Requests for complete record release: A three-step response protocol

Clients seen by therapists sometimes request the release of complete copies of their records to assist them with a variety of problems ranging from pe rsonal injury lawsuits, child custody litigation, criminal defense, and oth er issues. Because clients frequently do not know the contents of their rec ords, release of complete mental health records often creates special probl ems for therapists and, potentially, for clients alike. This multiple-case study describes the impact of therapist-supervised client chart review, edu cation about client rights, and potential consequences of complete record r elease on client decisions to maintain or rescind consent to release entire chart records. Participants were current or former clients(n = 27) who sub mitted requests for release of a complete mental health record. A three par t protocol designed to authenticate the request, discuss potential benefits and costs of record release, and read the mental health record was impleme nted. Subsequent decisions to release or rescind the request were documente d. Sixteen of 27 requests were rescinded following the intervention. Types of requests least likely to be rescinded were Social Security disability cl aims and personal injury lawsuits. Requests most likely to be rescinded inc luded health insurance reimbursement, family law, criminal defense, and gov ernment security clearance. Results suggest that therapist-supervised revie w and discussion of issues related to complete record release impact client decisions to follow through or modify original requests. The therapist's a dvocacy role and responsibility to educate clients about their rights and i mplications of releasing complete records are discussed. Study limitations are also discussed.