1. Welcome to Bachelor’s Capstone Class in Psychology-Seminar #5 With Dr. Goldstein

2. Capstone This week, we will discuss common issues that occur in client treatment that are not dictated by federal laws. Many agencies have standard policies to handle questions that arise during the course of treatment, but not all. We will work through some scenarios that will test your understanding of good ethical and confidentiality practice.

3. Capstone How do you define confidentiality in psychology?

4. Capstone In the US, federal laws governing the nature and confidentiality of mental health records may be overridden by more stringent state laws, so psychological practice can vary from state to state, but, in general, a psychotherapist is required to keep some basic records (per the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct.

5. Capstone Psychologists create, and to the extent the records are under their control, maintain, disseminate, store, retain, and dispose of records and data relating to their professional and scientific work in order to:

6. Capstone (1) facilitate provision of services later by them or by other professionals, (2) allow for replication of research design and analyses, (3) meet institutional requirements, (4) ensure accuracy of billing and payments, and (5) ensure compliance with law. (APA Ethical Principles of Psychologists and Code of Conduct, 6.01)

7. Capstone This week, you will use your research skills to create a list of laws and regulations that apply to psychologists in your related field of study (substance abuse, child development, or behavioral analysis).

8. Capstone An example: In California, per CA Health and Safety Code § 123105, the patient record (your “chart”) should consist of the dates of your sessions; your fees and payments; clinical information (if any) such as diagnosis, treatment plan, records of psychological testing, and records gathered from other providers; and psychotherapy notes that describe and justify your treatment.

9. Capstone According to California law, you “own” your chart. Yes, the psychotherapist owns the paper on which everything is printed and the folder in which it is all contained, but you have a right to look at everything in your chart if you want (per CA Health and Safety Code § 123100-123149.5).

10. Capstone Note that Federal law, per the Health Insurance Portability and Accountability Act (HIPAA), gives psychotherapists the freedom to keep psychotherapy notes confidential from everyone, even from patients. California law, however, being more strict in regard to patient rights, allows patients access to all that the clinical record contains.

11. Capstone Psychological practice uses the word privilege to describe the legal right of keeping your clinical records confidential. Because this right, in the strict legal sense, is thought of as a “thing,” psychological practice talks about “holding” the privilege. So who holds it?

12. Capstone In essence, the client does. The client holds the privilege of knowing and telling about his/her own life, and the client holds the privilege of determining what happens to their clinical records.

13. Capstone But the therapist also knows about the client’s life. Quite a bit in fact. Not just what’s in their chart, but everything they say and everything in between, including the simple fact of them being a client. Therefore, according to the principle of confidentiality, you as the therapist, is required to hold the privilege for the client—even after therapy has terminated.

14. Capstone This means that nothing the therapist knows about the client can be told to anyone else without the client’s permission. Period. Not even the fact that he/she is a client. That’s why a client has to sign a Release of Information (ROI) form to have their therapist give any information about their case to any other person, such as a physician.

15. Capstone What are the exceptions to confidentiality?

16. Capstone Exceptions to Confidentiality In California law, there are several exceptions to the confidentiality of psychotherapy. I suggest you look up the exceptions for each of your states!

17. Capstone Three of these exceptions to confidentiality concern harm to self or others: Where there is a reasonable suspicion of child abuse or elder adult physical abuse; Where there is a reasonable suspicion that you may present a danger of violence to others; Where there is a reasonable suspicion that you are likely to harm yourself unless protective measures are taken.

18. Capstone In all of the above cases, the psychotherapist is either allowed or required by law to break confidentiality in order to protect the client, or someone the client might endanger, from harm.

19. Capstone In the discussions you will research your home state to find out what the laws are in regards to these types of issues.

20. Capstone What are the series of assignments in this course? The assignments, aside from regular unit discussions, are outlined below: Problem Analysis (Unit 2) Needs Assessment (Unit 3) Prevention, Intervention, or Treatment plan (Unit 6) Outline of Treatment Plan (Unit 6) Power Point Presentation (Unit 8) Final project (Unit 9)

21. Capstone What are the requirements for the Capstone Project? The final project in this course will be chosen by a thorough assessment plan and treatment document that simulates a full course of treatment with a fictitious client. In each unit, you will complete one part of the project so that you will have a finished project by the time that you complete Unit 9 work.

22. Capstone Each week, you will add new documents to this virtual folder such that you have: *Unit Two: intake paperwork with the client’s basic information and identified problems *Unit Three: needs assessment paperwork including a case management plan to meet the needs *Unit Four: strengths based assessment including potential obstacles that might interfere with the client’s ability to complete treatment successfully as well as a plan to prevent or cope with those obstacles

23. Capstone *Unit Five: plan for keeping client information confidential *Unit Six: outline of a treatment plan *Unit Seven: two hypothetical case notes from sessions held with the client *Unit Eight: evaluation of the client’s treatment progress *Unit Nine: final project includes all of the above documents as well as a continuing education plan to meet all federal/state/ and agency mandated training

24. Questions?

26. Thank you! Have a wonderful week! Don’t forget to post in the discussion, answer my follow up questions, and interact with one another!