This month we're going to tackle an important topic of confidentiality as it relates to the law and ethics exam preparation. Confidentiality is both a legal and an ethical requirement placed on the therapist that restricts the volunteering of information obtained in a therapeutic relationship. By and large, maintaining confidentiality is the default state for therapists. However, there are mandatory and permitted exceptions to the rule, and the BBS wants you to know the information inside-out for the LMFT, LCSW, and LPCC law & ethics exams. Below, you’ll find a breakdown of the confidentiality content we cover in our law & ethics study programs, as well as a free practice question to test your knowledge.
You will need to know the following in order to successfully pass the test:
- Mandated reporting, including child/elder/dependent abuse or neglect and Tarasoff
- Legal and ethical guidelines for groups and families
- Clients with a high risk of suicide or who are considered “gravely disabled”
- Authorization to release information from clients or client representatives
- Billing insurance
- Disclosures to parents of minor clients or other mental health providers
- Confidentiality versus privilege
Are you ready to practice with a FREE MFT law & ethics exam question?
Confidentiality Practice Question:
Nia and Arin have seen a California-licensed AMFT for three months for premarital counseling. In between sessions, Arin calls the therapist and discloses they just found out they are HIV-positive. Arin verbally tells the therapist they are going to withhold the information from Nia, and they are going to intentionally engage in unprotected sex, even if it means infecting her. Arin says, “This has to be our secret. Nia can never find out!” The therapist should:
A. Remind them that the “No Secrets Policy” limits confidentiality between individuals in couple’s therapy.
B. Reassure them that confidentiality will be maintained and explore their reasons for not wanting to share it with their partner.
C. Encourage them to tell their partner in the next couple’s session.
D. Break confidentiality and inform the partner due to Tarasoff.
(Scroll for answer and rationale.)
The correct answer is B: Reassure them that confidentiality will be maintained and explore their reasons for not wanting to share it with their partner. Per California law, therapists are legally obligated to maintain confidentiality about a client’s HIV status unless the client gives written permission to disclose it. Answer A may have been enticing, but a “No Secrets Policy” is trumped by HIV disclosure in California. Maintaining confidentiality around an HIV diagnosis is a state law, regardless of the treatment unit. State law will always take precedence over an ethical issue, like a "No Secrets Policy.” Answer C does not meet the client where they are because it fails to address the confidentiality issue presented in the vignette and pushes the client toward the therapist’s agenda. Answer D can be ruled out because HIV does not fall under Tarasoff.
MFT & LCSW Exam Preparation:
Which answer did you choose? Do you have a solid understanding of confidentiality laws for HIV status, or did you learn something new? We would love to hear from you in the comments below. If you need to strengthen your clinical knowledge for an upcoming exam, TDC offers thorough, in-depth programs for MFT CA Law & Ethics, MFT CA Clinical, and AMFTRB exams that provide everything you need to successfully PASS your exams with confidence. And these programs even include access to coaching!
If you’re in need of the 12-hour law and ethics course, we offer a BBS-approved program that will fulfill your continuing education requirement HERE.
Already licensed? Check out our continuing education library that includes a range of courses from Gestalt Therapy to Clinical Supervision.