Confidentiality is one of the ethical imperatives that is held in the highest regard by psychologists and clients. Safeguarding information disclosed to psychologists during the course of a professional relationship is something both clients and psychologists alike expect. It is a fundamental building block of the trust needed between psychologist and client. This expectation crosses many types of psychological interventions, including (but not limited to) interpersonal therapy; assessment of children, individuals, and couples; and research with human subjects. Confidentiality is expected in both public and private professional settings and interactions.
Despite such protections of confidential client information, there has been a persistent weakening of these same rights, especially subsequent to the September 11, 2001 destruction of the World Trade Center towers in New York City. The passion for privacy needed to be balanced by the right to protect one’s homeland and life (Safire, 2004, p. A27). Safire observed that patients could no longer expect that their mental health histories would remain confidential. This, however, was true prior to September 11, 2001. Clients have long been forced to waive their right to privacy when utilizing insurance to pay for their mental health treatment, which routinely requires transmission to the insurer of client diagnosis, prognosis, and aspects of history. There also are other exceptions that have existed before 2001 and include the following: the legal mandate to report both child and elder abuse/neglect; the legal requirement to warn specified others of a client’s intent to harm; the legal requirement to cooperate in providing records for which a psychologist has received a court order; the requirement to provide information to an employer who has hired a psychologist to assess a client for “fitness for duty” or some other reason (and similarly providing information to the courts from court mandated assessments).
For your first research paper, you explore the significance of confidentiality in ethics as it applies specifically to the following case. Zora, the client in question in the case, is a member of the Thompson family presented in the Week 1 media.
Zora is a 14-year-old, multi-ethnic (African American, Columbian, and Mexican) female who appears older than her stated age. She is abusing marijuana, Percocet, and Oxycontin. In defiance of her parents, she is dating Caucasian college-age boys (which her parents do not know about) and has become pregnant. She seeks counseling at a clinic for teenagers to think through how she wants to proceed. She is unsure if she wants to get an abortion, have the baby and give it up for adoption, or have the baby and join the “pregnant and parenting” services at her school. She hopes to gain clarity about what she wants before she possibly involves her family. The psychologist whom she sees at the clinic is a middle aged, Caucasian woman who is Catholic and who feels conflicted about counseling a 14-year-old who is considering an abortion. The psychologist seeks peer supervision to help her decide how she should ethically proceed. In the peer supervision group is an African American psychologist who happens to know Zora and her family, and figures out from the psychologist’s description that the client is Zora. She is shocked that Zora is pregnant and is very concerned. She wants to talk with Zora, but Zora is not her client and this information was relayed in peer supervision, which is a confidential setting. This psychologist is a close friend of Zora’s mother. She feels extremely conflicted as to what she should ethically do.
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