Dealing with Issues of Confidentiality in Residential Addiction Treatment

Confidentiality is a cornerstone of substance abuse and mental health treatment. It provides the patient with the privacy needed to establish trust and confidence in the foundation of both the therapeutic process and in the providers that have been entrusted to their care.

Maintaining the integrity of patient information and records is therefore a fundamental part of treatment. The Privacy Rule found within The Health Insurance Portability and Accountability Act of 1996, or HIPAA as it is more commonly known, is essentially a federally mandated safeguard, that for the purposes of this post at least, helps to support the therapeutic process by establishing guidelines on how private information may be shared with others.

“Unfortunately, I can neither confirm, nor deny that there is a patient here by that name.”

If you have ever been told the above-mentioned phrase by a counselor at a drug and alcohol rehab center, you are probably all too familiar with some potentially significant flaws in the system. I can’t remember exactly where I heard it first, but somewhere early in my career, someone much more seasoned than me imparted, “You are only as sick as your secrets.”

Although getting someone to admit into a drug and alcohol rehab center is without question a vital part of the recovery puzzle, it may be equally as important to ensure that there is a robust and healthy channel of communication while that person is in treatment.

Maintaining a Channel of Communication

In simple terms, the doctor needs to know the symptoms in order to effectively treat the disease. With that said, the true symptoms of the disease of addiction are sometimes lost and often distorted deep within the dark manipulative mantle of the addict mind.

I have worked with hundreds of families all across the country and throughout the world. From Scarsdale to Calabasas, London, Bogota, and beyond, there appears to be a universal desire among all families to provide drug and alcohol rehab centers with as much collective information as possible so that they “know the truth” and get “the facts straight” while they treat the patient.

I firmly believe that all drug and alcohol rehab centers must carefully consider the significance of this collateral information as part of both the diagnostic and corresponding treatment experience. Given both the long-term organic effects of consuming mood altering substances and the manipulative nature of the addict mind, this information may prove to be a highly transparent window into the truth. In other words, by the nature of the disease itself, the person battling an addiction may not necessarily be able to be the best historian.

Stakeholder Involvement from the Beginning

At the same time, it is also important to keep in mind that sharing goes both ways. Not only do most of my clients want to share important information with treatment providers, they want to receive it as well, especially with regard to ...

• diagnosis
• treatment
• compliance
• progress
• planning

One of the most powerful tools to creating that robust and healthy channel of communication I talked about earlier is to lay out the groundwork for it prior to the admission into treatment:

Before the start of an intervention, for example, I encourage the family to select at least one member to serve as the gatekeeper of information. Once the intervention is underway, the identified person in need of help is then asked to accept both the gift of treatment and the plan to maintain an open line of communication with the treatment center.

Considerations for Finding a Program

In my opinion, rather than trying to find a loophole in the statute so that you can try to give and get sporadic bits and pieces of information, the treatment experience may be significantly enhanced for everyone involved by knowing how to effectively work with and within all of the federally mandated red tape, protection, and privacy found within HIPAA.

So while you are out there looking for the best rehab option for your loved one, now you may want to carefully consider finding a program that ...

• is genuinely interested in reviewing the collateral information you have to offer
• demonstrates a willingness to establish a collaborative working relationship with the patient’s primary support system, while at the same time...
• makes protecting patient privacy a priority