Privacy And Confidentiality Regarding Children In Elementary Schools
The academic, behavioral, social, and emotional life of a student is very important. However, most students are not in a position to manage their lives amongst these very demanding and important aspects of their lives. At this point, schools then seek the services of psychologists to provide services to students such that they can balance them and excel. The contribution of the school psychologists is very outstanding in the education system.
In today’s world, school psychologists are very highly trained in both psychology and education. These qualifications form the background that is required to provide assistance to parents and other school personnel in regards to the emotional, behavioral and learning challenges that their children face. To the students and youths, school psychologists provide direct educational and mental health services. School psychologists also work in collaboration with teachers, parents, and other professionals to establish supportive learning and social environments for all children.
In most cases, the psychologists are relegated to the field of special education and determine the eligibility of students through much time in assessment of students. The school psychologists have their professional roles and functions influenced external forces, qualities achieved from training (brought to the job), and the factors found on the job. To the job, the school psychologists bring about personal characteristics, personal background, professional training, professional interests and expectations. For the qualities found on the job, the psychologists find job descriptions, available resources, job-site characteristics and needs.
The external factors include legal and legislative changes, societal problems, and research findings. The general principle of “respect for the dignity of persons” appearing in the NASP’s professional principles of Ethics (2000 and 2010) defines psychologists’ practices. The psychologist’s professional nature of practice requires that the school psychologist demonstrates respect for the clients’ rights. The nature of practice defines the client’s rights as self-determination and autonomy, commitment to fair treatment of all persons, and privacy and confidentiality. The focus of this paper is on privacy and confidentiality regarding children in elementary school settings.
Privacy as a legal and ethical concept
According to Jacob, Decker, & Hartshorne (2011, p. 47), privacy is referred to as the liberty of persons to decide for themselves moments in time, and conditions under which, and the degree to which their belief, behaviors, and opinions are to be shared or withheld from others. The school psychologist must understand that the information contained in student files is protected by privacy laws. This means that the student’s information must be contained and managed in compliance with the requirements set apart by the law.
In addition, privacy of client’s information requires that no information that is not intended for the purpose is collected. NASP-PPE I.2.2; APA-EP 4.04 states that the school psychologists should not seek to store private information about clients that is not needed for services provisions. School psychologists are called upon to respect the right of their clients to personally determine whether or not their private information should be disclosed. In addition, it is up to the school psychologists to make every effort to minimize intrusions on privacy.
Minimized access to students’ personal and health information ensures that the student or the family is not placed at legal or social risks posed by third parties. The only exception for inclusion of a third party is as provided in the provider-client privilege state laws. School psychologists are required to maintain privacy and confidentiality for professional and ethical reasons within the school counseling systems. However, under the law, legal privilege is a legal term. Under school counseling only the ethical meaning of confidentiality applies.
The fact that school counselors are not legally bound does not imply that minor students in elementary schools have no privacy applied to them. For the elementary students however, several legal exceptions must be considered. For instance, it is only after the attainment of 18 years that students are eligible for the right to give consent. In the elementary school however, the student’s parent has the right to deny or give consent (Hassan, 2009, p.1). Given that only the parent to a minor has the right to give or deny consent, the parent can forbid a minor from seeing the school psychologist, or forbid the counselor from working with a minor.
However, provided the parent has not issued such consents, the school counseling which is considered as a regular educational service goes ahead. From the legal point of view however, many aspects where student’s privacy legal limitations are not clearly defined. This lack of legal clarity results to unavoidable conflicts between what the schools perceives as need or personal information about students and the right of parents and students to be free from unnecessary intrusions of privacy, Jacob et al., (2011).
Confidentiality as a legal and ethical concept
According to Jacob, et al., (2011), confidentiality is described as an overt assurance or contract to make known nothing about an individual except under conditions agreed by subject or source (p.58). According to Eric (n.d), all information concerning a given client should be kept confidential except when the client is a threat to self or to others; the client or parent requests that the information be accessed by a third party; or where a court order requires that information be disclosed.
Although confidentiality is mainly an ethical issue and school counselors have a confidential responsibility. Statutory privileges belong to the client and not the counselor and the court cannot compel the counselor to disclose confidential information (n.d). In some states, psychologists can be held as civilly liable under state law for an impermissible breach of the confidentiality of the client. Impermissible breach of client confidentiality can also result to the loss of psychologist’s practice credentials, that is, loss of license or certification to practice (Jacob et al., p.58).
Knowing the ethical and legal dilemmas involved in maintaining confidentiality, school psychologists cannot promise absolute confidentiality since there are situations where confidentiality has to be broken. However, professional relationship must be established between the psychologist and the student and their family. Privacy laws provide exemptions for extreme circumstances allowing for the disclosure of personal or health information where serious and imminent threat to the safety and health of the public is lessened. In addition, exemptions for extreme circumstances apply where it falls within legislation.
