Psychological Counseling/Mental Health and Confidentiality Frequently Asked Questions

Are school psychologists legally allowed to provide ongoing counseling services to all students, including those in general education?

The answer is YES! School psychologists are trained and supervised in school-based counseling methods and are credentialed to provide counseling services, including to those students in general education. These services include individual, group, and classroom/school-wide mental health/social-emotional learning interventions and prevention programs.

The specialization in School Psychology, per the Commission on Teacher Credentialing (CTC) authorizes the holder to perform the following duties:

• Provide services that enhance academic performance
• Design strategies and programs to address problems of adjustment
• Consult with other educators and parents on issues of social development and behavioral and academic difficulties
• Conduct psycho-educational assessment for purposes of identifying special needs
• Provide psychological counseling for individuals, groups, and families
• Coordinate intervention strategies for management of individuals and schoolwide crises

Source: http://www.ctc.ca.gov/credentials/req-services.html

What are the “permission” requirements in order for a school psychologist to provide counseling services to non-special education students in the public school setting? 

School psychologists should obtain parental/guardian permission in the provision of psychological counseling. Since school psychological services are not services regularly provided to all students as a general education function within the school, FERPA requires school psychologists to obtain parental/guardian permission for counseling services until the student’s age of 18. The exception to this is if the student is deemed mature enough to give their own consent/engage in counseling services AND if seeking parental/guardian consent would put the student at increased risk or if the minor is emancipated. This caveat is clearly vague, and, therefore, consultation with administration and legal counsel in the specific district wherein services are to be provided is recommended as best practice.

What is the school psychologist’s responsibility to maintain confidentiality?

Both the National Association of School Psychologists (NASP, 2010) and the American Psychological Association (APA, 2002) have set detailed guidelines around confidentiality. In situations wherein failure to release information would result in danger to the child or others (NASP, 2010), confidentiality must be breeched in order to ensure the safety of the child and those around him or her. In those situations, the therapist must use clinical judgment, knowledge of legal and ethical guidelines, and an understanding of risk factors that could increase harm to self or others in order to determine next steps. If the risk is deemed to be high, parents must be notified immediately and the high-risk student should be placed under constant supervision. The therapist must ensure that the parent understands the seriousness of the situation and should be prepared to guide the parent to the next appropriate steps in helping the child, from increased monitoring of the child at home and removing access to means, to taking the child to an emergency room or local psychiatric facility for further evaluation. Consultation in these situations is recommended for the school psychologist to ensure best practice.  

If risk is not a factor, confidentiality should generally be maintained. Because of the potential need to break confidentiality in the therapeutic relationship, it is important at the outset of therapy to review the limits of confidentiality with the child. The law also allows for sharing of information with school officials who have a legitimate educational interest in the student (such as members of an IEP team). 

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What should a school psychologist do if a subpoenaed for confidential information about a student?  

If the school psychologist has been subpoenaed it is recommended that consultation with their school administration and district legal counsel be immediately sought. Depending on the situation, the school psychologist may or may not need to divulge the confidential information. If the parent/guardian signs authorization for information to be shared/exchanged, this will likely create a situation wherein the school psychologist shares the confidential information.  However, consultation in all situations is recommended. If a school psychologist receives a court order, it is very likely information will need to be shared; here, again, consultation with administration and district legal counsel is recommended.  

Where in the education code does it specify that school psychologists can provide emergency counseling?

“Emergency counseling” does not appear in education code. It has long been accepted that a school psychologist can provide counseling in an emergency. The psychologist should provide the student with information about what cannot be kept confidential and ensure that the student has given assent. If a student is only seen once, is not deemed at-risk, and services are not going to continue, the student may be seen as a one-time event without prior parental consent.

Is a student who is obtaining a bachelor’s or graduate degree able to observe groups and individual counseling sessions with students or would it be a breach of confidentially? 

Students may be allowed to observe sessions, but CASP recommends parental consent and a letter of agreement be sought between the student, the student’s professor, and the school psychologist conducting the sessions outlining the student’s role as an observer and delineating the extent of the observations.   

Is there information or guidance regarding Educationally Related Mental Health Services (ERMHS) assessment to evaluate for residential placement?

Federal and state rules require that a private, non-sectarian school placement is available in the continuum of options for special education students. A comprehensive assessment should document why such a restrictive placement is necessary for the student to benefit educationally from the pupil’s educational program pursuant to an IEP. The IEP team determines the least restrictive environment to meet the student’s needs.  

Is it necessary or legally required to develop an assessment plan when adding psychological services to an IEP for a student who already receives services?

Any time that a student demonstrates a need in a given area, the IEP team should identify the need, develop a measurable goal related to the need, and offer service to allow the student to make progress in the area of need. The law requires that a student be assessed in any area of suspected disability. If staff are considering adding a service to an IEP, best practice is to conduct an assessment in the particular area; thus, an assessment plan should be developed and provided to the parent for consent. However, if the parent of the student will not consent to assessment, where the need is apparent, the lack of assessment information by and of itself does not necessarily mean that that the IEP team cannot offer services. Generally speaking, it is always best to conduct assessments, before offering services, as assessments provide critical information that assists in determining which services are appropriate. 

What best practice assessment measures should be used to determine base line, needs, goals and direct services for counseling/psychological services through an IEP?

A comprehensive mental health assessment should include a multi-method, multi-source, multi-setting design. In general, the following would likely be included:

• general behavior rating scales completed by parent, teacher and child
• specific rating scales based on area of concern completed by parent, teacher and child   
• “strength-based” rating scales on the student’s subjective well-being
• parent/teacher/student interviews focused on areas of concern
• behavioral observations
• file review