This is a presentation of a breakout session co-conducted by Rick Auger, Nick Abel, and Brandie Oliver at the American School Counselor Association (ASCA) annual conference in Boston, Massachusetts, in July of 2019

Abel, Nick R.

Auger, Richard

Oliver, Brandie M.

English

Digital Commons @ Butler University

Butler University Digital Commons @ Butler University Scholarship and Professional Work – Education College of Education 7-2019 Confidentiality vs. Sharing Richard Auger Nick R. Abel Brandie M. Oliver Follow this and additional works at: https://digitalcommons.butler.edu/coe_papers  Part of the Student Counseling and Personnel Services Commons Confidentiality vs. SharingRick Auger, Nick Abel, and Brandie OliverInsert Online Poll SlideQuestion #1Insert Online Poll SlideQuestion #2Insert Online Poll SlideQuestion #3Adolescents’ Attitudes About Help-Seeking • Adolescents, particularly boys, are generally unwilling to seek help for emotional problems from health care professionals • Willingness to seek help for psychological problems decreases as children move into adolescence• Broad research suggests that less than half of students are willing to see their school counselor Adolescents’ Attitudes About Help-Seeking Facilitative Factors• Good listener• Empathic• Nonjudgmental• Trustworthy• GenuineAdolescents’ Attitudes About Help-Seeking Barriers• Concerns about counselors being negative/judgmental• Concerns that the counselor couldn’t help• Desire for self-reliance• Stigma (counseling as a sign of weakness; fear of being judged)Adolescents’ Attitudes About Help-Seeking BarriersConcerns about confidentialityStudents’ Attitudes About Seeking Help from School Counselors• 3,584 students from 12 schools in two states• Grades 6-12• 77% White, 5.3% African American, 4.4% Hispanic/Latino, .4% Asian/Pacific Islander, 3.8% multiracial• Instrument: Online survey, administered by field coordinators For what reasons have you met with your school counselor?Number of Students PercentageAcademic issues 1,644 45.9%College/career issues 1,045 29.2%Social/emotional issues 633 *17.7%I have not met with my school counselor1,194 33.3%* 22.3% female; 12.1% maleMiddle School High SchoolSocial/emotional 27% 12.5%Academic 13% 65%College/career 2.5% 44%For what reasons have you met with your school counselor?Note: Middle school students were far more likely to report zero meetings with their school counselor than high school students (48% vs.17%) Would you go to your school counselor for the following issues?1 - Very unlikely      2 - Unlikely     3 - Undecided     4 - Likely      5 - Very likelyMeanChange your schedule 3.47Explore college options 3.42A friend told you they were thinking of self-harm 3.08Bullying 2.81You’ve been feeling very sad lately 1.98To what degree would the following reasons STOP you from seeing your school counselor for a personal issue?1 - Very unlikely      2 - Unlikely     3 - Undecided     4 - Likely      5 - Very likelyMeanI would talk to to a parent, friend, or teacher about this instead of talking to my counselor3.17I like to handle stuff like this on my own 3.15I don’t know my counselor well enough to talk about this2.93The counselor might tell someone what I said 2.89I didn’t know the counselor did stuff like this 2.47To what degree do you feel the following reasons would STOP students from coming to see you for a personal issue?1 - Very unlikely      2 - Unlikely     3 - Undecided     4 - Likely      5 - Very likelyMeanI like to handle stuff like this on my own 3.67I would talk to to a parent, friend, or teacher about this instead of talking to my counselor3.54I don’t know my counselor well enough to talk about this3.34It’s embarrassing or not cool to see the school counselor for this3.31The counselor might tell someone what I said 3.25What would be the biggest reason you would NOT choose to see your school counselor when you had a problem?• Don’t feel comfortable with the counselor• It is weak to share personal problems with adults• Prefer to talk to family/friends• Don’t want to miss class• Counselor is too busy or don’t know when the counselor is availableWhat would be the biggest reason you would NOT choose to see your school counselor when you had a problem?Confidentiality concernsWhat would be the biggest reason you would NOT choose to see your school counselor when you had a problem?If they would tell other people what we talked aboutShe may tell someone else what I said (trust factor)Because I don’t trust them with my issuesIf they would tell people what I talked to them aboutI don’t know who the information I give is shared withIf the counselor told other people my problemsWhat would be the biggest reason you would NOT choose to see your school counselor when you had a problem?They have told people other problems in the pastIf she would tell someoneIf the counselor would email my mom and dad about itI would be afraid the counselor would call parents or tell teachers about the issuesIf I had a personal problem I would be afraid they would tell people or judge meWhat would be the biggest reason you would NOT choose to see your school counselor when you had a problem?Nothing, I love herConfidentiality“A professional’s promise or contract to respect clients’ privacy by not disclosing anything revealed during counseling except under agreed upon circumstances” (ASCA, 2003)Who Wants to Know?“Regularly ask questions regarding contents of counseling sessions that would require breaking confidentiality.”Teachers/Staff: 41.3%Administrators: 36.5%Parents/Guardians: 34.9%Stone, 2017Who Needs to Know?