Confidentiality, Privileged Communication, and Record Keeping
Core concepts
Distinguish confidentiality (an ethical duty of the psychologist) from privilege (a legal evidentiary protection held by the client that prevents compelled disclosure in proceedings). Arkansas recognizes a psychologist-client privilege with exceptions such as client waiver, certain court-ordered evaluations, and situations involving danger or mandated reporting. Know limits on confidentiality: imminent risk of harm, suspected abuse or neglect, court orders, and client consent. Record-keeping rules require accurate, timely records, secure storage, retention for the period the Board rules specify, and release only with proper authorization or legal compulsion. Understand HIPAA interactions and the minimum-necessary principle.
Traps
The biggest trap is conflating confidentiality and privilege - privilege belongs to the client and can be waived; confidentiality is the clinician's duty. Another trap is assuming a subpoena is a court order: a subpoena is a request that generally requires a response but not automatic disclosure of protected records without appropriate authorization or a court order. Questions may also test who may consent to release for a minor and what to do when records are requested by an attorney.
Rule of thumb
Before releasing anything, identify the legal instrument (signed authorization, subpoena, or court order), confirm it is valid, and release only the minimum necessary. When in doubt, seek guidance or a protective order rather than disclosing.
Worked example
An attorney serves a subpoena for a client's therapy records without the client's authorization. The psychologist does not automatically produce the records; the psychologist notifies the client, asserts privilege on the client's behalf if appropriate, and seeks clarification or a court order before releasing.