Avoiding Liability Bulletin – August 2005

… Therapists often ask whether or not confidentiality may or must be compromised when the therapist finds out that the patient has been diagnosed with AIDS/HIV. The question comes in a variety of forms with a variety of scenarios. Because applicable laws may vary from jurisdiction to jurisdiction, as will ethical standards of the various professions, you must be sure that you fully understand the law and ethics in your particular state for your particular profession. If there is a conflict in the two, you will have to resolve the conflict. While each particular situation is different, therapists or counselors would generally be best served if they act in compliance with applicable law.

On the narrow question of whether or not confidentiality may or must be compromised when the therapist finds out that the patient has been diagnosed with AIDS/HIV, my hope is that most states’ laws are like the law in California. In short, the therapist in California would be duty bound to keep this information confidential. There is no permission and no mandate to break confidentiality. Even where the therapist knows that the patient is continuing to have consensual sex with one or more partners, the therapist would generally be required to maintain confidentiality. This would typically not be a “Tarasoff situation” since the patient is not threatening serious and imminent physical violence against another.

What is the law in your state? Is there a law applicable solely to physicians and their duty? Is it different for counselors or therapists? Does it matter whether or not the therapist or counselor is employed by a governmental entity or is in private practice? This is a critical area to get clear on now, before being suddenly faced with such a situation.

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Richard Leslie

Richard S. Leslie is an attorney and acknowledged expert on the interrelationship between law and the practice of marriage and family therapy and psychotherapy. Most recently, he was a consultant to the American Association for Marriage and Family Therapy (AAMFT) and has written articles regarding legal and ethical issues for their Family Therapy Magazine. Prior to his work with AAMFT, Richard was Legal Counsel to the California Association of Marriage and Family Therapists (CAMFT) for approximately twenty-two years. While there, he also served as their director of Government Relations and tirelessly advocated for due process and fairness for licensees and applicants.

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