Confidentiality | Department of Psychology

Confidentiality

Texas law protects the privacy of communications between a client and a psychologist. Every effort will be made to keep your evaluation and treatment strictly confidential. In most situations, the clinic will only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements.

In the following situations, no authorization is required:

  • Clinical information about your case may be shared fully within the UNT Psychology Clinic by the students enrolled in clinic practicum and faculty for educational and therapeutic purposes. If clinical staff present case information at professional conferences, the information will be disguised such that it is impossible to link the information to you or your family.
  • Personal information is also shared for Clinic administrative purposes such as scheduling, billing, and quality assurance. Clinic files are also available to program site visitors. Data contained in your file are available for archival research (i.e., reviews of records to describe clinic referrals, outcomes, and trends) as long as your identity cannot be linked to the data used. All staff members have been given training about protecting your privacy and have agreed not to disclose any information without authorization or approval of the Clinic Director in mandated reporting situations (See Care During Crisis Situations).
  • On occasion, the Clinic may find it helpful to consult with another health or mental health professional. During such a consultation, every effort is made to avoid revealing the identity of the client. The other professional is legally bound to keep the information confidential. If you don't object, it is our policy to tell you about such consultations only if it is important to you and your clinician working together. All consultations are noted in the client's Clinic record.
  • Disclosures required by health insurers or to collect overdue fees are discussed elsewhere in this agreement.

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Limits to Confidentiality

There are situations where the Clinic may be required or permitted to disclose information without your authorization. These situations are unusual in this clinic.

These include:

  • If the clinic has knowledge, evidence, or reasonable concern regarding the abuse or neglect of a child, elderly person, or disabled person, it is required to file a report with the appropriate agency, usually the Department of Health and Human Services. Once such a report is filed, we may be required to provide additional information.
  • If a client communicates an explicit threat of serious physical harm and has the apparent intent and ability to carry out such a threat, the clinic may be required to take protective actions. These actions may include contacting the police and/or seeking hospitalization for the client.
  • If we believe that there is an imminent or even, in our judgment, high risk that a client will physically harm himself or herself, we will also take protective actions (See Care During Crisis Situations).
  • Although courts have recognized a clinician-client privilege, there may be circumstances in which a court would order the clinic to disclose personal health or treatment information. We also may be required to provide information about court ordered evaluations or treatments. If you are involved in, or contemplating litigation, you should consult with an attorney to determine whether a court would be likely to order the clinic to disclose information.
  • The Clinic is required to provide information requested by a legal guardian of a minor child, including a non-custodial parent.
  • If a government agency is requesting information for health oversight activities or to prevent terrorism (Patriot Act), the clinic may be required to provide it.
  • If a client files a worker's compensation case, the Clinic may be required, upon appropriate request, to provide all clinical information relevant to or bearing upon the injury for which the claim was filed.
  • If a client files a complaint or lawsuit against the Clinic or professional staff, the clinic may disclose relevant information regarding the client in order to defend itself. If any of these situations were to arise, the Clinic would make every effort to fully discuss it with you before taking action, and would limit disclosure to what is necessary.

The laws governing confidentiality can be quite complex. In situations where specific advice is required, formal legal advice may be needed.

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Care During Crisis Situations

The UNT Psychology Clinic is not able to provide emergency services or psychiatric medications. Individuals, who because of psychiatric difficulties need substantial case management, on-going medication adjustments, and/or emergency clinician access, are generally not appropriate for a training clinic. Such clients may be seen at the clinic when their situation is more stable.

UNT Psychology Clinic clients who are experiencing a crisis are encouraged to discuss this with their clinician as soon as possible so that a crisis plan can be developed. A crisis may be generally defined as a situation or period in which the person's usual coping resources fail and they experience a state of psychological disequilibrium in which they may be at risk for impulsive or harmful behavior. There are many examples of crisis situations, which may include: a client who is struggling with suicidal thoughts, a teenager who under distress runs away from home, a psychotic client who experiences severe symptoms such as hallucinations or paranoia because they have discontinued medications, and an alcohol/drug client who relapses to uncontrolled drug use with danger of overdose or serious harm. Such clients may or may not constitute an imminent danger to themselves or others; nevertheless, sometimes a judgment must be made to protect the client.

The policy of the UNT Psychology Clinic to which you consent as a client is to provide conservative treatment during a crisis situation. Your clinician would work with you to establish a plan to restore normal functioning as soon as possible. In addition to coping skills and possible environmental changes, this may include consultation with your physician, or if necessary, a family member or significant others. If you are a student living in university housing, it may mean letting appropriate university officials know of your situation. The clinic may divulge your client status and the minimal treatment information necessary to protect you during a crisis period. The need for such action will be discussed with you beforehand if at all possible. This exception to normal confidentiality would remain in effect until the crisis is over or your care has been successfully transferred to another mental health provider or treatment program. This crisis policy requires you trust in our professional judgment to balance risks with your rights to confidentiality. The crisis policy is consistent with a training clinic that supervises graduate trainees.

The clinic instructs clients who cannot reach us and are having an emergency to contact their physician or other community resources directly such as 911 or MHMR Crisis Line (800-762-0157).

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