Confidentiality And Documentation In Clinical Consultation

I received an email from J. Kipp Lanning, LIMHP of AdultSpan Counseling in Nebraska asking about peer consultation groups.  He says:

A professional group of which I am a member is working on setting up a peer consultation group (APPT: Association of Private Practice Therapists).  Do you have suggestions on how to make this most effective/beneficial regarding paperwork that demonstrates consultation with peers?  Of particular concern to the group is a confidentiality agreement for the group and paperwork for the file demonstrating consultation with peers.

Thanks, Kipp

PS – love your blog!”

Thanks, Kipp, for being part of our online community here at Private Practice from the Inside Out and dropping in to chat!

Confidentiality

I am not an attorney and not qualified to give legal advice.   However, here is some of the information that I have been given related to this issue.  According to mental health attorney, Denis K. Lane,

The generally accepted standard, established by ethical codes and practices nationwide, is that clinical supervision is a confidential process, the same as the counseling done by a supervisee with a client.  Some states have exceptions to this rule, established by their state licensing board rules, but in general the supervision process is as confidential as mental health treatment itself . . . .  Because consultations are a form of supervision according to the Licensing Boards’ Supervision Rule, they, too are confidential.”  (The Legal Guide for Practicing Psychotherapy in Colorado, 2010 Edition, pp. 190-191)

I understand the mandated exceptions to confidentiality to be the same ones that pertain to counseling – those related to the potential for self-harm or the harm of others, court orders requiring disclosure, etc. Because Denis Lane is an attorney practicing in the state of Colorado, I would encourage you to take a moment to check with a mental health attorney in your own state to insure that you, your colleagues, and your clients are fully protected.

Permission from Your Client

You will also want to remember that in order to discuss any client, you must first have that client’s written permission to do so.  Former attorney and now counselor-in-training, Michelle Stevens of Introspection Counseling, offers this language to include in your consent to treatment and disclosure statement:

There may be times when I, as your psychotherapist, may need to consult with my supervisor or with a colleague or another professional, such as an attorney, concerning issues raised by you in therapy. Confidentiality is not waived during these consultations. By signing this disclosure statement, you give me permission, as your psychotherapist, to consult with other professionals as needed to provide professional services to you. This permission may be revoked at any time.”

Obviously, if you are not working under supervision, you do not need to include any reference to a supervisor in your statement

[Michelle is quick to note that the language above “is not intended as legal advice. I am not a practicing attorney and have never been licensed in or practiced in Colorado. When in doubt you should always consult an attorney with the expertise appropriate to your issue.”]

Clinical Documentation

The only other paperwork that comes to mind is the documentation that you need to include in your clinical note.  I wrote about that here in The 5 W’s of Clinical Consultation.

Kipp, I hope you’ll drop back in and let us know how your new consultation group fares!  We can all  learn from your challenges and your successes!  I look forward to hearing from you!