Explanation

Confidentiality is a cornerstone of the therapeutic relationship. While mandated reporting laws require clinicians to report specific categories of harm (child abuse, elder abuse, threats of imminent harm to identifiable individuals), patient disclosures of other criminal activity — including insurance fraud — are protected by confidentiality. The PMHNP's personal ethical discomfort does not create a reporting obligation. The appropriate clinical response is to maintain confidentiality while addressing the behavior therapeutically, exploring the patient's motivations, the potential consequences of the behavior, and pathways toward change.

Key Takeaway

Confidentiality covers patient disclosures of criminal behavior not in mandated reporting categories.