Ethics Committee Chair — Katie (Wren) Busse, MS, Registered AMFT

Confidentiality and Treatment Teams

As mental health professionals, we’ve all had pretty extensive training starting in graduate school about confidentiality, privacy, and how to uphold these client privileges. We know that each adult and child client has these rights which are our responsibility to protect. We know the exceptions to confidentiality and what to do when one of these situations arises. We know when to comply with a subpoena, court order, or search warrant. We know that with a written release of information (ROI) we can collaborate with other members of our client’s treatment team, family, or friends.

What you may be less familiar with are the situations in which you are not required to have a written ROI. For instance, therapists may communicate with other healthcare providers or facilities to discuss pertinent information regarding diagnosis or treatment of the client. This means if your client was hospitalized and the treating psychiatrist is reaching out regarding your client, you can speak with them regarding pertinent diagnostic and treatment information. With this being said, the most ethical approach to consulting with another provider about a client is to first obtain an ROI that outlines what the client is giving you permission to discuss. But we know in situations like the one described above, that’s not always an option.

An important tip to always remember — having verbal consent from a client NEVER constitutes a valid authorization to release information. What if the client denies ever having provided consent? How could you prove they actually did? To avoid setting yourself up for a liability, always obtain a written release of information before talking about a client, unless there is an exception outlined by the law (like the hospitalization example previously mentioned.)

So now let's look at what needs to be done to create a valid ROI. Drawing from Civil Code Section 56.11, the following must be true for an ROI to be considered valid. The release must:

1. Be handwritten by the individual signing or is typed with no smaller than 14-point font.
2. Clearly separate from any other language on the same page and be authorized by a signature.
3. Be signed and dated by one of the following: the client, the client’s legal representative, the client’s spouse or the person financially responsible for the client when being used for health insurance enrollment purposes, or a deceased client’s beneficiary or personal representative.
4. State specific uses and limitations on the types of information disclosed.
5. State the name or functions of the healthcare provider that may disclose the information.
6. State the name or functions of the persons or entities authorized to receive the information.
7. State the specific uses and limitations on the use of the information by the authorized persons or entities.
8. Provide a date after which the authorization expires.
9. Advise the person signing the authorization of the right to receive a copy of the authorization.

You can find an example of a CAMFT authorization to release information at the following link: https://www.camft.org/LinkClick.aspx?fileticket=5ouNDrnKUes%3d&portalid=0.

Disclaimer: The preceding article does not constitute legal advice. Always consult with a CAMFT attorney or another legal professional for any legal or ethical questions you may have.

Katie Busse is a Registered Associate Marriage and Family Therapist 111673 in private practice under Kent Toussaint, LMFT 44685 at Teen Therapy Center in Woodland Hills. She works with preteens to adults and their families in addressing challenges such as anxiety, depression, anger, and family conflict. Learn more about Katie by visiting her website at www.katiebussetherapy.com. She can be reached at 747.217.2257 or katie@teentherapycenter.org.