When should a counselor explain the limits of confidentiality and obtain informed consent?

• A. Only after a crisis
• B. At intake and in writing
• C. During discharge planning
• D. After a court order

Answer: (B)

From the start of counseling, clients need to understand what will be kept confidential, what the limits are, and how informed consent works. Explaining confidentiality and obtaining consent at intake—and getting it in writing—ensures the client is aware of what information may be shared, with whom, under what circumstances (for example, mandated reporting or court orders), and how they can participate in decisions about their care. Documenting consent in writing provides a clear record that both parties understand the expectations and rights, and it supports ongoing consent if services or circumstances change.

Waiting until a crisis, only during discharge planning, or only after a court order misses the opportunity to establish trust and transparency from the outset. A court order may necessitate disclosure, but it does not replace the need for a proper, prior informed consent process.