Alicia Fishlock

9/26/2021
Written Assignment #1

Confidentiality in Substance Use Disorder Counseling

Substance Use Disorder Counselors are bound to protect their client’s rights to

confidentiality. According to The Department of Health Services, “All treatment records

or spoken information which in any way identifies a patient are considered confidential

and privileged to the subject individual.” (DHS, 2008). In order to disclose any treatment

information to others, you must obtain informed consent from your client. In order to

obtain informed consent you must receive written consent from your client stating what

information can be shared, with whom the information can be shared, and the period of

time in which the information can be shared (Wisconsin Department of Health Services,

2016).

There are a few exceptions when informed consent is not needed to release

confidential records to other organizations (Client’s Rights Office, 2012). These

exceptions include sharing records with organizations that are designated to conduct

audits or program evaluations, organizations who are in charge of billing or collections,

organizations that are conducting research approved by The Department of Health

Services, a judge or court if a subpoena or search warrant has been issued, healthcare

providers during an emergency situation where informed consent cannot be given, and

facilities that are going to receive a patient on an involuntary commitment (Client’s

Rights Office, 2012). Although these exceptions exist we should always limit the
information given to that which is absolutely necessary for the receiver of the

information to carry out their duties (Client’s Rights Office, 2012).

Another exception to the confidentiality law is when a patient poses a risk of

imminent danger to themselves or others (Pajer, 2019). There may be times when our

clients are thinking of acting on suicide or homicide (Pajer, 2019). In the case of suicidal

intent, the counselor may have to breach confidentiality in order to involuntarily commit

the patient to inpatient services or inform someone who can keep them safe (Pajer,

2019). In the case of homicidal threats or intent, the counselor is obligated by the duty

to warn which can include notifying local law enforcement or the person who is in

danger (Pajer, 2019). The counselor must make their client aware of these exceptions

at the beginning of their treatment (Pajer, 2019).

Confidentiality Laws are still in place for minors in substance use disorder

counseling and treatment with a few exceptions (Wisconsin Department of Health

Services, 2019). In most cases the parent or guardian of the minor has the right to attain

any of the minor’s treatment records (Wisconsin Department of Health Services, 2019).

This however does not include treatment notes which can be kept confidential by the

therapist or counselor (Wisconsin Department of Health Services, 2019). There are a

few exceptions to disclosing a minor’s records to a guardian (Wisconsin Department of

Health Services, 2019). In the event of the counselor or therapist believing that the

release of the minor’s records to their guardian will put the minor in danger, they do not

have to release the records (Wisconsin Department of Health Services, 2019). Another
exception is that if the parent or guardian has been denied periods of physical

placement with the minor the records do not have to be released (Wisconsin

Department of Health Services, 2019). Physical placement implies that the minor is

living with the guardian (Wisconsin Department of Health Services, 2019). However,

access to the minor’s medications and physical health issues can never be kept from

the parent or guardian (Wisconsin Department of Health Services, 2019).

These confidentiality rules and laws are in place to protect our clients (American

Psychological Association, 2019). We are lawfully obligated to uphold these laws or we

may be barred from licensure and could face criminal charges in the court of law

(American Psychological Association, 2019). These laws create a safe space for our

clients to divulge information that they would otherwise feel uncomfortable talking about

if confidentiality laws weren’t in place (American Psychological Association, 2019). It is

our ethical and legal duty to uphold these laws (American Psychological Association,

2019).
 References

American Psychological Association. (2019, Oct 19). Protecting your privacy: Understanding

confidentiality. Retrieved from https://www.apa.org/topics/ethics/confidentiality

Client’s Rights Office, Division of Mental Health and Substance Abuse Services, Department of

Health Services. (2012, Jun 26). Confidentiality Explained. Retrieved from

https://www.dhs.wisconsin.gov/clientrights/cro-confid-explained.pdf

The Department of Health Services. (2008, Nov). CONFIDENTIALITY OF TREATMENT

RECORDS Chapter 92 Published under s. 35.93, Stats. Retrieved from

https://docs.legis.wisconsin.gov/code/admin_code/dhs/030/92.pdf

Pajer, N. (2019, Sept 10). What Therapists Are Legally Obligated to Report Despite

Confidentiality. Retrieved from https://www.huffpost.com/entry/what-therapists-report-

confidentiality_l_5d2cf063e4b0bca603641a62

Wisconsin Department of Health Services. (2016, Oct 25). Client Rights - Informed Consent.

Retrieved from https://www.dhs.wisconsin.gov/clientrights/informedconsent.htm

Wisconsin Department of Health Services. (2019, May 16). Client Rights: Minors, Records.

Retrieved from https://www.dhs.wisconsin.gov/clientrights/minors-records.htm