The psychologist has to create trust by informing pupils and other clients about confidentiality and the boundaries where such confidentiality applies. Trust should be seek for a shared understanding with the clients regarding the type of information that will not be shared with third parties (NASP-PPE I.2.3). unless for emergency situations, the onset of offering psychological and counseling services requires that psychologists discuss confidentiality and its limits. For instance, the case of child abuse or child being suicidal is an emergency situation that may not allow for the onset discussion of confidentiality and its limits (Williams, Armistead & Jacob, 2008). The parameters of confidentiality promise will vary depending on the maturity and age of the student, reasons for referral and nature of service offered.
A case of promising an obsolete confidentiality
Williams et al. described an explicated case in which a discussion on confidentiality limits would prevent a possible betrayal of trust.
A school psychologist began intervening with a 7-year-old male child. This male child had behavior problems in school and so the psychologist planned to meet with the child regularly for counseling. The aim of the school psychologist was to explore the excessive use of anger feelings that seemed to be happening to the child. On the onset of the meeting the school psychologist explained the intentions of the meetings. The psychologist also told the child that the content of their conversations would remain confidential (p.37).
The counseling sessions proceeded well and on the fifth session, the boy revealed that his father had used extremely excessive “discipline” techniques on him. This happened whenever the boy’s father had been drinking. After listening to the child, the school psychologist felt that he had heard information that was reportable under the state law mandating that psychologists and other persons report suspicions of child neglect and abuse. However, he had promised the boy confidentiality (p. 37-38).
Unfortunately for this case, the psychologist had already made a promise of complete confidentiality, and the child may feel betrayed because the promise was broken. On the other hand, the child is suffering from child abuse and the court may have to order that the information be disclosed for further investigations and for the best of the child’s security and safety. In addition, the child’s case presents embarrassing personal information and improper dissemination of such information may result to increased discrimination against the child by the father.
Child abuse information can be very harmful when released despite of the presence of proven or inaccurate information. A bleach of confident information may also mean that other children avoid seeking psychological help for fear that their information will be revealed to other persons like teachers or parents. The fact that there was an assurance of confidentiality enabled the student to seek help and to fully disclose what he was going through. This is essential for their treatment and maintenance of trust (NCREL, n.d.).
At this point, the school psychologist is in a situation presenting conflict between ethics and law (APA, 1.02). The psychologist must elucidate the environment of conflict and make known their nature of Ethics Code then take reasonable step to resolve the conflict which must be in line with the General principles and Ethical standards of the ethics code. This standard must not however be used to justify any violations of human rights. In this situation, the school counselor is required to report acknowledged or alleged child abuse or abandonment. Only the essential information may have to be revealed. That is, only information directly required to deal with the child’s abuse should be revealed (Susan, 2009, p. 3). This is because the less the information revealed by the psychologist, the more they salvage the trust and rapport with the student.
The “need to know” principle
Like in the case above where the psychologist has to reveal the student’s abuse information despite confidentiality promise, the disclosure must be within the need to know basis. This is because the boy’s abuse by father information has been learnt in the course of the practitioner-client relationship. In such a case, the need to know principle will force the psychologist to discuss, reveal and or release private information. The revelation must however be such that the third party has legitimate need to know and that the information will be only for confidential purposes only (NASP-PPE I.2.5). The revelation of confidential student information must also be done within stringent restrictions of pertinent privacy decrees (NASP, 2010).
Under the needs to know principle, the agency interested in the confidential information of a given student must provide sufficient information to the school. It is this information that will be used to enable the relevant person to make a decision about the request. The school must then evaluate the requested information to confirm that this information would in fact be of assistance to the agency in decision assessment or plan (APS, 2012). The information is considered relevant if it is used to conduct any investigations, and provide service, concerning the happiness or comfort of the youngster or young person.
Confidential information can also be used to manage a risk regarding that young person or child. To minimize unauthorized access of client’s confidential information, the psychologist can object under cover of a letter of objection in the case where they doubt the motive behind information release (ASP, 2012). In addition, the psychologist must always ensure that they observe the difference between professional collaboration and social conversation, (Williams et al, 201). In professional collaboration, confidential information is discussed in an official environment and not over a cup of tea like any other social conversation. Any psychologist should avoid social conversations where confidential information is involved as this would breach the ethical principle mentioned.
Does the child have any legal and ethical rights for privacy and confidentiality?
