When is it appropriate to discuss confidentiality limits with a client in CCAR practice?

• A. At intake or first session, and whenever limits change; obtain informed consent.
• B. After a crisis occurs.
• C. Never discuss confidentiality; it's automatic.
• D. Whenever the client requests it.

Answer: (A)

The principle at work is establishing clear boundaries around what will be kept confidential and when disclosures are allowed or required. In CCAR practice, you set this up from the very first contact and then revisit it any time those limits change. Explaining confidentiality and obtaining informed consent early creates trust, helps the client understand what information will be shared and with whom, and protects both the client’s rights and your ethical responsibilities.

Discussing this at intake or the first session ensures the client understands the safeguards and exceptions upfront, such as safety concerns, abuse reporting, or legal requirements that may necessitate sharing information with others. If the limits change—for example, you begin sharing information with a supervisor or treatment team, or new policies affect what must be disclosed—you revisit the conversation and obtain updated consent. This ongoing consent process keeps the client empowered and aligned with how their information is handled.

Doing this after a crisis misses a critical window where expectations are set and trust is built. Treating confidentiality as automatic or only addressing it when the client asks can lead to surprises and erode trust, and it’s not appropriate to say it’s never discussed.