Psychologists' Multiple Roles in Long-Term Care Untangling Confidentiality Quandaries

• Published in: Clinical gerontologist Vol. 25; no. 3-4; pp. 261 - 275
• Main Author: Norris, Margaret P.
• Format: Journal Article
• Language: English
• Published: Taylor & Francis Group 06-03-2003
• Subjects: Balancing; Confidentiality; Elderly people; ethics; geropsychology practice; Long term care; Multiple roles; Psychologists; Treatment; USA
• ISSN: 0731-7115; 1545-2301
• DOI: 10.1300/J018v25n03_04

Psychologists consulting in long-term care settings face unique challenges in protecting the confidentiality of their clients. In multidisciplinary health service facilities, the psychologist typically provides direct therapy services to clients, while at the same time they coordinate their treatment efforts with numerous other health service providers. The psychologist must balance the confidentiality of their clients with their collaborative role as a member of a treatment team. This article will summarize confidentiality standards of various professional organizations, discuss the issues involved in these multiple roles, suggest guidelines that psychologists may use to resolve conflicts, and present brief scenarios that illustrate confidentiality dilemmas. Recommended practices include (1) informing clients at the initiation of services about communication procedures of the facility (e.g., progress notes, treatment team meetings); (2) obtaining agreements about what types of information will and will not be communicated in these forums, as well as what information patients want shared or protected from family members; (3) establishing a practice of providing general rather than specific information to staff; (4) adopting the "need to know" principle, i.e., restricting all communication to information that is essential to the facility's care and treatment of the patient.