Ethics, Boundaries, and Confidentiality
This domain tests whether you can hold an ethical frame under pressure: protecting privacy, keeping roles clean, and disclosing your own story only when it serves the person. Items cluster around confidentiality law, boundary crossings versus violations, dual relationships, self-disclosure, mandated reporting, and duty to warn.
Confidentiality is layered
HIPAA governs covered entities. Substance use disorder treatment records held by federally assisted programs fall under 42 CFR Part 2, which is stricter: written, specific, time-limited, revocable consent naming the recipient before disclosure, and a prohibition on redisclosure. State law may add more. Explain the limits up front: harm to self or others, child and elder abuse or neglect, court order, and internal supervision. A release of information must be informed and specific - "all records forever" is not valid consent.
Boundaries
Boundaries protect the person, not just you. Avoid dual relationships: no romantic or sexual relationships ever, no business dealings with current participants, no providing services to close friends or family, and agency-specific rules on gifts, money, transportation, and social media friend requests. Self-disclosure is a tool: brief, purposeful, person-centered, tied to the person's need rather than your need to tell it, and never with graphic detail of substance use or trauma.
Worked example
A mother calls: "Is my son still coming to your group? I'm his mother, I have a right to know." The peer does not confirm or deny that the person is served. Correct response: explain that you cannot discuss who attends or what happens in group; offer to pass a message along; if the person has signed a specific release naming the mother, information can be shared within its terms. Feeling sympathy for a worried parent is not a legal basis for disclosure.
Traps that cost marks
Thinking "it's fine because I only told my own story" - details about your own experience can identify the person. Discussing participants in hallways, break rooms, rideshares, or private texts on personal phones. Accepting a large gift to avoid awkwardness. Assuming a 12-step contact from a meeting is not a dual relationship. Promising absolute secrecy before the person discloses risk.
Group settings
In peer-led groups, state clearly that participants are asked to keep what is shared private but that confidentiality cannot be guaranteed among members. Avoid pressing for identifying details; no sign-in sheets left exposed; no client names in shared calendars.