topic Clinical Psychologist - privacy guidelines around sensitive information clarification please... in Treatments, health professionals and therapies

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Thu, 27 Sep 2018 14:17:11 GMT

I have just started seeing a clinical psychologist, he told me about privacy which I understand. However, I want to discuss some sensitive information and provide him with sensitive documents that I don't want other people or third party agencies to know about. I called AHPRA today and they referred me to the APS Code of ethics which is a legally binding document. However, I am still uncertain about whether a clinical psychologist can retain a sensitive file and less sensitive file. I am just concerned about third party agencies like Centrelink, insurers, worksafe etc finding out about sensitive information that is not relevant and then using that against me. I just feel that people should be able to consult with professionals without having to worry about this kind of thing. I also don't want him to keep an electronic file. Maybe I should discuss this with him at our next session, any advice would be appreciated.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

blondguy — Thu, 27 Sep 2018 15:26:12 GMT

Hello Tweet-Heart

Thankyou for the great thread topic.

I have had anxiety followed by depression for 35 years and have never had an issue with any psychologist and/or trust issues where privacy is concerned. They are bound by a strict code of ethics including non disclosure to anyone....including any business (insurer) or government department.

The only counselors that can report any information are health professionals (usually a psychiatrist) that have been appointed to carry out a health assessment on behalf of a government agency which you would be made aware of prior to attending. A consultation with a clinical psychologist is privileged and any details are not available to any private or government entity

Like you mentioned Tweet....asking your psychologist is a good idea even just for your peace of mind..

Just a note on electronic files....I think all psychologists/GP's/psychiatrists keep everything on a hard drive for record keeping purposes.......including my doctors too.

The forums are a safe and non judgemental place for you (and me too) to post Tweet 🙂

Any questions or comments are more than welcome. Your privacy is paramount to us Tweet

my kind thoughts

Paul

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

romantic_thi3f — Fri, 28 Sep 2018 00:00:08 GMT

Hi Tweet-Heart,

Thanks for your post. AHRPA was right to refer you to the APA Code of Ethics as this is the one that all psychologists follow, even though psychologists practice differently - whether that's private practice, with a clinic, as part of your employer or with Centrelink.

A big part of answering this question is how you know your Clinical Psychologist and how you were referred to them or where they are based. If you are seeing them as part of a work-safe claim for example then their interests and information recording is going to be different vs if you were seeing them private practice. This also includes the information that they'll be able to disclose.

As a general rule though, all psychologists will keep their own file and that's up to them whether that's electronic or hard-copy.

They also have the right (and are recommended) to have a two part record. The first part is the client record, which contains standard information about you (name, address, phone, dates of each appointment, letters from the GP). The second part is the confidential client record. This is where more information about the appointments are included, sensitive information, test records, etc. Generally third parties (like worksafe) will only request the standard record, but they can request the second one.

Hope this answers your question! It might be best if you can chat with your clinical psychologist about it - that way he/she can give you much more clarity.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

smallwolf — Fri, 28 Sep 2018 00:29:27 GMT

Hi,

The other posters hit the nail on the head. From my understanding, as a client, working in IT and studies I am doing now...

Information disclosed is supposed to be confidential. There would be some scenarios whereby this might be broken.

As far as computer files are concerned, these should be stored in a secure manner.

But the best thing to do really is to raise any issues or questions you may have with your psychologist for peace of mind.

Tim

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Elizabeth CP — Fri, 28 Sep 2018 06:05:44 GMT

The only time my psych has shared information it has been at my request. A few times he has written a written report (at my request) but has given me a copy to check & approve the report before forwarding to the other person. I believe the only time confidentiality can be broken is if issues arise showing a risk to you or others (eg child abuse) when mandatory reporting regulations apply.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Fri, 28 Sep 2018 06:49:07 GMT

That's really helpful. I don't know how it all works. I've had my privacy breached in the past.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Fri, 28 Sep 2018 06:54:54 GMT

