you share information THINK WHY are you sharing the information? WHY are you sharing the information? WHAT information are you sharing? WHAT information are you sharing? WHO are you sharing this information with? WHO are you sharing this information with?

Can You Share Information with Outside Sources? Only if you have a signed release of information Only if you have a signed release of information This applies to DCFS workers, outside community agencies (mental health, medical, legal, etc…) This applies to DCFS workers, outside community agencies (mental health, medical, legal, etc…) If you are unsure…. consult with your field instructor If you are unsure…. consult with your field instructor

Can you share information with Parents? Yes- Only if it pertains to Limits of Confidentiality Yes- Only if it pertains to Limits of Confidentiality It is best to encourage the client to communicate with parent about something parent might need to know It is best to encourage the client to communicate with parent about something parent might need to know

Limitations to Confidentiality Abuse/Neglect Abuse/Neglect Danger to self Danger to self Danger to Others Danger to Others“Tarasoff”

TARASOFF - “Duty to Warn” A California Supreme Court decision that held that a psychologist could be held liable for failing to take reasonable steps to protect the intended victim when a client threatens violence. This decision created the “duty to warn” a reasonably identifiable victim when a client threatens violence. A California Supreme Court decision that held that a psychologist could be held liable for failing to take reasonable steps to protect the intended victim when a client threatens violence. This decision created the “duty to warn” a reasonably identifiable victim when a client threatens violence.

Exceptions Students 12 years of age or older that need “sensitive services”

What are sensitive services? Pregnancy, contraceptive and abortion Pregnancy, contraceptive and abortion HIV testing and services HIV testing and services Medical care of an STD Medical care of an STD Rape services Rape services In cases of rape or sexual assault, students can provide consent, but parents must be notified unless they are the perpetrators. In cases of rape or sexual assault, students can provide consent, but parents must be notified unless they are the perpetrators.

Students age 12 or older can provide consent themselves for mental health services if they meet two criteria: Student is deemed mature enough to make an informed decision Student is deemed mature enough to make an informed decisionAND One of the two following apply: One of the two following apply: 1. Without mental health services, student would present a danger of serious physical or mental harm to self or others. 2. Student is an alleged victim of incest or child abuse.

How many times can you meet with a student before getting parental consent? Once! But only……………………………. To receive a consent form to take home To receive a consent form to take home For a crisis situation For a crisis situation

What if parent refuses consent? You MAY NOT see the student Unless…… not receiving mental health services would pose a significant health or mental health risk to the student not receiving mental health services would pose a significant health or mental health risk to the student Your reasons for seeing the student must be documented.

Vignette DCFS case manager is working with Tommy. The case manager asks the school mental health professional about Tommy, whether he seems happy, is making friends, etc. The case manager then says she wants to talk to Tommy’s teacher to find out if he is out ill often. DCFS case manager is working with Tommy. The case manager asks the school mental health professional about Tommy, whether he seems happy, is making friends, etc. The case manager then says she wants to talk to Tommy’s teacher to find out if he is out ill often. What do you do? What do you do?

Other Things to Consider Regarding Confidentiality Leaving phone messages Leaving phone messages ing ing Running into clients in a public setting Running into clients in a public setting

CLIENT RECORDS Progress Notes Keep track of significant events/dates/people Keep track of significant events/dates/people These notes should remain general and neutral These notes should remain general and neutral Document “as if” your records could be subpoenaed in a court of law and read in front of the client Document “as if” your records could be subpoenaed in a court of law and read in front of the client Do not leave notes or charts where others can see them Do not leave notes or charts where others can see them

Personal Notes Are designed to reflect your longer thoughts, reflections and observations Are designed to reflect your longer thoughts, reflections and observations Are to be kept separate from pupil records Are to be kept separate from pupil records Process recordings fall under this category Process recordings fall under this category Personal notes remain personal as long as they are not shared in a public forum Personal notes remain personal as long as they are not shared in a public forum

In Conclusion…… Be mindful of what you say and what you write Be mindful of what you say and what you write Review limits of confidentiality before every individual and/or group session Review limits of confidentiality before every individual and/or group session Get signed consent and release of information forms for every client Get signed consent and release of information forms for every client

QUESTIONS??? QUESTIONS???