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Confidentiality, Mandated Reporting, and Duty to Warn Laws in North Carolina

Sophie J. Young

Department of Counseling, Wake Forest University

CNS 780: Professional, Ethical & Legal Issues in Counseling

Dr. Jamie Crockett

February 23, 2022

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Confidentiality, Mandated Reporting, and Duty to Warn Laws in North Carolina

Professional counselors are both ethically and legally obligated to uphold the laws and

codes set in their state of practice. For the purpose of this paper, I will be summarizing,

analyzing, and reflecting on some of the laws that exist for clinicians providing services in the

state of North Carolina as this is where I plan to be licensed and practice for at least the first few

years of my counseling career. First, the laws regarding confidentiality, exceptions, and

privileged communication will be described.

Confidentiality and Privileged Communication

In the statutes of the North Carolina General Assembly (N.C.G.S.) § 122C-52 (1985)

states that confidential information obtained from a client is not a public record and that each

client has a right that none be disclosed by the facility in which the information is stored. It is

noted that unauthorized disclosure of confidential information is a Class 3 misdemeanor

punishable by fine. However, exceptions do exist. One of these includes if the client or legally

responsible person provides written consent for the release of information. Additionally, a client

or legally responsible person can receive access to any confidential information in their record

unless this information would be harmful to their physical or mental wellbeing. Another

exception is that a facility can share with the next of kin that a client was admitted/discharged

(including the time and location) when this is done in the client’s best interest. Furthermore, an

internal client advocate can receive access to confidential information without client/legal

person’s consent. Similarly, confidential information can be disclosed to an attorney (i.e.

privileged communication) upon an adult client or legal person’s request. And finally, exceptions

will be made when necessary persons must be notified of the escape and return of a client from

an in-patient facility.
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Duty to Warn/Protect

According to the Licensed Professional Counselor Association of North Carolina’s

website (2022) the state of North Carolina does not have a duty to warn/protect law, although

there is also no law prohibiting counselors from doing so. Essentially, counselors have legal

permission to warn/protect threatened others but this is not a legal requirement. It is

recommended that professional counselors review the article by Mobley and Naughton (2011)

titled Tarasoff and Duty to Protect in North Carolina for more information. Additionally,

professional counselors are encouraged to use ethical decision making when engaging or

abstaining from warning others, and to respond in ways that promote the safety of the individuals

involved.

Reporting Abuse or Neglect

Regarding a professional counselor’s duty to report abuse or neglect, N.C.G.S. § 7B-301

(2016) states that when there is cause to suspect juvenile abuse or neglect, an individual or

institution must report this orally, by phone, or in writing to the director of the department of

social services (DSS) in the county of the juvenile’s residence. Reports must include the

juvenile’s name and address and that of their parent, guardian, or caretaker. Additionally, the

juvenile’s current whereabouts (if not in the home) and age as well as the names and ages of

other juvenile’s in the home must be included. The nature and extent of injuries or conditions

resulting from the abuse or neglect, as well as any other information deemed necessary for the

DSS to know, must also be given. The individual making the report must give their name,

address, and phone number at the time of the report. Failure to report a case of juvenile abuse or

neglect results in a Class 1 misdemeanor. N.C.G.S. § 108A-102 (1973) states the similar
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requirements that exist for reporting the abuse or neglect of disabled adults, although the

reporter’s identity can remain confidential when doing so. The final group of individuals that

require abuse or neglect reporting is elder adults (i.e. someone 60 years of age or older who is

unable to independently provide what is necessary to their physical and mental wellbeing) as

indicated by N.C.G.S. § 14-32.3 (2005).

Ethical Codes

Since counselors are also required to abide by the ACA Code of Ethics (2014), these will

now be considered in relation to the laws previously described. For the issue of confidentiality,

section B titled Confidentiality and Privacy thoroughly covers how counselors are ethically

obligated to respect client rights to their confidentiality and privacy. Section B.2. titled

Exceptions aligns with the previously described law about exceptions to confidentiality. Both

warrant exceptions when there is serious or foreseeable harm and legal requirements/court-

ordered disclosure. The ACA Code further addresses confidentiality matters in more specific

situations such as how counselors have the option to maintain confidentiality regarding a

terminally ill client’s end-of-life decisions (B.2.b.), as well as how counselors may be justified

when disclosing to third-parties that a client has a contagious, life-threatening disease (B.2.c.).

Additionally, the Code provides details about maintaining confidentiality from subordinates

(B.3.a.), within interdisciplinary teams (B.3.b.), and when a client is deceased (B.3.f.). Overall,

the ACA Code of Ethics supports the North Carolina law in that client confidentiality must be

maintained unless the client or legal person consents to a release of information, or in a few other

specific situations.

While the ACA Code does not explicitly address the duty to warn and reporting abuse

laws, it is crucial that professional counselors take into account the following ethical codes when
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engaging with these issues: client welfare (A.1.a.), avoiding harm (A.4.a.), respect for

confidentiality (B.1.c.), serious and foreseeable harm and legal requirements (B.2.a.), and

consultation on ethical obligations (C.2.e.).

Implications and Takeaways

By researching North Carolina’s laws about client confidentiality, warning/protecting

others, and reporting abuse or neglect, I have gained a more concrete yet rich understanding of

what my legal requirements will be as a licensed counselor in this state. I also learned that the

duty to report juvenile, disabled adult, and elder abuse or neglect is a legal requirement for all

citizens of North Carolina, counselors or not. While I agreed entirely with the extant

confidentiality and reporting laws, I am surprised that no law exists regarding the duty to

warn/protect dilemma, especially after the outcomes of the Tarasoff case. Personally, I would

feel more comfortable if this was made into a required law for professional counselors in North

Carolina rather than existing as a permissible law. While the confidentiality and reporting laws

align well with the ACA Code of Ethics, I feel that the lack of a duty to warn/protect law could

be seen as unethical if a professional counselor knowingly failed to warn a threatened individual

which resulted in serious harm. After reviewing the laws, I do not think any would pose

challenges with upholding, especially because I plan to consult whenever I run into any legally

and ethically relevant situations.

Overall, I feel much more informed about the specifics of my legal requirements as a

citizen and soon-to-be professional counselor in North Carolina. By obeying these laws,

counselors in the state of North Carolina will be adhering to the overarching themes I noted

across documents—the importance of upholding the rights of clients and our duties of ensuring

client welfare and minimizing foreseeable harm.

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References

American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/reso

urces/aca-code-of-ethics.pdf 

Licensed Professional Counselors Association of North Carolina. (n.d.). FAQ’s. Retrieved

February 22, 2022 from: https://www.lpcanc.org/faqs.php

Mobley, A. K. & Naughton, E. (2011). Tarasoff and duty to protect in North Carolina. NC

Perspectives, 4, 5-14.

North Carolina General Assembly. (2016). General Statute 7B-301. Retrieved February 22, 2022

from: https://www.ncleg.net/EnactedLegislation/Statutes/PDF/BySection/Chapter_7B/GS

_7B-301.pdf

North Carolina General Assembly. (2005). General Statute 14-32.3. Retrieved February 22, 2022

from: https://www.ncleg.gov/EnactedLegislation/Statutes/PDF/BySection/Chapter_14/G

S_14-32.3.pdf

North Carolina General Assembly. (1973). General Statute 108A-102. Retrieved February 22,

2022 from: https://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByArticle/Chapter

_108A/Article_6.html

North Carolina General Assembly. (1985). General Statute 122C-52. Retrieved February 22,

2022 from: https://www.ncleg.gov/EnactedLegislation/Statutes/html/bychapter/chapter_

122c.html