I was referred by my GP under a mental health care plan. He briefly explained at the start of our first session about privacy and circumstances it would need to be disclosed and my file could be given to a court under subpoena. But even then there should be some kind of priveledge. He didn't elaborate further and it was up to me to do my own research into the specific record keeping requirements for clinical psychologists. So next session I will most certainly be raising this with him armed with a copy of the APS code of ethics. How would this work with my GP? I'll have to discuss this with her at our next session.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Sat, 29 Sep 2018 14:02:30 GMT

This is off topic but I wanted to know why when I was having a panic attack and started hyperventilating why he told me to look at him and breathe through my nose. Maybe cos breathing through the nose helps.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

geoff — Sat, 29 Sep 2018 19:40:44 GMT

Hi Tweet-Heart, and I agree with all the great replies above me, however, if you want to change doctors from one practice to another one, you have to sign a form allowing the transfer of your documents on the computer over to another doctor, but I believe that your files may stay with both doctors, although the doctor you're not seeing has no interest unless the new doctor wants to contact him/her.

In regard to Life Insurance ( LI ) policies when you pass away, the LI can subpoena your records with a court order only because they want to find out something so they don't have to pay out, that's why I have denied this new 'my health record opt out' but talk to your lawyer.

I don't like to give people sites to google but this has so much information 'can my health record opt out be subpoenaed'.

I could spend hours reading the guildlines, however, what I'm saying is that 'it means to believe what they are saying without proof', so I'm just directing you to this site.

Best wishes.

Geoff.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

geoff — Sat, 29 Sep 2018 19:51:27 GMT

Hi Tweet-Heart, I've just seen this it has been copied and pasted,

Doctors working for life insurance companies and my employer will access my record.

False.

Only registered clinicians providing you with health care can access your record. Doctors being paid by employers and life insurance companies are not allowed to access your My Health Record for this purpose.

Geoff.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

blondguy — Sun, 30 Sep 2018 10:18:37 GMT

Hi Tweet

Its not off topic at all. Breathing through our nose (slowly) does slow down our breathing which then also helps in avoiding hyperventilation too!

Geoff has mentioned a good point above about doctors and access to your private information.

Your GP cannot divulge any of your records unless you have provided written permission

I hope you had a good weekend Tweet

my kind thoughts

Paul

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Mon, 01 Oct 2018 06:20:30 GMT

Thanks Paul

I am sure that is why he asked me to breathe in and to look at him as I was having a full on panic attack in front of him.

Also I'm concerned about confidentiality as he started giving me some details of a former patient who was stalking him. I was telling him about someone stalking me and he was giving me advice. I know he didn't mention her name but I don't feel it was necessary or appropriate to go into such details.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Mon, 01 Oct 2018 07:48:14 GMT

I also want to add I feel very unsafe going to his practice rooms as he told me the former patient who stalked him walks past his practice and she can do this as the intervention order expired. I am really freaking out I should discuss this with him.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

smallwolf — Wed, 03 Oct 2018 01:56:30 GMT

Hi,

Regarding your latest posts... my psychologist tells me stories involving herself in order to help me see something in a different light. Admittedly I cannot recall if any of these would include other patients; nor do I know from your description the amount of information provided. But if the matter is concerning to you, you probably should tell them, if only so that you can both maintain a good relationship in a safe environment. Whether you do or not is up to you? This way you are helping to define the boundaries of the sessions?

Tim

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Wed, 03 Oct 2018 09:14:33 GMT

Hi Tim

Thanks he told me she's harmless but by what he described it is very concerning and I know he was telling me to assist me in gathering evidence against the male who is stalking me but he went into allot of detail and also said she accused him of doing something very bad which I won't repeat. I just don't feel safe Tim and not sure how to tell him and I don't want to bombard him with a call before our session.

I am getting nightmares, flashbacks and I am too scared to leave the house.

Please let me know what he can do to make me safe when we next meet I'm feeling frightened.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

smallwolf — Thu, 04 Oct 2018 02:23:55 GMT

Tweet-Heart,

Sorry that you do not feel safe anymore because of this situation.

