| Course | PAC 415 Healthcare Ethics |
|---|---|
| Module | Module 5 |
| Paper type | Confidentiality analysis |
| Length | About 1,013 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | September 2026 |
Free sample paper for PAC 415 Module 5
When Privacy Meets Danger: Confidentiality and the Duty to Protect in Addiction Counseling
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 415: Healthcare Ethics
Instructor Name
Month Day, Year
When Privacy Meets Danger: Confidentiality and the Duty to Protect in Addiction Counseling
Near the end of a session at Cedar Hollow Health, a composite client who had lost a custody hearing that morning said, 'She's going to pay for this. I know where she parks.' He had been drinking the night before, owned a handgun and had once been arrested for a domestic assault. Then he laughed and said he was only venting. His counselor faced one of the hardest questions in clinical ethics: when does a duty to protect someone else outweigh a client's confidentiality? This paper explains why confidentiality matters, describes the legal duty to protect and how it varies, examines how federal rules for addiction records complicate it, and describes how the counselor responded.
Why Confidentiality Matters
Confidentiality is a promise that makes counseling possible. Clients disclose drug use, crimes, shame and anger only when they trust that what they say will stay private. In addiction treatment, where disclosure can lead to arrest or loss of custody, that trust is especially fragile. Breaking confidentiality without strong reason damages the client, the relationship and the willingness of others to seek help. Confidentiality is therefore protected by professional codes, including the NAADAC code, and by law (NAADAC, 2021).
The Duty to Protect
Confidentiality is not absolute. In the 1976 Tarasoff decision, the California Supreme Court held that a therapist whose patient poses a serious danger of violence to an identifiable person must take reasonable steps to protect that person. States have since taken different paths. Johnson et al. (2019) documented wide interstate variation: some states impose a mandatory duty to warn or protect, some permit but do not require disclosure, and some have no clear rule, and they found gaps in how well clinicians understand the law in their own states. A counselor must know which kind of state they practice in.
Addiction Records Add a Complication
Federal rules for substance use disorder records restrict disclosures that identify a person as a patient of an addiction program, and the 2024 revisions kept strong limits on using records against patients (U.S. Department of Health and Human Services, 2024). These rules permit some disclosures, such as to medical personnel in an emergency and reports of crimes on program premises, but a threat against someone elsewhere fits less neatly. Programs facing such a situation typically consult legal counsel and, where the law allows, give a warning or contact police in a way that does not reveal that the person is in addiction treatment.
Assessing the Threat
The first task is assessment, not disclosure. The counselor asked directly about the statement: what he meant, whether he had thought about hurting his former partner, whether he had a plan, whether the gun was accessible and whether he had been drinking. Relevant factors include a specific target, a plan, access to means, past violence, current intoxication and the person's own statements about intent. The client had an identifiable target, access to a gun, a history of violence and recent heavy drinking, and he would not say that he would not act.
Options
The table sets out the counselor's options.
| Option | Protects the partner? | Protects confidentiality? | Assessment |
|---|---|---|---|
| Do nothing because he said he was venting | No | Yes | Unsafe given the risk factors |
| Continue assessment and safety planning with the client | Partly | Yes | Necessary first step |
| Ask the client to agree to remove the gun and to a same-day crisis evaluation | Partly | Largely | Strong option if he agrees |
| Warn the partner and notify police, following law and counsel | Yes | No, but may be required | Needed if risk remains serious |
| Seek emergency psychiatric evaluation | Partly | Limited disclosure to medical personnel | Appropriate if he appears unable to control himself |
The Response
The counselor kept the client in the office, brought in her supervisor, and continued talking with him. She was honest that his statement worried her and that she might have to act to keep people safe. He agreed to let his brother hold the gun that evening and to meet with the clinic's crisis clinician. When the crisis clinician found that he still would not rule out harming his former partner, the program director consulted the program's attorney, and, under the state's duty-to-protect law, the clinic notified police and the partner of a threat without disclosing that he was a patient in addiction treatment. The client was taken for an emergency evaluation.
Documentation
The counselor documented the exact words the client used, her questions and his answers, the risk factors, the consultation with her supervisor and the attorney, the actions taken and the reasons for each. Careful documentation shows that the decision was made thoughtfully and within the law, and it guides whoever works with the client next.
After the Crisis
Breaking confidentiality does not have to end the therapeutic relationship. When the client returned to treatment after his evaluation, the counselor explained what had been disclosed and why. He was angry, but he also said that part of him had wanted someone to stop him. Addressing his anger about the custody loss, his drinking and his access to weapons became the focus of treatment.
Practical Wisdom Under Pressure
Practical wisdom here meant taking a laughing remark seriously without overreacting, assessing before acting, trying the least intrusive effective option first, consulting quickly, knowing the law, and staying honest with the client throughout. No rule could have told the counselor exactly when a statement crossed the line; judgment informed by knowledge, consultation and care did.
The counselor also reviewed the clinic's policy afterward, since the crisis had shown that staff were unsure whom to call first.
