Like many counselors, I’m on some Facebook groups and e-mail lists where counselors submit requests for referrals for clients who perhaps don’t fit into a counselor’s schedule or require a specific type of insurance that counselor doesn’t take. Many requests sound something like this: “I’m looking for a counselor for a 45-year old man dealing with grief over the death of his teenage daughter while also handling his high-stress job. Must have evening openings and be in-network with Providence and near his home in Sellwood or Woodstock area.”

Was all of that information truly necessary in order to find an appropriate referral? Was it necessary to share age, specific location, and the exact issue the client is dealing with?

The ACA’s rules for its own community forum contain a fairly restrictive interpretation of the ACA Code of Ethics: “It is not permissible to present aspects of a case on a counseling listserv or online forum even if the client’s name is not given. Information shared by a client and clinical impressions must be afforded the same level of confidentiality as the name of the client. Describing a client’s presenting problem, diagnosis, or clinical treatment approach through listservs or online forums – even if the client’s name is not given – is a violation of confidentiality.” (Click here for more info.) 

There’s also the concept from HIPAA that we can apply here, that of “minimum necessary disclosure,” or, “what is the least amount of personal information I can share to achieve a goal.” If the goal is to find a counselor for the man described above, we can eliminate much of the details from the original request.

So how could that imaginary referral request above have been made in a manner that obscures the client's information better? How about this: “I’m looking for a counselor in Sellwood or Woodstock, in-network with Providence with evening hours available, who’s experienced with grief and loss in adults.” 

Aaron Good, MS, CRC, LPC Registered Intern is a counselor in private practice, focusing on career, purpose, and identity. When he's not seeing clients he works for Roy Huggins, consults on marketing and advertising for counselors, and builds houses for immigrant and refugee families.