Last updated June 17, 2015
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NASW Law Note

Client Confidentiality and Privileged Communications

A majority of the legal concerns raised by individual National Association of Social Workers [NASW] members involve questions relating to the privacy of clients’ mental health treatment information. For many people, the acronym “HIPAA” (Health Insurance Portability and Accountability Act) has become synonymous with health care privacy; however, the underlying principles of confidentiality and privilege remain fundamental to any analysis of patient privacy. Applying the concepts of confidentiality and privilege to the professional services provided by social workers requires an understanding of federal health privacy laws and regulations, as well as state law standards and ethical obligations. This Law Note discusses the two principles and outlines some of the exceptions applicable to them, particularly in the context of clinical social work practice. In an era of rapid change in information technology capacity, society is experiencing a paradigm shift that impacts expectations about privacy; however, the fundamental need for confidentiality remains as a lynchpin to successful mental health treatment and effective social worker interventions.