How to Administer it…
What is in the WHODAS?
How To score it?
Finally A Copy of The WHODAS 2 Assessment
During the informed consent process, clients should be explained how privileged communication and documentation will be utilized, and what measures are taken to protect their privacy. Corey, et al, (2011) note that confidential is both an essential right for clients and necessary for effective therapy (p. 210). Additionally, “as a general rule, psychotherapists are prohibited from disclusing confidential communication to any third part unless mandated by law to do so” (Corey, et al, 2011, p. 211). However, certain legal limitations exist regarding a therapist’s ability to protect a client’s information. They must be warned of this in advance…
Essentially it is the counselor’s responsibility to help the client understand that confidentiality is not absolute and there are circumsantes in which client’s must reveal confidential information. These four key reasons are as follows:
As a result of a series of court rulings, mental health professionals have two seemingly contradictory concerns to contend with. On the one hand, they must protect the privacy of their clients. On the other hand, it is essential to protect the safety of the client and/or others if this information is revealed in therapy. In other words, you have public safety on one hand, and personal privacy on the other.
“Applies to those circumstances where case law or statue requires the mental health professional to make a reasonable effort to contact the identified victim of a client’s serious threats of harm, or to notify law enforcement of the threat” (Corey, et al, 2011, p. 231).
“Applies to situations where the metnal health professional has a legal obligation to protect an identified third part who is being threatened; in these cases the professional generally has other options in addition to warning the person of harm”
“The Health Insurance Portability and Accountability Act of 1966 (HIPAA) was passed by congress to promote standardization and efficiency in the health are industry and to give patients more rights and control over their health information…and are required to sign the appropriate forms authorizing the health care provider to provide information to other health care providers” (Corey, et al, 2011, p. 228). The purpose of this rule is to provide a federally based uniformity to how health care facilities and workers are required to protet client’s confidentiality. There are four main categories of requirements:
“Practitioners take reasonable precautions in safeguarding patient information. Licensed health care providers are expected to ahve workign knowledge of and guard patients’ rights to privacy in disclosure of information, health care operation, limiting the disclosure of protected information, payment matters, protected health information, psychotherapy notes, and a patient’s medical record and treatment activities” (Corey, et al, 2011, p. 229).
“HIPAA aims at creating one national form of communication or “language” so that health care proiders can communicate with one another electronically in this common language.” (Corey, et al, 2011, p. 229).
“Minimum requirements are outlined in HIPAA that are designed to safeguard confidential information and prevent unauthorized access to health information of patients.” (Corey, et al, 2011, p. 229).
“It is essential that covered entities be able to communicate with one another efficiently. Health care providers and health plans are required to have national identification numbers that identify them when they are conducting standard transactions” (Corey, et al, 2011, p. 229).
Corey, et al, (2011) state that maintaining confidentiality in a school setting is especially problematic. While “obliged to respect the privacy of minor clients and maintain confidentiality [this can] conflict with laws regarding parental rights.” (Corey, et al, 2011, p. 217) In other words, the counselor must weight the parent’s rights to be a guiding force in their child’s lives against their client’s desire and right for privacy. One way of handling this, is for the counselor to ask for permission of information release before and let them know about the limts to privacy. “The basic standard of care for school counselors is clear, courts have uniformly held that school personnel have a duty to protect students from foresseable harm.” (Corey, et al, 2011, p. 236).
The guidelines and rules discussed here also apply to suicidal clients. The issue here is knowing when to take the client’s serious. “Therapists have a legal duty to make assessments from an informed position and carry out their professional obligations in a manner comparable to what other reasonable professionals would do” (Corey, et al 2011, p. 241).
“Privileged communication doesn’t apply in case of child abuse and neglect, nor does it apply in cases of elder and dependent adult abuse…Such matters constitute a situation of reportable abuse…The professional is required to report the situation under penality of fines and imprisonment. IF adults reveal in a therapy session that they are abusing or have abused their children, the matter must be reported….the goal of reporting is to protect a child or older person who is being abused….National Child Abuse PRevention Treatment Act (PL 93-247).
The American Counseling Association states that clients have the freedom to choose whether they will enter to and/or remain in counseling (ACA, 2014, p. 4). Therapists are responsible for protecting this client right by providing them with the adequate information to make an informed decision. The APA (2017) adds the following:
“(a) When obtaining informed consent to therapy as required in Standard 3.10, Informed Consent, psychologists inform clients/patients as early as is feasible in the therapeutic relationship about the nature and anticipated course of therapy, fees, involvement of third parties, and limits of con- dentiality and provide su cient opportunity for the client/ patient to ask questions and receive answers. (See also Stan- dards 4.02, Discussing the Limits of Con dentiality, and 6.04, Fees and Financial Arrangements.)” (Section 10.1)
Essentially, the right of informed consent allows the client to make an independent and knowledgable decision regarding the services we provide. The first step in protecting this rights for the client includes the review of essential bits of information the client might need in order to make an informed decision (Corey, et al, 2011). The second step is to have the client read through and sign the informed consent documentation (Corey, et al, 2011). The important point here, is that the client gives their consent with an understanding of the facts provided.
Corey, et al, (2011), state that the informed consent is an educational process which is usefl as a collaborate therpeutic relationship-buildiing process. Examples of common questions asked include the following:
According to the ACA Code ef ethics (2014) and my old course textbook, (Corey, et al, 2011). What follows is a list of information that should be included in the informed consent document.
THE THERAPEUTIC PROCESS: It is important to help the client understand the nature of the therapy process. There will be frank discussions and as the client’s level of awareness increases, old anxieties and traumas may resurface. Also make a point to explain the nature of any procedures & therapy goals
BACKGROUND OF THE THERAPIST: What kind of training, credentials, licenses does the therapist have? What types of clients, specialized skills, and/or theoretical orientation is utilized by the therapist?
COSTS INVOLVED: make the client aware of the costs involved, how payments are received, and methods of payment allowed
LENGTH OF THERAPY / TERMINATION: In addition informing the clien of the length of therapy, they should be informed that htey have a right ot terminate services at any time
CONSULTATION W/ COLLEAGUES: Make sure the client understands that it may be necessary to consult with your therapist regarding their case from time to time.
INTERRUPTIONS IN THERAPY: Who can the client contact in case of emergency? Who can they see in the event that you need to take time off?
BENEFITS/ RISKS – As stated above, clients shoul dunderstand what the therapy process involves. “Clients need to know that no promices can be made about specific outcomes, which means that ethical practitioners avoid promising a cure…” (Corey, et al, 2011, p. 169)
ALTERNATIVES TO TRADITIONAL THERAPY: What alternatives are there to therapy? Help the client learn aobut various community resources and support systems available to the client (Corey, et al, 2011).
RIGHT TO ACCESS FILES: “Clients records are kept for the benefit of clients…A profssional writes abot a client in descriptive and nonjudgmental ways. A clinician who operates in a professional manner should not have to worry if his or her notes were to become public information or be read by a client” (Corey, et al, 2011, p. 170).
RIGHTS PERTAINING TO DIAGNOSTIC CLASSIFCATION: Therapists frequently need to give clients a diagnostic classifications for insurance purposes. “Some clients are not informed that they will be so classified…or that the classifications…will be given to insurance companies…Clients also do not have control over who can receive this information…Ethical Practice includes informing clients that a diagnosis can become a permanent part of their life” (Corey, et al, 2011 p. 171).