8.3 Informed Consent, Confidentiality, Privacy, and Records

Protect Choice and Information

Informed consent is the foundation for psychological services. It tells the client what service is being offered, who is providing it, what the likely risks and benefits are, what alternatives exist, what fees or payment arrangements apply, what records are kept, and what limits apply to confidentiality. On the EPPP, consent is rarely only an intake form. It is an ongoing process that should be revisited when the service, role, modality, risk level, third-party involvement, or financial arrangement changes.

Confidentiality protects the information learned in the professional relationship. Privacy is broader and concerns a person's control over access to personal information. Privilege is a legal concept that may protect communications in legal proceedings, depending on jurisdiction. The exam may use these terms carefully. A strong answer does not promise absolute secrecy, and it does not disclose casually because a requester sounds authoritative.

Records must be useful and protected. Good records include relevant assessment data, informed consent, diagnosis or case formulation when applicable, treatment plan, progress, risk assessment, consultation, releases, missed appointments, fees, and termination or referral information. Records should avoid unnecessary speculation, stigmatizing language, and unsupported conclusions. They should be understandable to another qualified professional while respecting client dignity.

Third-party involvement increases complexity. In a custody matter, forensic evaluation, school consultation, employment-related service, or insurance request, the psychologist must clarify who the client is, what role the psychologist serves, what information may be shared, and who will receive reports. Failure to clarify roles can create consent, confidentiality, and conflict problems.

When legal or safety limits apply, communication still matters. If a psychologist must make a report or take protective action, the client should be told when it is safe and appropriate. The explanation should be accurate and calm. It should not overstate what will be shared. It should not invite the client to veto a legally required action.

For EPPP questions, look for answer choices that balance protection and lawful disclosure. An option that releases the entire file automatically is often too broad. An option that refuses every request forever may ignore legal authority. The best option usually verifies the request, checks consent or law, consults when unclear, discloses narrowly, and documents the rationale.