Deck 8: Confidentiality and Informed Consent

Question 1

Which of the following is true about confidentiality?

A)Confidentiality is a higher principle than the power of law.
B)More than half of clients leave treatment when they find out that their therapist broke confidentiality to make a mandated child abuse report.
C)Confidentiality as an ethical principle is based on an oversimplified practice model that includes only the social worker and the client.
D)The NASW Code of Ethics requires that social workers maintain absolute confidentiality.

Answer 1

C

Question 2

Define confidentiality and privacy and describe how they are different.

Answer 2

no answer

Question 3

HIPAA is a voluntary agreement between healthcare providers to safeguard patients' medical information.

Answer 3

False

Question 4

Social workers and other professionals who are required to report suspected child abuse and neglect admit to reporting only about 75 percent of the cases they suspect.

Question 5

Which of the following is NOT true regarding voluntary consent?

A)When the clients have blind faith in their social worker, instead of giving voluntary consent, they may just agree with whatever she wants.
B)Even though they are incarcerated, prisoners still must give voluntary consent.
C)The consent of a person who needs assistance probably reflects desperation more than voluntariness.
D)There is a wide range between voluntary and involuntary consent.

Question 6

List the five ways of consenting and briefly describe each one.

Question 7

There are laws to protect community members from sex offenders once a person has been convicted.What are they? What do you think the social worker's responsibility is if she knows her client has committed a sexual offense but has not been convicted? EPAS: 2.1.2.b.d; 2.1.3.a

Question 8

A social worker testifying in court can only withhold confidential information if client-social worker privilege has been granted by state law.

Question 9

When the worker is asking the client to consent to the disclosure of confidential information to a third party, he must inform the client of which of the following?

A)What information will be released
B)Who will receive the information
C)The purpose of releasing the information
D)The consequences of releasing the information
E)All of the above

Question 10

Which of the following steps would be ethically appropriate when the worker has knowledge of child abuse in a family she is working with?

A)Confront the family member who is the alleged abuser
B)Report the abuse to CPS anonymously so that there is no damage to the therapeutic relationship.
C)Help the family member to call CPS themselves
D)Ignore the abuse for the present but try to monitor the situation.

Question 11

Informed consent involves:

A)Disclosure of information
B)Clients' competence
C)Clients' volunteering for treatment
D)All of the above

Question 12

Whereas social workers are ethically bound to maintain confidentiality, group members are free to discuss the personal business of other group members with family and friends.

Question 13

Confidentiality refers to the inherent right of every person to decide what, if any, information about them is shared with others.

Question 14

In order to give confidential information in court in a state where the social worker-client relationship has been granted privilege, the social worker must waive privilege.

Question 15

The 2008 NASW Code of Ethics clearly states that unless clients give prior authorization to the social worker, that social worker should not disclose confidential information to third party payers.

Question 16

Under which of the following circumstances is a breach of confidence likely to occur?

A)Conversations with other social workers working on the case.
B)Reports to insurance companies or other third party payers.
C)Information given to other professionals involved in the case.
D)The keeping of administrative and electronic records
E)All of the above.

Question 17

Which of the following is NOT part of informed consent?

A)Using professional terminology
B)Explaining risks related to services
C)Explaining the cost of services
D)Informing the client of how long the consent will last

Question 18

According to the Tarasoff ruling a therapist must keep confidentiality even when the client makes a believable threat to kill another person.

Question 19

The social worker thinks that the client needs to attend parenting classes but is worried that the client won't agree to go.Instead of saying, "Are you willing to attend parenting classes?", the worker asks "Do you want to begin parenting classes tomorrow or next week?" This is an example of forced consent.

Question 20

HITECH is a federal law which was passed to encourage health care providers to use health information technology.

Question 21

Describe how privileged communications and confidentiality are similar.
Discussion Topics:

Question 22

Review with the class HIPAA regulations.Discuss what has improved since the initiation of HIPAA and what has not improved.Discuss the difficulties social workers experience in navigating a system under HIPAA.
Class Exercises:

Question 23

According to the 1969 landmark legal decision - Tarasoff v.the Regents of the University of California - when it is determined that a patient is potentially violent and presents a serious danger, the social worker has a duty to warn the intended victim.Despite the possibility of destroying the confidential nature of the therapy, what are four steps the social worker should take to ensure protection?

Question 24

Explain how the ethical principle of confidentiality is related to the client's right to privacy.

Question 25

Using the following case study on duty to warn, allow students five to ten minutes to review the case and to formulate an answer of yes or no with a brief explanation of how they arrived at their answers and to share their answers with the class.Then open it up for discussion.
Melanie is 19-year-old female who works as a hooker in New York City.She comes to your office for help when she learns she is HIV positive.She has been a hooker since the age of fifteen when she ran away from home.She informs you that she continues to have unprotected sex and on average has intercourse with four men per day.As her therapist do you have a duty to locate all the men she has had intercourse with to warn them they may be infected with HIV? Do you have an obligation to call the police?

Question 26

Review with the class the Tarasoff vs.Regents landmark court case concerning duty to warn.

Question 27

Discuss some of the consequences for the client/therapist relationship if confidentiality is breached.

Question 28

What are three options that a social worker has when a report of suspected child abuse needs to be made to the Department of Protective Services? EPAS: 2.1.2.b.d

Question 29

Referring to pages 154-155, have the class divide into two groups and debate why or why not sharing confidential information with a client is beneficial to treatment.

Question 30

What are some of the arguments in favor of giving clients access to their own records?

Question 31

Discuss the importance of the Health Insurance Portability and Accountability Act (1996, HIPAA).

Question 32

Disclosure of information, voluntariness, and competency are the three issues of informed consent.Discuss some of the problems involving any of these that make for difficult ethical dilemmas in social work practice.

Question 33

Discuss the issues of duty to warn.How did it come about? What was the landmark court decision surrounding this issue? What is a therapist's legal obligation to warn? EPAS: 2.1.2.b.d; 2.1.3.a