School psychologists reverence people’s rights to choose for themselves whether or not to reveal their personal position, thoughts, behaviors and beliefs (NASP-PPE I.2). Given that the privacy and confidentiality principle, there is need to establish whether or not a young student in elementary school can decide whether or not they are willing to disclose their private information. In my opinion, the school psychologist is faced with one or more ethical dilemmas. By allowing the student to permit the assessment of the confidential information, the psychologist builds trust and relationship between them. Informed consent from the student also reveals that the student did, indeed, choose their decision freely.
However, it is not obvious that the students have the right to a full range of privacy rights as is afforded to adult citizens (William et al, P. 45.). as a result, children are not eligible for legal and ethical rights for privacy and confidentiality. On the contrary, it is their parents and their legal guardians who are granted the right to act on the children’s behalf regarding their legal and ethical rights for privacy and confidentiality. This means that the minors like those in elementary schools have no absolute privacy and confidentiality rights.
Although the parent offers consent for the child, this does not apply in all cases as the psychologist may decide not to reveal a student’s information to the parent or guardian especially where the parent is the cause of behavior change in the child. For instance, a child may become violent after several instances of experiencing violence at home. A child may hate women from the words used to and the way his father describes them. In this instance, the psychologist should prevent breaking such news to the family and involve a third party directly. However, there are times when the psychologist discovers that the data obtained from the tests are at the best interest of the student for others to know.
Confident information disclosure requires that the student reveals such information only to parties deemed as clearly concerned about the student like parents and teachers. Some interveners feel that parents and teacher work towards the best interests of the child and therefore find it essential to disclose such information to them. According to NASP-PPE I.2.4, third parties are not allowed to access confidential information without the youngster’s parent’s consent. Except for situations in which failure to disclose information would result to endangering of the life of the student and others like his or her family, the parent’s consent is required by the law.
In the best interest of the child
Despite the fact that the parent is the only consent provider for minors, the psychologist may decide to proceed without parents consent and inform the student why this was done and work to repair any damage to the established psychologist-client relationship (UCLA, 1994, n.p). Williams et al claim, founded the NASP-PPE, IV.A.2 that the school psychologist’s main responsibility is the client. In school locale, the client is the scholar, and the sponsor acts as an advocate of the child’s rights and welfare.
In cases where seeking the consent of the parent or guardian or revealing to the parents and guardians will result to conflict, the psychologists goes to a conclusion that best supports the child’s interests (p. 11). The child’s information put the life of the child in or out of stake in any psychology situation. It is in this light that the psychologist will always act in the child’s interest no matter how much they have to sacrifice. In addition, the psychologist will at all times be willing to advocate the child’s life and welfare.
For the minor child, there is not any given time that the minor student is eligible to provide his or her consent to reveal personal information in privacy and confidentiality principles. However, the student, under privacy and confidentiality situations, is entitled to issue his or her assent. In psychology, assent is used to refer to minor’s affirmative agreement for the child to participate in psychological and psychoeducational services. For instance, it is wrong for a psychologist to reveal a child’s test information that might increase the possibilities of the child’s discrimination or harm by their parents or fellow students.
The withheld information revelation is mostly in times where there is no positive proof of the act or lack of accurate information. While acting in the best interests of the student, the counselor may be forced to proceed with the counseling process. However, an explanation must be provided to the student for such move, and for reasons of retaining the good relationship between the psychologist and the student.
Informed consent: meaning and purpose
Informed consent is the method of contact between the psychologist and the student. This communication process begins and continues throughout the counseling sessions. The privacy and confidential information process with the client requires that the patient is provided with the right information. The information of the assessment must be understood by the potential students who are then empowered to make a deliberate resolution on whether or not to be part of his or her own hospital.
The main intention of informed consent for confidentiality and privacy is to protect the client’s rights. With informed consent, it means that the person given the consent has the legal authority to make a consent decision. Consent decisions can only be done when the child has in-depth indulgent of what he or she is consenting. Clients also understand that his or her consent is freely issued and withdrawn at any time without prejudice or heard feelings. According to Jacob et al., (2011) stress in consistence with ethical standards for consent, school psychologist should be made aware that under IDEA, the parents and adult students may withdraw consent to pave the way for assessment, and student education placement or services at a given point. Such withdrawal of consent should remain honored by the psychologist (p.143).
For children in elementary school settings, the establishment of any school psychologist-client relationship must first be approved by the student’s parents or guardian. Such approval is done for the purposes of psychological diagnosis, assessment of eligibility or special education or disability accommodations. Parents approval for minor children consent is also required for the provision of ongoing individual or group counseling or other therapeutic interventions. The only exception were school practitioners do not seek parent’s consent is during urgent or self-referral situations by the minor pupil.
