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Maintaining Confidentiality and Balancing Stress Relief
By Betsy Cauble

Relieving stress by talking with colleagues or friends about a tricky situation is normal. Social workers, who regularly deal with extremely difficult and personal situations, face the unique challenge of balancing the professional demands for client confidentiality with the personal need for support when listening to such emotionally draining stories and helping clients through difficult circumstances.

While getting support during difficult cases may seem at odds with preserving clients’ privacy, intentional planning can bring both needs into alignment and help combat the high burnout rates that plague the social work field. Accidents—giving away a client’s identity—can happen, but establishing clear plans for preventing and responding to them will help to relieve pressure from social workers and enhance the quality of care offered to clients.

Cultivating Confidential Support
Support groups are essential for social workers, especially those in rural areas who may not have the luxury of local other social workers to meet. Support groups create a space for social workers to process difficult clients and situations with the help of fellow social workers. These collaborations can help fight burnout and improve the quality of care provided. Even in these groups, however, protecting a client’s identity must be the top priority.

Support groups can be invaluable for gleaning tips and firsthand experience on how to protect clients’ privacy. Ask your peers how they approach client confidentiality or how they’ve managed difficult situations in the past. Their understanding of the field can also help reinforce confidentiality—they know the rules and won’t press you to go into further detail and can empathize with how it feels to navigate a difficult client relationship.  Learning from many social workers will set you up for success as you navigate the nuances of privacy.

Thinking often about confidentiality from your client’s perspective is a helpful way to remind yourself of its importance. Apart from the professional and legal implications, preserving confidentiality has real personal impacts on clients who entrust you with some of their most difficult times. What may seem like an innocent mistake from your perspective could change relationships from theirs.

Preparing a Response
If confidentiality is broken, there are specific measures that must be taken to mitigate any damage to yourself or your clients. First, you must immediately report it to HIPAA. Any delays in filing the necessary paperwork can cause you to appear guilty. Acting quickly helps you stay ahead of any additional problems related to the legal implications of a breach.

Next, discuss the situation with your client. Apologize for your mistake, then take full responsibility. Explain how you will remediate the situation and the steps you are taking to prevent it happening in the future. While breaking confidentiality is a significant problem, it doesn’t have to break your relationship with the client. As with any relationship built on trust, taking ownership of any mistakes and acting promptly to address them can go a long way in maintaining a healthy dynamic and moving forward with understanding.

Navigating the aftermath of a breach in confidentiality is a considerable undertaking for social workers. Oftentimes, social workers can feel guilty and overwhelmed at the prospect of remedying their mistake while managing an already busy schedule.  Working with professionals who can walk you through the process is an effective way to relieve some of the pressure while ensuring you stay on track. For particularly sensitive cases such as divorce or child custody, consulting a lawyer can help you stay prepared in case of a lawsuit. There are plenty of avenues toward resolution that don’t involve court, but it’s best to be prepared and speak to professionals in the early stages.

Conclusion
Social workers deal with a wide range of emotional, mental, and legal issues that require delicacy and empathy. Learning to get support without compromising client confidentiality is an essential part of the job. Caring for yourself is the first step in caring well for your clients. While the support of peers can help to minimize the chance of a confidentiality breach, social workers must still prepare for the unexpected. With the right community and professional partners, social workers can protect their clients and their careers.

Betsy Cauble, PhD, MSW, is a board member at Preferra Insurance Company RRG, a behavioral health liability insurance company overseen by social workers, and the retired department head and associate professor of social work emeritus at Kansas State University.