When are breaches of confidentiality allowed in cases of substance abuse?

Breaches of confidentiality in cases of substance abuse are permitted under specific circumstances primarily driven by safety concerns. When an individual poses a real and immediate risk of harm to themselves or others, the obligation to protect life takes precedence over the confidentiality agreement. This aligns with ethical standards that encourage counselors to act to prevent harm.

Moreover, mandatory reporting laws exist for suspected child abuse and in some jurisdictions for elder abuse. These laws require professionals to report any reasonable suspicion that a child or vulnerable elder has been abused or neglected. This legal requirement is in place to safeguard vulnerable populations, ensuring that they receive the necessary protection and intervention.

Both of these situations represent critical exceptions to confidentiality regulations, highlighting the balance between a client's right to privacy and the need to protect individuals from harm. As such, both conditions justify a breach of confidentiality, thereby making the response that includes both situations the most accurate.