The importance of informing before obtaining consent
The process of counseling a minor involves a very important step of providing detailed information of what the student is to expect in the process. In this case, the school psychologist has to ensure that an individual who is providing consent for psychological services is fully aware of the nature and range of services to be provided to him or her (NASP-PPE I.1.3). The individual providing consent must also be informed of the assessment, intervention, goals and procedures as well as any possible benefits and risks to expect in the course of the service. The student must also be made aware of the advantageous alternatives present, compensation for injuries and contact in case the student has questions or concerns.
In order to eliminate bias in obtaining informed consent, the school psychologists engage in a discussion that entails the discussion of boundaries of privacy and confidentiality. Other information provided to the student in details includes the recipient of the assessment information or the outcomes of intervention, and the possible results or consequences to be expected from the assessment or intervention. The school practitioner must also ensure that they make available alternative services during the process of informing before the consent.
As the practitioner explains to the student, they must ensure that they take into consideration the language and cultural differences, age, cognitive abilities, developmental level, and other factor that will be applicable in such a situation. Every other detail or factor that the student should require in order to give an informed consent must also be considered. This will allow the student to understand before giving the consent. While informing prior to obtaining the student’s informed consent, a school psychologist should ensure that they document written an oral consent ( NASP-PPE I.1.3)
Informed consent and the minor child
The provision of psychological assistance to students is ethically in order without the consent of the parent in emergency situations (Fisher, 2009). The school practitioner refers to a situation as an emergency when the child poses a danger to self and to others. Apart from emergencies, parental consent is not required in situations where the minor student presents herself or himself to the school psychologist for assistance. In this case, the lack of parental consent is ethically permissible especially for the first few meetings in order to develop the nature and degree of the need for services. The first few meetings will ensure that the child is assured of safety and not in any danger at all (NASP-PPE I.1.2).
Conversely, for a pupil not old enough to receive the school psychological assistance without a parent’s consent, the school psychologists has to seek for parental consent in order to provide continued assistance to student (NASP-PPE I.I.2). In addition, the school psychologist will require parental consent in instances where consultation about a particular child has the possibility of being intensive and continuous. Parental consent is also essential where the child’s actions are likely to result to major interference on the child or family outside what might be anticipated in the course of ordinary activities at school (NASP-PPE I.1.1).
It addition, any psychologist is good provided they seek out for the pupil’s assent to services. In so doing, the minor child receives the necessary encouragement to participate in decision making process concerning school psychological services (unitforsight, 2012). However, when the service in question is considered to have direct benefit to the child or is needed by law, the assent of the student should not be allowed. In cases where student assent for services is not requested, the school psychologist must ensure that the student’s right t information about the services provided is honored.
In the case where a student has the option to accept or refuse services, the professional school psychologist has to guarantee that the scholar appreciates what is on offered, the respect for their choice, and guard against overwhelming the child multiple alternatives that they are incapable of choosing, or that they do not want (NASP-PPE I.14)
Privacy and confidentiality in APA’s and NASP’s ethical principles
With regards to ethical practices on privacy and confidentiality, both APA’s principles and NASP’s standards discuss and depict almost similar concepts and ethical terms. For instance, both APA and NASP define the importance of informed consent. This importance is emphasized through the discussion of the limits of confidentiality, minimizing intrusions on privacy and information disclosure to third parties for professional purposes.
While APA’s ethical principles’ discussion focuses merely on adults, NASP’s ethical standards concentrate to the largest extent on children and their parents. The APA’s ethical guidelines, for instance, does not provide discussions about informed consent regarding to the minors. These standards do not also offer the importance of third parties, or acting as advocates or children’s rights and welfare.
From the perspective of a school psychologist, daily functions calls for the working with parents, educators, children and teacher among other professionals. On a daily basis, seeking for effective relationships with the school community is a very challenging job. The school psychologist is required to take care of some legal and ethical issues when dealing with these daily activities and the challenges they present. These challenges faced by the school psychologist make the concept of privacy and confidentiality turn out as very complicated. It is the role of a school psychologist to ensure that he or she protects the right for privacy and confidentiality of their clients. This protection could be through protection from intrusion, explaining confidentiality limitations and following the need to know principle.
The school psychologist also protects the student by obtaining their assent whenever possible prior to releasing private information to third parties. Again, the school psychologist has the role of fully informing the student of services offered prior to attaining a prior. For students in elementary school, the school psychologists are faced with the main dilemma regarding privacy and confidentiality (Weithorn, 1983). Dilemmas arise from the fact that the elementary students have no legal or ethical rights on the confidentiality and privacy nature of their information. Even with lack of student rights to privacy and confidentiality, school psychologists provide very significant work with students. The minor student has to be made the primary obligation of a good professional school psychologist. This way, the psychologist will strive to act in the best of the student’s interests by protecting their rights and promoting sell welfare and quality of life.
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