Not So Confidential Counseling

Experts fear plan at George Washington U. to have psychologists share some information on students with administrators.
December 2, 2005

College counseling centers have long promised their student patients that their confidentiality can be assured. But a plan under consideration at George Washington University -- causing concern there and among psychologists elsewhere -- would have students seeking counseling sign a waiver to allow some information about their sessions to be shared with administrators in certain circumstances.

Sources who wished to remain anonymous said that Diane M. DePalma , director of the center, has been told to work with a university lawyer to develop a protocol that would protect the liability of administrators in instances where those receiving counseling might harm themselves or others. DePalma referred questions to the university’s press office. 

Psychologists, under various state laws and their own professional codes, already have an obligation to take necessary action whenever patients may be a danger to themselves or others, but those obligations involve breaking confidentiality only to those who would need to provide immediate care or security to the patients and do not permit confidentiality to be broken to others.

The plan under consideration at GW would ask that students, faculty members or anyone else receiving counseling services at the center sign a waiver that would allow notes and discussions that occur during sessions to be shared with certain administrators. Sources could not confirm whether the protocol would require a signed waiver in order for an individual to receive service. 

In reference to these reports, Matt Lindsay, a spokesman for the university, said, “Basically, we periodically review protocols, but no changes have been made.”  He added that there is currently a lawsuit against the university that could possibly be connected to this development.

Increasing numbers of administrators nationwide have grown concerned about their institutions’ liability in instances where psychologically disturbed students act in harmful ways to themselves or others. In 2002, the parents of Elizabeth Shin filed a $27.65 million wrongful death lawsuit suit against the Massachusetts Institute of Technology, charging that its counseling service failed to take their daughter’s depressed situation seriously. Two years earlier, Shin, then a student at MIT, lit herself on fire in her dorm room and died as a result of burns. Ultimately, MIT was cleared of wrongdoing, but some counts filed against individual MIT administrators are still going forward.

At least two recent suicides at George Washington have heightened concerns at the university.

While saying that he understands administrators' unease over student suicide and possible liability lawsuits, Stephen Behnke, director of ethics at the American Psychological Association, said Thursday that protocols like the one George Washington is considering are “immensely troubling.”

Behnke noted that he’s heard some details about the situation, but hasn’t seen any concrete drafts of proposed procedures. He said that legal authorities as high as the U.S. Supreme Court -- in the 1996 ruling in Jaffee v. Redmond -- have recognized that effective therapy depends on an atmosphere of confidence and trust.

“When you remove confidentiality, you remove the ability for effective psychotherapy,” he said.  “Anything that threatens [the patient’s] ability in confidence, I would be very concerned about.”

Behnke said that to his knowledge no state laws allow confidentiality to be broken without a patient’s prior consent. He also added that he’s not familiar with other institutions of higher education that have pursued paths similar to that under consideration at George Washington.

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