This week, our free MFT Law and Ethics exam and LCSW Law and Ethics exam practice question will focus on the topic of client confidentiality. Confidentiality is a key component of the therapeutic relationship. Without it, therapists would likely learn very little from their clients and it would substantially limit what could be achieved through psychotherapy. As therapists, we want our clients to feel safe in sharing the most intimate details of their life; information they may not feel comfortable disclosing to anyone else. Yet, confidentiality is not without limits.
How Will Confidentiality Show Up on the Exam?
The issue of confidentiality is so important to our profession that you are guaranteed to see questions about the topic on your MFT Law and Ethics exam, LCSW Law and Ethics exam, or your Clinical exam. So how can this confidentiality be tested? Following are just a few examples of how this subject can be tested:
- What are our reporting requirements regarding child or elder/dependent abuse and neglect?
- What are permitted exceptions to confidentiality and what should we do in these instances?
- How do we manage confidentiality when engaging in group, family, or couples work
Let’s see how you do on this week’s FREE practice question regarding confidentiality.
Practice Question:
A therapist has been working with a 19-year-old female client who was brought to therapy five years earlier for an eating disorder. When the client began therapy, her parents consented to treatment and engaged in numerous collateral sessions with the individual therapist. The family also participated in ongoing family therapy. Following a sustained period of symptom stabilization, the mother calls the therapist because she is concerned the daughter is exhibiting troubling behaviors. She asks the therapist if the daughter specifically discussed regressive behaviors in recent sessions. How should the therapist respond?
A. Inform the mother that the daughter is legally an adult and the therapist must maintain confidentiality
B. Inform the mother that the daughter is legally an adult and she can only provide information the client has authorized the therapist to share
C. Break the client’s confidentiality if the therapist believes the client is engaging in regressive behaviors
D. Break the client’s confidentiality if the therapist is concerned for the client’s safety
Share your answer and rationale in the comments section below and check back tomorrow for a discussion of the answer and rationale for this week’s Law and Ethics practice test question.
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Comments
A - b insinuates she’s a patient and it’s still breaking confidentiality
B, the mother already know client is currently doing therapy, different is that client started when she was 14 years old and needed parents to consent, no she is an adult and without a release the therapist cannot disclose anything to the parents at this time.
I'm going with A because "confidentiality" asserts and prioritizes the client - therapist contract.
B - I believe it is "B" and not "A" in this case due to the fact that the Mother was also a previous client (family counseling) along with her daughter, therefore the therapist would make a distinction that she can only share what the adult daughter has given "permission" to be shared. If the mother had not been a part of the earlier therapeutic configuration, the therapist would not even be able to acknowledge that her daughter was a current client.
A. I am going with" A "because the client is now an adult. We don't know if Mom has signed a new release or has informed consent to disclosure. At least, it is not mentioned in the vignette. B, would be some form of "breaking confidentiality" due to admittance by the therapist, that the 19 year old is a client and it suggests that there has been a discussion of her regressive behaviors.
A; the daughter is now an adult, and must give ROI consent for release that she is still a client. A. Although the vignette does not indicate how long she's been stable, or if daughter still lives at home, the daughter is now an adult, and must give ROI consent for release that she is still a client, and any other info.
A-Now that the daughter is of age I feel that the therapist have to keep everything confidential unless the client states that it is ok to discuss. It does not state in the seam that the client states that the therapist could discuss anything with her parents.
D..... I am going t ok say D because we would be allowed to discuss safety with a family member in order to ask them to do a 24 hour watch. So I would say if a therapist is concerned about the clients safety then it would be D.