I an not sure that I could really answer "Please let me know what he can do to make me safe" and prefer not to give advice, but I can make the following suggestion to you in relation to "telling" him. I have on the odd occasion sent an email to my psychologist about things. During the week I would not be sure whether my psychologist is in the office, with a client etc. By writing down the problem in an email you get the chance to think about what you want to say, make sure it is in some logical format, and contains everything you want to say. Just make sure you don't shout etc in what you say. In this way, you get to say what you want and when your psychologist is available they can read it and respond appropriately?

Regarding the nightmares... something to talk to your psychologist about? Write down in a journal for your next session? I know these sorts of dreams are bad, but remember they are a dream. Trying to tell us something.

I assume the story you were told triggered the flashbacks and made you scared to leave your house? Has anything else changed to make you scared? Do you have any distraction or coping techniques bring to back to the present moment? Perhaps the nightmares are also making you scared? If you can figure out the whys, wherefores and/or triggers/causes, you might have something to work with. It won't solve the original problem, but help to get through to next week.

For what it is worth, I find writing things down on paper helps to reduce the negative thoughts in my head. And my hope is that it might work for you also.

Tim

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Thu, 04 Oct 2018 04:41:15 GMT

Hi Tim

That is very useful. I feel he is being quite selfish and inconsiderate. I almost felt like he wanted to off-load by going into detail and he should have known that would trigger things for me.

I am not his counsellor he should find another outlet to express his feelings. At the end of the day he is not the one feeling unsafe I am and when I called him a few days later when I was having a panic attack I felt like he was fobbing me off. He told me it's a social workers job to help me in this sort of crisis situation or to ring WIRE.

I'm going to take him to task on this I'm angry.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

smallwolf — Thu, 04 Oct 2018 08:33:55 GMT

Tweet-Heart,

Hello again. I hope you dont mind if I tell you a little story... I am not doing any study this term, but am doing a subject by auditing... something was said in the 1st lecture that made me angry, feel judged etc. I was affected (badly) for about a week. In that next week, I brought up the issue with my psychiatrist. I explained what had happened in that first lecture and how I felt. (I wanted to disappear at that time.) My psychiatrist told me that my feelings were natural, and there are people who will make you think/feel that way. She said something else that put me at ease as well.

I think that what my psychiatrist said to me would apply to you as well. The one caveat I would put to you is that if you intend to "take him to task" as you suggest, please try to do it is an assertive manner rather than angry? I agree your counselor should have considered your feelings in telling you that story. He probably misread your body language or ??? Not an excuse, but worth considering?

The other thing I would like to ask relates to when you were having a panic attack... I am not sure what sort of terms you might have in your contract (?) with the organization re contacting them. Now I have my psychologist number on my phone in relation to my safety plan, but I have other number to try before her, such as my own support people, lifeline etc. Do you have similar numbers on your phone? Maybe when you see him next, ask him who you should have called?

Tim

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

Tweet-Heart — Fri, 05 Oct 2018 07:50:28 GMT

Hi Tim

He is being precious and I tell you what I am feeling hormonal and I don't know if I trust him anymore.

He wants me to do Jeffrey Young's scheme questionnaire, he just wants to pathologise and label me.

You wait until I see him next I'm going to blast him.

Clinical Psychologist - privacy guidelines around sensitive information clarification please...

romantic_thi3f — Sun, 07 Oct 2018 22:45:08 GMT

Hi Tweet-Heart,

Thanks for your post and apologies for the late reply.

I'm not sure how many of your questions have really been answered so I might echo some responses!

With the confidentiality concerns, absolutely raise this with your GP. If your GP doesn't know your psychologist will, so if you can be specific with your questions they can be specific with their answers. Once you know what you can disclose I imagine it would be a lot more reassuring.

I was a little bit worried though when you mentioned them discussing a former client. That would raise a big red flag for me. When psychologists make disclosures like that they need to make sure that it's confidential, not going to identify anyone, brief, and relevant to you and your situation. Ultimately though, it's up to you and how comfortable you feel with it.

and finally - there are a couple of reasons why your GP might have asked you to breathe through the nose. One of the reasons it's that it's harder - forcing you to really focus on your breath which helps to ground you. Nose breathing also helps to regulate our 'parasympathetic nervous system' aka our flight/fight response.