Module 11: young people and drugs - issues for workers: facilitator's guide

5.3 Confidentiality and case records

Page last updated: 2004

Task - writing exercise
Distance learners

Task - writing exercise

Read the following scenario in your Learner's Workbook with another learner. Make note of the places where confidentiality may have been breached.

A day in the life of the 'Henry Smith' record: A horror story

This is the story of a case record for a young man called Henry Smith. It contains case notes and other confidential information about Henry. For example, it contains his drug use history and details of the court decision about his possession of cocaine.

9.00 am Henry's record is resting quietly in a locked cabinet in the back room. The record is aged four. (In other words Henry Smith has been a client for four years). The record is nice and fat. It bulges out of the sides of its manila folder with various reports from doctors, psychiatrists, youth workers and drug and alcohol workers. At present Henry's case is in the hands of Susan, a Drug and Alcohol Worker at the Sunnyvale Rehabilitation Centre.

9.30 am Susan arrives at work and takes the record from the locked cabinet and carries it to her desk to leaf through. In comes the admin person (Sam) who borrows it, takes it to his desk and files some new pages in it and removes some others for copying. The 'Henry' file is left on his desk while he goes off to do the copying in another part of the building. When he's finished Sam returns the file to Susan's desk.

10.00 am Susan is reading the file and discovers that an important document is missing. She asks Sam if he's seen it. Sam panics and runs to the copying room hoping to find it still in the photocopier. It isn't!! Sam spends the next 15 mins looking for the document and eventually finds it with the admin person of the section next door. One of the staff from that section had found the report and read it, but couldn't figure out who it belonged to, so he left it on the desk of the admin person for his section.

12.00 noon Henry's file remains on Susan's desk while she goes to lunch.

1.30 pm Another worker enters the room and shuffles through the papers on Susan's desk. He takes the file to his desk to write down some phone numbers he needs for making a referral for one of his own clients. On the way to his desk a piece of paper falls out of the file and lands on the floor. It goes unnoticed. The other worker returns the file to Susan's desk.

3.00 pm Susan has to attend a staff meeting with the rest of her team. She takes Henry's file with her so that she can talk about some of the problems she is having with his case. At the meeting the file is passed around to various workers to illustrate her point.
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5.00 pm It is time for Susan to go home. She has decided to take home some of her case files and catch up on some paper work. She catches the bus home and fills in the journey by reading over her case notes. The bus is very crowded.

6.00 pm Henry's file arrives at Susan's house where she is greeted by three children, two dogs, and her partner. The file is deposited hastily on the dining room table where it sits while Susan starts making dinner. Meanwhile her two-year-old is restless. He heads for the table and amuses himself by drawing nice pictures on the cover of the file.

7.00 pm Susan's teenage daughter arrives home. She is bored and hungry. Her eye falls upon Henry's file. It soon becomes the most fascinating reading she has seen in ages.

8.00 am The next day the file travels to work by car. Upon arrival, Susan is told that they are having a cleanup day. Henry's file is accidentally included in the box of papers to be discarded and it arrives at the tip where its pages are caught by the wind and blown all around.

11.00 am Later that morning, Bob the businessman picks up one of the pages, sees that they belong to the Sunnyvale Rehabilitation Centre and rings to let them know that confidential information flying around the tip. Sam is horrified. He hastily arranges for a maintenance crew to go down and retrieve as much information as possible. This needs to be done quickly, so as to avoid a major lawsuit.

Task - writing exercise/group activity

Answer the following questions and discuss your answers with other learners.

Question - How could Susan have kept this record confidential and still kept up with her paperwork?

Question - Can you suggest ways to keep electronic records confidential (e.g. computer files, emails)?

Question - The 'Henry Smith' Horror story is an extreme example of what can happen to client records but similar incidents can, and do, occur from time to time. Have you had any similar incidents at your workplace? How could the incident have been avoided?

Question - Does you workplace have a policy on protecting client information? How specific is it?


Overhead transparency

  • Confidentiality requires that we ensure a client's family and health history are kept in a secure and confidential manner

  • Case notes can be brief or detailed, depending on your organisation's requirements

  • Young people are legally able to access case notes

  • Case notes need to be kept simple and relevant

  • You may be subpoenaed to court to explain your case notes. Hence they need to be accurate.
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Distance learners

(A good point for student to contact facilitator.)

Distance learners have been advised to make contact with you, the facilitator, to check their learning progress.