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Referrals and Case Consultation Online: What About Confidentiality?

By DeeAnna Merz Nagel. LMHC, BCC

Back in the day, we were all on listservs such as Yahoo Groups. Now Facebook and Linkedin Groups have largely taken the place of other online “bulletin board” formats. Various organizations and like-minded professionals often create groups to communicate efficiently with one another. Once a member, you can usually be notified by email when new member activity takes place, or you may be like me and keep your Facebook open most of the workday. Many coach groups focus on providing a place to network, share resources, find potential referrals, and even discuss cases. Yes. That is correct… discuss cases. Said differently, coaches talk about their clients in these groups.

The ICF Code of Ethics (2015) requires that coaches must “maintain the strictest levels of confidentiality with all client and sponsor information unless release is required by law” and that this should be clearly spelled out prior to the first meeting, as well as the Coaching Agreement.

Sometimes though, the person is not our client and we are seeking a referral for someone for any number of reasons. Perhaps your caseload is full or the person seeking a coach wants to work on a specific Life/Work/Wellness area that is outside your area of expertise.

Here are some points to consider when discussing client-specific information in such a Group.

  1. When asking for a possible referral, keep in mind if you name the town and state the client’s need (e.g. seeking a referral for a client who lives in Anywhere, TN. He was recently laid off from his factory job and is seeking a career coach) then you potentially disclose enough information to identify the client.
  2. Since many coaches will conduct a short complimentary session to determine compatibility, your discussion/communications may include personal information beyond what would be necessary for referral (e.g. interested in hiring a career coach, but also made a few casual comments about health issues and inability to lose weight); sharing that information challenges the individual’s rights to privacy and should be discouraged.
  3. Even when you “blind the record” removing all identifying information, if you talk about a client (e.g. 35 year old female client who is seeking in-person transition coaching after the death of her spouse who died several months ago) you may reveal the location of the client by way of your very own email signature line. (e.g. Respectfully, Jane Coach, BCC, Anyone looking up the website can see the coach’s location and begin to connect the dots.
  4. Not all colleagues follow the same code of ethics or interpret their codes similarly. Some colleagues do not understand confidentiality issues. If you are on an online group without a moderator who screens posts, a colleague may post a scenario that reveals much more than they should.
  5. Not all colleagues are ethical. Intentional or unintentional, our colleagues get involved in ethical blunders. So Jane Coach may see an interesting case description, then copy and paste the information to another colleague who is not even in the group.
  6. Clients have a right to know that their case will be discussed, formally or informally. The most common statement I hear is, “We aren’t doing supervision.” Peer supervision, case consultation, case supervision - in the end it boils down to telling another colleague your client’s personal business. Build consultation and supervision into your Coaching Agreement. Also consider whether recordings are being used, and creating the boundaries so those recordings are protected.
  7. Consider not participating in groups that engage in case consultation and consider an encrypted alternative. We are approaching a time when encryption will be standard for all online communication but for now, we must practice due diligence and protect our client’s case material to the extent possible. Encryption used to be cost prohibitive but that is not necessarily true anymore.
  8. If you decide to remain in an online group that discusses client information for the purposes of referral or consult, consider educating your colleagues about some of the issues discussed here.

I spoke specifically about online groups available through Facebook and Linkedin because many of us are members of these groups and have been for years. But these same points hold true for other social networks, forums and online methods of communication that are not encrypted. Maintain the strictest levels of confidentiality that you can for your clients. It may not be as convenient but compare what I am saying to hearing a group of colleagues in a restaurant who are discussing cases over lunch. While they may not be revealing specifics or names, we discourage this behavior, don’t we?