WordPress database error: [Duplicate entry '22292' for key 1]
INSERT INTO wp_bas_visitors (visit_ip, referer, osystem, useragent, lasthere) VALUES (644300604, 1, 205, 1322, '2008-08-20 13:13:17');

WordPress database error: [You have an error in your SQL syntax; check the manual that corresponds to your MySQL server version for the right syntax to use near 'AND referer = referer_id AND osystem = os_id AND useragent = ua_]
SELECT * FROM wp_bas_visitors, wp_bas_refer, wp_bas_ua, wp_bas_os WHERE visit_id = AND referer = referer_id AND osystem = os_id AND useragent = ua_id

WordPress database error: [You have an error in your SQL syntax; check the manual that corresponds to your MySQL server version for the right syntax to use near ' '2008-08-20 13:13:17', 0, 377)' at line 1]
INSERT INTO wp_bas_log (visit, stamp, outbound, page) VALUES (, '2008-08-20 13:13:17', 0, 377);

Comments on: Those Confidentiality Disclaimers At The End Of Your Email…….. http://clinicallawyer.com/files/2007/07/31/those-confidentiality-disclaimers-at-the-end-of-your-email/ Where the law meets mental health practice Wed, 20 Aug 2008 13:13:17 +0000 http://wordpress.org/?v=2.0.2 by: Clinical Lawyer http://clinicallawyer.com/files/2007/07/31/those-confidentiality-disclaimers-at-the-end-of-your-email/#comment-485 Sat, 06 Oct 2007 22:32:24 +0000 http://clinicallawyer.com/files/2007/07/31/those-confidentiality-disclaimers-at-the-end-of-your-email/#comment-485 Dear Holly, The duty of confidentiality is something that clinicians owe to their patients, not the other way around, so it likely wouldn't be *legal* problem if a patient spontaneously sends their own confidential information to the therapist via unsecure channels. However, it could be a problem if the therapist responds via the same channel. In addition, this could be problematic if the therapist knows that the patient will do this and doesn't say anything in the session about how or why it might not be such a good idea. Many states are developing laws and regulations that address these issues, so the answers could be variable depending on jurisdiction. As for therapists responding, it's generally a good idea to address these things in the session. Communications outside the session sometimes are just about practicalities (i.e., rescheduling), but other times they can reflect boundary difficulties. Some states have held that, owing to the stigma that still surrounds mental health treatment, the mere fact that someone is in treatment is confidential. In these states if responding to the email identifies/confirms someone as a patient is a breach, this could be a violation of the duty of confidentiality. Remember, you never know who is sending the email or who is reading it. By talking about these things ahead of time, it possible to avoid unintended breaches of the duty of confidentiality. Some therapists have their patients sign waivers, but the validity of these waivers would depend on (1) state-specific laws, (2) the language of the waiver, (3) whether the therapist is a HIPAA covered entity, (4) the length of time the waiver purports to cover, and (5) the kinds of information the parties contemplate sending via email. Thanks for the question. This is an issue that will become increasingly more prevalent as time goes on. If you have follow-up questions, please feel free to post them as comments. Dear Holly,

The duty of confidentiality is something that clinicians owe to their patients, not the other way around, so it likely wouldn’t be *legal* problem if a patient spontaneously sends their own confidential information to the therapist via unsecure channels. However, it could be a problem if the therapist responds via the same channel. In addition, this could be problematic if the therapist knows that the patient will do this and doesn’t say anything in the session about how or why it might not be such a good idea.

Many states are developing laws and regulations that address these issues, so the answers could be variable depending on jurisdiction.

As for therapists responding, it’s generally a good idea to address these things in the session. Communications outside the session sometimes are just about practicalities (i.e., rescheduling), but other times they can reflect boundary difficulties. Some states have held that, owing to the stigma that still surrounds mental health treatment, the mere fact that someone is in treatment is confidential. In these states if responding to the email identifies/confirms someone as a patient is a breach, this could be a violation of the duty of confidentiality. Remember, you never know who is sending the email or who is reading it.

By talking about these things ahead of time, it possible to avoid unintended breaches of the duty of confidentiality. Some therapists have their patients sign waivers, but the validity of these waivers would depend on (1) state-specific laws, (2) the language of the waiver, (3) whether the therapist is a HIPAA covered entity, (4) the length of time the waiver purports to cover, and (5) the kinds of information the parties contemplate sending via email.

Thanks for the question. This is an issue that will become increasingly more prevalent as time goes on. If you have follow-up questions, please feel free to post them as comments.

]]> by: Holly http://clinicallawyer.com/files/2007/07/31/those-confidentiality-disclaimers-at-the-end-of-your-email/#comment-466 Thu, 04 Oct 2007 13:04:53 +0000 http://clinicallawyer.com/files/2007/07/31/those-confidentiality-disclaimers-at-the-end-of-your-email/#comment-466 Can a patient send confidential information to the therapist? If the therapist responds to the email in some minimal way, does that violate confidentiality? Can a patient send confidential information to the therapist? If the therapist responds to the email in some minimal way, does that violate confidentiality?

]]>