Maintaining confidentiality is a cornerstone of trust in any helping relationship. More than that, it’s a legal and ethical obligation. As peer support specialists, it’s crucial to understand and uphold these standards to ensure the safety, dignity, and trust of those we serve.
That being said, it’s not always a hard and fast rule.
In this post we will cover the ins and outs of maintaining confidentiality in peer support. Moreover, we will look at instances when staying quiet may not be an option.
Table of Contents
Confidentiality In Peer Support Is Crucial
Let’s start with the basics and get an understanding of why confidentiality is so important in mental health and addiction treatment. You know, aside from the fact it’s part of the law.
First and foremost, it protects the individual’s privacy. In doing so, it ensures they feel safe to share their experiences, thoughts, and feelings without fear of judgment or unwanted disclosure.
Think about it, would you open up to someone about your darkest secrets knowing there was a chance it would get shared with others?
This trust forms the foundation of peer support relationships. Knowing that nothing they say, or any information about their past will be shared with others, they can rest a little easier.
Best Practices For Maintaining Confidentiality
Maintaining confidentiality in peer support settings is fairly simple for the most part. That being said, there are a few things you should know.
Obtain Written Consent
Before sharing any information, always obtain written consent from individuals. This is often referred to as an ROI or release of information. These are simple documents that allow information to be shared with a specific person or agency.
Typically, an ROI has a section where the individual can set the terms for what types of information can be shared. Moreover, it allows them to set an expiration date for when authorization ends.
Transparent communication is key to maintaining trust and rapport with the individuals we serve. This involves being clear about what information will be shared, with whom, and for what purpose.
In fact, this is part of informed consent, which is another ethical responsibility.
Moreover, it involves being honest about if you need to break confidentiality for any reason. There are a few cases where peer specialists are obligated to do so, but we’ll get to that in a minute.
Avoid Public Discussions
Never discuss client information in public or semi-public settings. I know this may seem obvious, but you might be surprised how often it happens.
For example, you may be speaking with another member of the clinical team and not realize that someone is standing just around the corner.
Bottom line, wait until you have a private space to discuss anything that might break confidentiality. Also, if an individual is discussed outside of their presence, be transparent about that too.
Secure Storage of Information
Make sure all confidential information is stored securely and protected from unauthorized access.
This includes keeping physical documents out of sight, using encrypted communication channels, and storing electronic records with strong passwords.
Most likely, whatever agency you are working for has documentation software that already does this for you. If this isn’t the case, take extra precautions when storing sensitive information electronically.
When in doubt, ask. Don’t hesitate to reach out to a supervisor or colleague if you’re unsure of something. Alternatively, you can refer to your organization’s policies to ensure you’re in line with all confidentiality requirements.
Managing Risky Disclosures in Peer Support
In peer support, especially within mental health and addiction treatment, managing disclosures is a delicate balance. As peer specialists, we often find ourselves in situations where individuals share deeply personal, sometimes distressing, information.
The primary role of a peer support specialist is to provide understanding, empathy, and guidance.
That being said, there are times someone discloses something that raises concerns about the their safety or the safety of others.
Which brings up the fact that, in many places, peer specialists are considered mandated reporters.
Even when that’s not the case, there is still our duty to warn. To be sure, handling these kinds of disclosures requires a tactful approach. We must do so in a way that ensures the individual’s well-being, while still adhering to ethical and legal obligations.
Recognizing Risky Disclosures
After all that, you may be wondering what constitutes risky disclosures. Let’s look at some common situations where this might apply.
Immediate Harm to Self or Others
Any indication that the individual might be considering harming themselves or someone else requires immediate attention. This includes explicit statements of intent or more subtle hints that suggest that someone may be in danger of imminent harm.
The key word there is imminent harm. In other words, there needs to be a clear and present danger for this to apply.
Abuse or Exploitation
Something that suggests someone is being abused or exploited also falls into this category. Whether physically, emotionally, or financially, these kinds of statements should be taken seriously.
This is especially true if the individual is part of a vulnerable population, such as a minor or an elderly person.
Breach of Law
Someone disclosing involvement in illegal activities may also fall into this category.
In these situations, peer support specialists need to be aware of their obligations, both to the individual and to the broader community.
If you are unsure about whether what someone has said requires your attention, always ask a supervisor.
Best Practices for Handling Risky Disclosures
Now that we have a better understanding of what a risky disclosure might look like, how should you handle it?
Stay Calm and Listen
The first step is to remain calm and provide a safe space for the individual to share. Often, just being heard can reduce stress and deescalate a crisis. If there’s any confusion about what’s being shared, ask open-ended questions to understand the situation better.
However, it’s important to avoid asking leading questions or making assumptions.
If you are still worried about what the individual is saying, let them know that you’re concerned for their well-being. Still, this should always be done in an empathetic way. Try to make they don’t feel judged or threatened.