Conclusion
Confidentiality is essential to addiction counseling, but it yields when a client poses a serious danger to an identifiable person. The duty to protect varies by state, and federal rules for addiction records shape how disclosure can be made. Assessing the threat, trying less intrusive options first, consulting, following the law and documenting carefully allowed the counselor to protect a potential victim while treating her client with as much respect as the situation allowed.
References
Johnson, R., Persad, G., & Sisti, D. (2019). The Tarasoff rule: The implications of interstate variation and gaps in professional training. Focus, 17(4), 435-442. https://doi.org/10.1176/appi.focus.17402
NAADAC, the Association for Addiction Professionals. (2021). NAADAC/NCC AP code of ethics. https://www.naadac.org/code-of-ethics
U.S. Department of Health and Human Services. (2024, February 16). Confidentiality of substance use disorder (SUD) patient records (Final rule). Federal Register. https://www.federalregister.gov/documents/2024/02/16/2024-02544/confidentiality-of-substance-use-disorder-sud-patient-records
Reading the PAC 415 Module 5 assignment instructions
Confidentiality closes the list of fundamental concerns in Aspen's PAC 415 description, and this module usually explores where it ends. Because the fifth module's directions are provided in the course site, this example analyzes one high-pressure case. Explain why confidentiality matters, especially in addiction treatment. Describe the legal duty to protect and how it varies by state, using a credible source. Address how special federal rules for addiction records affect disclosure. Show the assessment that must come before any disclosure, with the factors that raise concern. Present options from least to most intrusive. Describe what was done, who was consulted and how it was documented, and what happens to the relationship afterward.
How the PAC 415 Module 5 example is put together
The paper begins with the client's remark and the risk factors behind it: an identifiable target, a handgun, a history of domestic assault and recent drinking. It explains the value of confidentiality, then the Tarasoff decision and the mandatory, permissive and absent rules states have adopted, citing a study of interstate variation and gaps in clinicians' training. A section explains how federal addiction record rules complicate disclosure. The assessment questions follow, then a four-column table of five options. The response section describes keeping the client in the office, a voluntary handover of the gun, a crisis evaluation, legal consultation and a warning given without revealing his treatment. Documentation, the conversation when he returned and practical wisdom close the paper.
Where the marks sit in the PAC 415 Module 5 rubric
Confidentiality papers are judged on accurate law, careful assessment, proportionate action and attention to the relationship. This example states the Tarasoff principle correctly, acknowledges state variation and avoids offering legal advice. Its three APA sources are a Focus article on interstate variation in the Tarasoff rule, the Federal Register rule of February 2024 on addiction treatment records and the NAADAC/NCC AP code. The sequence of assessment, less intrusive options, consultation and then disclosure shows proportionate reasoning. Explaining how a warning can be given without revealing addiction treatment shows understanding of the special rules. The account of the relationship after the crisis shows the human care instructors expect alongside legal compliance.
PAC 415 Module 5 help: mistakes that cost marks
The most common mistake is treating the duty to protect as automatic whenever a client expresses anger. Assess the threat first, using specific risk factors. Another mistake is ignoring the special federal rules for addiction records. Explain state variation and say which kind of state your case assumes. Present options from least to most intrusive and explain why the chosen one was necessary. Describe consultation and documentation. Address what happens to the therapeutic relationship. Avoid presenting your analysis as legal advice. Look up your own state's statute or a professional association summary, and ask a tutor to check how you have described it, since misreading the law is where these papers most often go wrong.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More PAC 415 and Psychology and Addiction Studies sample papers
- PAC 415 Module 1: Practical Wisdom in Ethics
- PAC 415 Module 2: Autonomy and Capacity
- PAC 415 Module 3: Beneficence and Client Goals
- PAC 415 Module 4: Justice and Access to Treatment
- PAC 415 Module 6: Harm Reduction Ethics
- PAC 415 Module 7: A Complex Case, Several Principles
- PAC 415 Module 8: Reflection on Practical Wisdom
- PAC 115 Module 7: Abbreviations and Safe Use
- PAC 310 Module 7: Colleague Impairment and Reporting
PAC 415 Module 5 questions, answered
What does PAC 415 Module 5 usually ask for?
Aspen's PAC 415 includes confidentiality among the fundamental concerns of medical ethics, so a paper on confidentiality and its limits in addiction care is a typical fifth assignment. Follow your classroom prompt.
What is the Tarasoff duty?
A duty, established by a 1976 California case, for a therapist to take reasonable steps to protect an identifiable person from a patient's serious threat of violence; states now vary in how they apply it.
Does every state require clinicians to warn potential victims?
No. Some states make the duty mandatory, some permit disclosure without requiring it and some have no clear rule, so clinicians must know their own state's law.
Where can I find a free PAC 415 Module 5 sample paper?
Scroll up for the whole paper, which weighs confidentiality against the duty to protect with a threat assessment and a four-column table of options.
What should a counselor do first when a client makes a threat?
Assess it by asking about intent, plan, target, access to weapons, intoxication and history of violence, before deciding whether disclosure is necessary.