Confidentiality, Privileged Communication, and Mandatory Reporting
What the exam tests
This domain distinguishes confidentiality from evidentiary privilege and tests exceptions under Nebraska law. Confidentiality is the professional duty not to disclose client information; privilege is the client’s right to prevent compelled testimony, generally under Nebraska’s psychotherapist-client privilege rule.
Core rules
- Obtain valid authorization before disclosure, except where law requires or permits disclosure.
- Mandatory child abuse or neglect reporting is required for licensed practitioners under Nebraska child protection law; report to DHHS or law enforcement as the statute directs.
- Adult protective reporting applies to vulnerable adults under applicable Nebraska law.
- Serious danger to self or an identifiable other may justify protective disclosure; do not treat privilege as absolute.
- A subpoena is not automatic authorization; verify legal basis and disclose only what is required.
- Tell clients the limits of confidentiality at intake and when a limit becomes relevant.
Worked example
A client discloses that a child in the home is being injured. Reasoning: the therapist explains the reporting duty, makes the required report promptly to the designated agency, and discloses only information needed for protection. The therapist does not wait for proof or a supervisor’s permission, and documents the report and the limited disclosure.
Traps
Saying confidentiality is “absolute”; confusing a subpoena with a court order or client authorization; investigating before reporting; over-disclosing to family members; discussing cases in public or unsecured channels.