As mentioned before, transparency is crucial. Be clear with the individual about any necessary breaches of confidentiality. If there’s a risk to their safety or the safety of others, this is especially important.
If you feel the need to disclose what they have said to you, just be up front and honest about it. Being transparent is the best way to maintain trust in these situations.
Refer to Professionals
If someone’s safety is at risk, always refer them to appropriate professionals or emergency services. As peer support specialists, we need to be aware of our limitations and prioritize the wellbeing of the individuals we serve.
Your first step should probably to reach out to a supervisor if possible. This way, they can help you make the referral.
Follow Established Protocols
Most likely, the organization you work for already has a policy and procedure regarding disclosures of this kind. Similarly, there may be local or state laws that come into play. This might include informing supervisors, making a note of the disclosure, or, in extreme cases, contacting emergency services.
In any case, sticking to the plan is always your best bet.
Because of how sensitive these situations can be, you don’t want to take any chances. Besides, these protocols are there to ensure the safety of the individual, as well as the peer support specialist.
Seek Supervision and Support
Handling these types of disclosures can be stressful. Moreover, it just doesn’t feel good; I speak from personal experience. Because of this, peer support specialists should seek supervision to discuss challenging cases.
This way you can be sure to handle them correctly. On top of that, because it can be an uncomfortable situation to be it, its helps to have support. Speaking with supervisors and colleagues can help you manage any struggles you’re having
Bottom line, except in situations where there’s an immediate risk, we should always maintain the individual’s confidentiality. In the event that something does come up, a breach of confidentiality should be done with the utmost care.
More importantly, it should be done only when absolutely necessary for the individual’s safety.
Maintaining Confidentiality in Telehealth Platforms
In today’s day and age, telehealth platforms are becoming increasingly popular. Not only do they make mental health services more accessible, but they are just more convenient for many people.
That said, they also present unique challenges when it comes to maintaining confidentiality in peer support.
Best Practices for Telehealth Confidentiality
Since more and more peer support services become available online, it’s important to understand and implement best practices.
Choose Secure Platforms
Look for platforms that prioritize security and are compliant with health information privacy regulations.
Platforms like Zoom have features designed specifically for healthcare professionals to ensure compliance with standards such as the Health Insurance Portability and Accountability Act (HIPAA).
Chances are, you won’t really have to worry about this. The organization you work for most likely already has a preferred system in place.
In the off chance that you do, make sure the platform provides end-to-end encryption for all sessions. Simply put, this means that the data is encrypted from the sender’s side and only decrypted at the receiver’s end. This way, no third party can access the information during the session.
Avoid Recording Sessions
Unless there’s a compelling reason and you have obtained explicit consent from the individual, avoid recording telehealth sessions. Having them saved only increases the chance of information being leaked or stolen.
If recordings are necessary, make sure they are stored securely with encryption. Moreover, make sure that all accounts and devices have strong passwords
Adherence to Ethical Guidelines
When it comes to telehealth, peer support specialist still need to maintain ethical standards. This includes getting informed consent, maintaining boundaries in the virtual space, and being aware of potential risks associated with online interventions.
In fact, we should take the time to educate individuals about those risks so they can make informed decisions about their care.
Confidentiality In Peer Support: Final Thoughts
We should always strive to maintain confidentiality in peer support. Not only is it an ethical and legal responsibility, but its just the right thing to do. The level of trust needed for healthy and constructive peer support can only be built when someone can feel safe when sharing.
By following best practices, we can create that space for the individuals we support.
Be sure to familiarize yourself with the guidelines set forth by your organization. Moreover, don’t hesitate to ask for support if you are unclear about anything.
We hope you found this article helpful, and we want to thank you for the work you do.
Will you leave us a comment and let us know how we’re doing? We want your feedback so we can continue to build this community of peer support professionals.
Frequently Asked Questions
What is the Importance of Confidentiality in Peer Support?
Confidentiality is a must in peer support. It builds trust and ensures a safe space where individuals feel comfortable sharing personal issues without fear of judgment or disclosure to others.
How Can Peer Support Workers Maintain Confidentiality?
Peer support workers can maintain confidentiality by clearly communicating the boundaries and limits of confidentiality to participants, securely storing any records or notes, and never sharing personal information without explicit consent or legal necessity.
Are There Exceptions to Confidentiality in Peer Support?
Yes, there are exceptions such as when there is an immediate risk of harm to the individual or others, or a legal requirement to disclose information. Always make participants aware of these limits.
What Should I Do if I Accidentally Breach Confidentiality?
If a breach occurs, inform your supervisor immediately and take steps to mitigate the damage, such as informing the affected party and reviewing confidentiality protocols to prevent future incidents.
Elijah Meason is a Certified Peer Support Worker in the State of New Mexico. He is a SMART Recovery facilitator and is working toward getting his Masters degree in social work. He is currently working at a dual diagnosis treatment center helping individuals overcome mental health and addiction challenges.