251 CMR, § 1.11 - Confidential Communications
Except as otherwise provided by law, all communications between a licensed psychologist and the individuals with whom the psychologist engages in the practice of psychology shall be deemed to be and treated as confidential in perpetuity.
(1) Notwithstanding the
provisions of M.G.L. c. 112, § 129A(b), information which is acquired by a
psychologist pursuant to the professional practice of psychology, whether
directly or indirectly, may be disclosed, without client consent, written or
otherwise, to another appropriate professional as part of a professional
consultation which is designed to enhance the services provided to a client or
clients. In disclosing such information, psychologists shall use their best
efforts to safeguard the client's privacy by not disclosing the client's name
or other identifying demographic information, or any other information by which
the client might be identified by the consultant, unless such information is,
in the psychologist's judgment, necessary for the consultation to be
successful.
(2)
(a) The reference to "initiation of the
professional relationship" in M.G.L. c. 112, § 129A shall mean that the
client must be informed of the limits on confidentiality by the end of the
first professional session, unless there are documented substantial clinical
reasons for withholding such information and the decision to withhold such
information is reviewed and redocumented on a regular basis. If the client has
come to the psychologist specifically for psychological evaluation, court
ordered evaluation, or psychological testing, the client shall be informed
about all confidentiality limitations before said evaluation or testing
begins.
(b) In the event that,
before the psychologist has an opportunity to inform the client concerning the
limits on confidentiality, a client begins to discuss matters which the
psychologist knows, or in the exercise of his/her professional judgment should
know, are likely to result in the psychologist's having to reveal confidential
information without the client's consent, then the psychologist shall
immediately inform the patient of the limits on confidentiality.
(c) Where the client is an unemancipated
minor, the psychologist shall have, in addition to the duties described in
251
CMR 1.11, the duty to inform the client's
legal guardian in the event that the psychologist has determined pursuant to
M.G.L. c. 112, § 129A(c)(1), (c)(2) or (c)(3), that a nonconsensual
disclosure of information is warranted.
(3) The reference to "clear and present
danger" in M.G.L. c. 112, § 129A(c)(1) shall mean that the client presents
a clear and present danger to him/herself when:
(a) the psychologist, in the exercise of
his/her professional judgment, believes that the client presents a substantial
risk of physical impairment of injury to him/herself as manifested by evidence
of threats of, or attempts at, suicide or serious bodily harm; or
(b) the psychologist, in the exercise of
his/her professional judgment, believes that the client presents a very
substantial risk of physical impairment or injury to him/herself as manifested
by evidence that such person's judgment is so affected that he or she is unable
to protect him/herself in the community and that reasonable provision for
his/her protection is not available in the community.
(4) The reference to "reasonable basis to
believe that there is a clear and present danger of physical violence against a
clearly identified or reasonably identifiable victim" in M.G.L. c. 112, §
129A(c)(3) shall mean when the psychologist believes, in the exercise of
his/her professional judgment, that the patient's words or behavior strongly
suggest that there is a reasonable possibility that the client will attempt to
kill or inflict serious bodily injury on a reasonably identified victim or
victims whom the client's words or behavior or history have clearly identified
as a likely target of such behavior.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
Except as otherwise provided by law, all communications between a licensed psychologist and the individuals with whom the psychologist engages in the practice of psychology shall be deemed to be and treated as confidential in perpetuity.
(1) Notwithstanding the provisions of M.G.L. c. 112, § 129A(b), information which is acquired by a psychologist pursuant to the professional practice of psychology, whether directly or indirectly, may be disclosed, without client consent, written or otherwise, to another appropriate professional as part of a professional consultation which is designed to enhance the services provided to a client or clients. In disclosing such information, psychologists shall use their best efforts to safeguard the client's privacy by not disclosing the client's name or other identifying demographic information, or any other information by which the client might be identified by the consultant, unless such information is, in the psychologist's judgment, necessary for the consultation to be successful.
(2)
(a) The reference to "initiation of the professional relationship" in M.G.L. c. 112, § 129A shall mean that the client must be informed of the limits on confidentiality by the end of the first professional session, unless there are documented substantial clinical reasons for withholding such information and the decision to withhold such information is reviewed and redocumented on a regular basis. If the client has come to the psychologist specifically for psychological evaluation, court ordered evaluation, or psychological testing, the client shall be informed about all confidentiality limitations before said evaluation or testing begins.
(b) In the event that, before the psychologist has an opportunity to inform the client concerning the limits on confidentiality, a client begins to discuss matters which the psychologist knows, or in the exercise of his/her professional judgment should know, are likely to result in the psychologist's having to reveal confidential information without the client's consent, then the psychologist shall immediately inform the patient of the limits on confidentiality.
(c) Where the client is an unemancipated minor, the psychologist shall have, in addition to the duties described in 251 CMR 1.11, the duty to inform the client's legal guardian in the event that the psychologist has determined pursuant to M.G.L. c. 112, § 129A(c)(1), (c)(2) or (c)(3), that a nonconsensual disclosure of information is warranted.
(3) The reference to "clear and present danger" in M.G.L. c. 112, § 129A(c)(1) shall mean that the client presents a clear and present danger to him/herself when:
(a) the psychologist, in the exercise of his/her professional judgment, believes that the client presents a substantial risk of physical impairment of injury to him/herself as manifested by evidence of threats of, or attempts at, suicide or serious bodily harm; or
(b) the psychologist, in the exercise of his/her professional judgment, believes that the client presents a very substantial risk of physical impairment or injury to him/herself as manifested by evidence that such person's judgment is so affected that he or she is unable to protect him/herself in the community and that reasonable provision for his/her protection is not available in the community.
(4) The reference to "reasonable basis to believe that there is a clear and present danger of physical violence against a clearly identified or reasonably identifiable victim" in M.G.L. c. 112, § 129A(c)(3) shall mean when the psychologist believes, in the exercise of his/her professional judgment, that the patient's words or behavior strongly suggest that there is a reasonable possibility that the client will attempt to kill or inflict serious bodily injury on a reasonably identified victim or victims whom the client's words or behavior or history have clearly identified as a likely target of such behavior.