Case Study
Patient Demographic: Client Age: 4 Sex: Female Gender: Female Sexuality: Unknown Ethnicity: Caucasian Relationship Status: Not applicable Counseling Setting: Private Practice Clinic Type of Counseling: Family Therapy Presenting Problem: Foster Care; Disengaged Child; Behavioral Problems Diagnosis: Provisional Diagnosis of Reactive Attachment Disorder (F94.1)
Mental Status Exam: Mental Status Exam: The client is disengaged, and when the foster parents prompt her to answer questions, she ignores them and continues playing. The client appears oriented to person, place, time, and situation because she answered questions about these topics. The client appeared more responsive to your questions than her foster par
Presenting Problem: You are a private practice counselor specializing in working with children with developmental disorders. The 4-year-old female client is referred to you by her PCP and arrives with her foster parents, who join her in the first session. The client has been with her foster parents for the last 13 months after being removed from the care of her biological parents due to their incarceration for drug trafficking and attempted armed robbery. The foster parents are worried because the client exhibits minimal positive mood, irritability without an obvious trigger, and behaviors that appear to be clearly connected to attachment with caregivers. She experienced emotional and physical neglect from the birth parents and changes in primary caregivers. The foster parents also report that the client does not seek comfort when something happens that upsets her. The client did not engage very much in the intake session and was instead playing with the toys provided by the counselor. During the session, the client becomes upset with her foster parents when they prompt her to answer some questions. She hits the foster father, runs out to the lobby, and sits down with the toys. You leave the office and meet her in the lobby.
Other Contexts:    ents. Family History: The client entered foster care 1 year ago when her parents were arrested on charges of drug trafficking and armed robbery. The client has been with the same foster parents for the past year. The client experienced emotional and physical neglect by her birth parents and was separated from her 5-year-old brother and 2-year-old sister when she entered foster care. He appears to have had trouble with attachment to the foster parents per the foster parents’ report.  Following the first session, the birth mother calls you from jail asking about her daughter’s treatment, and you are able to verify that this is indeed the birth mother

Question: Following the first session, the birth mother calls you from jail asking about her daughter’s treatment, and you are able to verify that this is indeed the birth mother. Which of the following is true regarding the birth parents’ right to access information regarding their biological daughter?
(A): Only the foster parents have access to all of the information because they are the caregivers.
(B): The birth parents still have a right to access information if their parental rights have not been terminated.
(C): Regardless of whether the birth parents’ rights have been terminated, they still have access to your client’s information.
(D): Because social services took over care of the child, they can decide if the birth parents have access to treatment information.

Correct Answer: The birth parents still have a right to access information if their parental rights have not been terminated.
Explanation: Unless parental rights are terminated, the birth parents have rights to PHI. The foster parents are able to provide reasonable medical and mental health care for the child that they are taking care of; therefore, because they are part of the therapeutic process, they also have access to this information. Therefore, the correct answer is (C)
Competency: professional practice and ethics