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1. What is informed consent, and why is it important? What should be covered in a counselor's informed consent?

2. Discuss the applications of privileged communication in your state(Pennsylvania) and at the federal level.

3. What are the complexities of confidentiality relative to working with couples and with special populations?

4. Why is HIPAA compliance important?

5. According to the text, Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Social workers should use clear and understandable language to inform clients of the purpose of the services, risks related to the services, limits to services because of the requirements of a third party payer, relevant costs, reasonable alternatives, clients' right to refuse or withdraw consent, and the time frame covered by the consent.

Social workers should provide clients with an opportunity to ask questions. Fellow classmates, if the client felt the need to disclose hardship after receiving the informed consent documents, what should be the next step in the process?

6. Clients have a right to privacy. Once clients decide to share otherwise private information with social workers, practitioners must then apply relevant confidentiality standards. According to the NASW Code of Ethics, "Social workers should respect clients' right to privacy. Social workers should not solicit private information from clients unless it is essential to providing services or conducting social work evaluation or research. Fellow classmates, what are your thoughts?

7. According Corey, "Confidentiality belongs to the client," I believe this to be true, it is up to the client on what the psychotherapist can reveal by law and ethical standards, although, a therapist, or any counseling professional cannot reveal anything that their client says in a session, except when the client agrees to inform when mandated by a court of law. When it comes to working with couples it is upto the member of the group to reveal secrets of sorts. The counselor is required to inform all members of the group of the confidentiality laws at the beginning of therapy.

If a member decides to confess openly within the group that is upto the member but it is the duty of the counselor not to share any information expressed in the sessions because of the privilege laws. The counseling professional under no circumstances can reveal any private communications between his clients when the client has signed the confidentiality forms.

These laws protect the client and group members of any therapy sessions. What happens when a member of the group therapy goes and sues the counselor for allowing another member to disclose intimate private information is the counselor still protected with signed documents?

8. I personally found this article to be very interesting since I live in Texas now. I can see both ways but also really never completely understood until now. In reality the Mental Health Professionals have no floor to stand on for protection from the aftermath of reporting on a client. There is no protection what so ever even from the law because a client can sue the professional as retaliation. In the state of Texas we have no leg to stand on if we break confidentiality.

The 1976 ruling by the California Supreme Court in the now famous Tarasoff case (Tarasoff v. Regents of the University of California) established a precedent in that state that mental health professionals have an obligation to warn and protect third parties when a client reveals an intent to harm (Corey, Corey, &Callanan., 2007).

Although this ruling has jurisdiction only in California, a duty to warn and protect doctrine, as established by Tarasoff, is considered a national standard or mandate by many therapists (Corey, et.al., 2007).
Interestingly, Texas does not adhere to the precedent set by Tarasoff.

To the contrary, the opinion in Thapar v. Zezulka, rendered by the Texas Supreme Court in 1999, stipulated that mental health providers do not incur a duty to warn and protect (Dalrymple, 1999; Grinfeld, 1999; Texas Supreme Court, 1999). Specifically, the opinion written for a unanimous court by Justice Craig T. Enoch stated that "we refrain from imposing on mental health professionals a duty to warn third parties of a patient's threats" (FNl) (Texas Supreme Court, 1999).

In short, the reluctance of the Court to impose a duty to warn is an attempt to prevent mental health professionals from being placed in an awkward and vulnerable position in which they are not protected by state confidentiality statutes when disclosing client information. In light of existing statutes, there is most certainly a case to be made in Texas that mental health professionals should not violate confidentiality under any circumstances whatsoever, unless reporting positive HIV results and suspected cases of child abuse.

As is stated above Texas mental health professionals can report HIV results, but isn't this a violation of HIPAA law?

Barbee, P. W., Combs, D. C., Ekleberry, F., & Villalobos, S. (2007). Duty to warn and protect: Not in texas. Journal of Professional Counseling, Practice, Theory, & Research, 35(1), 18-25.

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