• Rarely black and white• Wrestle with tough choices about disclosure• Feel the tension between a student’s right to privacy, the law, and the rights of others to know• Follow a consistent processHow to Decide?• Ethical Decision Making Model• Law & ASCA Ethical Standards• Serious & Foreseeable Harm• Standards of PracticeEthical Decision MakingStone (2017) STEPS Model• Define the problem emotionally and intellectually• Apply the law and ethical standards• Consider the student’s age & developmental level• Consider the setting and parent’s rights, student’s rights and the school authority’s right to know• Apply the moral principles• Determine your potential courses of action and their consequences• Evaluate the selected course of action• Consult• Implement the course of actionLaw & Ethical Standards• Is there a law mandating that I tell someone?• Examples: Abuse/Neglect, Threats of Harm to Others• Is there an ethical standard to guide me?• ASCA Ethical Standards for School CounselorsExample: Standard A.2.• h. In absence of state legislation expressly forbidding disclosure, consider the ethical responsibility to provide information to an identified third party who, by his/her relationship with the student, is at a high risk of contracting a disease that is commonly known to be communicable and fatal. Disclosure requires satisfaction of all of the following conditions: 1) Student identifies partner, or the partner is highly identifiable; 2) School counselor recommends the student notify partner and refrain from further high-risk behavior; 3) Student refuses; 4) School counselor informs the student of the intent to notify the partner; 5) School counselor seeks legal consultation from the school district’s legal representative in writing as to the legalities of informing the partnerExample: A.2.• f. Recognize their primary ethical obligation for confidentiality is to the students but balance that obligation with an understanding of parents’/guardians’ legal and inherent rights to be the guiding voice in their children’s lives. School counselors understand the need to balance students’ ethical rights to make choices, their capacity to give consent or assent, and parental or familial legal rights and responsibilities to make decisions on their child’s behalf.Example: Standard A.2.• e. Keep information confidential unless legal requirements demand that confidential information be revealed or a breach is required to prevent serious and foreseeable harm to the student. Serious and foreseeable harm is different for each minor in schools and is determined by students’ developmental and chronological age, the setting, parental rights and the nature of the harm…Serious & Foreseeable Harm• “A reasonable person would be able to predict or expect the ultimately harmful results…”• “…not involving the parents/guardians poses a greater risk to the student” and outweighs the benefits of maintaining trust and continuing counseling.Stone, 2017Serious & Foreseeable Harm• Chronological Age / Developmental Level• Frequency / Intensity / DurationStudent is smoking17-year old student vs. 9-year old studentOccasionally at a party vs. 2 packs a dayNo health issues vs. Diagnosed asthmaStandards of Practice“What would a reasonable school counselor with similar education and training in a similar community have done?”• Consult (colleagues, other schools, email listservs / online discussion groups)• Search for similar scenarios online or in books• Consider researchStandards of Practice• Moyer & Sullivan, 2008• Surveyed ~200 MS and HS Counselors• Asked how likely they would be to break confidentiality in each situation• Scale from 1 (Unquestionably Unethical) to 6 (Unquestionably Ethical)Standards of PracticeN Mean             SDN Mean             SDSuicide vs. Substance Use• “School counselors…have a high standard of care when a student’s suicide is even a remote possibility.  School counselors must always contact parents/guardians and refer them to appropriate resources…” Stone, 2017• Confidentiality with students for whom we have knowledge of their drug and/or alcohol use falls under the complications of confidentiality.  It is difficult to determine whether or not we should breach confidentiality…the type of drug, the student’s age, the student’s family support, and the frequency of drug/alcohol use all come into play…” Stone, 2017Who Needs to Know?• Rarely black and white• Wrestle with tough choices about disclosure• Feel the tension between a student’s right to privacy, the law, and the rights of others to know• Follow a consistent process• Define the problem emotionally and intellectually• Apply the law and ethical standards• Consider the student’s age & developmental level• Consider the setting and parent’s rights, student’s rights and the school authority’s right to know• Apply the moral principles• Determine your potential courses of action and their consequences• Evaluate the selected course of action• Consult• Implement the course of actionInsert Online Poll SlideQuestion #4cc: Leo Reynolds - https://www.flickr.com/photos/49968232@N00QUESTIONS?Thank you for attending our session!   Feel free to contact us with further questions or comments:Rick Auger Nick Abel Brandie Oliverrichard.auger@mnsu.edu nabel@butler.edu bmoliver@butler.edu

Confidentiality vs. Sharing

https://digitalcommons.butler.edu/cgi/viewcontent.cgi?article=1174&context=coe_papers

Confidentiality vs. Sharing

Abstract

Similar works

Full text

Available Versions

Digital Commons @ Butler University