Members of the Committee on Privacy and Confidentiality of the California State Psychological Association collaborated on this article, whichaddresses the subject of personal and informational privacy in relation to psychotherapy. Among the topics discussed are procedures for obtaining informed consent; federal requirements for breaching, and provisions for guarding, confidentiality; the vulnerability of records kept in Medicaid and other third-party insurance cases; some implications of the Tarasoff decision; and the status of trust as an element of the therapeutic relationship. Findings of the committee with respect to these topics are reviewed and summarized, and recommendations for professional conduct are advanced.• ' .One of the most compelling issues currently being confronted by those psychologists who engage in psychotherapy concerns the privacy of clients and the confidentiality of their case records. For several years the Committee on Privacy and Confidentiality of the California State Psychological Association (CSPA) has collected information on these subjects, has met regularly to discuss their meaning, and has prepared public reports of its findings. The committee conducted symposia at both the 1976 and 1977 CSPA conventions and at the 1977 APA convention in San Francisco.

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Although Asian/Pacific Island Americans (A/PIs) represent only 2.9% (7.27 million) of the total US. population, the number of A/PIs in the US. increased by 95% between 1980 and 1990. This rapid growth is expected to continue well into the next century and is projected to reach 18-20 million by 2020 (Ong & Hee, 1992). The increase was stimulated primarily by the 1965 immigration law change and the admission of refugees from Southeastern Asian countries beginning in 1975. Among them, the percentages of children under 19 and between 10 and 19 are 32.2% and 15.9%, respectively (Asian and Pacific Islander Center for Census Information and Services, 1992).The term AsianlPacific Island Americans is often used by policymakers and the general public, who tend to think of them as a homogeneous group. However, they are a diverse group of people with vastly different backgrounds, including their history, language, culture, socioeconomic status, needs, and problems (Takaki, 1989). Among them, Asian Americans make up 95% of the population, representing 28 ethnic groups, including persons of Chinese, Japanese, Filipino, Asian Indian, Korean, and Vietnamese ancestry (Chen, 1991). Although their number is small, Pacific Islanders consist of approximately 30 different ethnic groups from the Pacific Island region, including Hawaiians, Samoans, Tongans, and Guamanians. Some of the Asian American groups such as Chinese, Japanese, and Filipinos began immigrating to the United States more than 100 years ago and have fifth-and sixth-generation offspring. However, a majority (65.6%) are foreign born, with wide variations among ethnic groups (e.g., 32.4% of Japanese vs. 79.9% of Vietnamese or 79.4% of Laotians; US. Bureau of the Census, 1993). In 1990, 58% of A/PIs lived in the western United States, with the highest concentration living in California. New York, Hawaii, Texas, and 11linois also have significant Asian American populations.

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S53In this presentation, I will demonstrate findings from the research by the DVAP regarding the psychological responses and mental health conditions of disaster workers after the great earthquake. Twenty-six percent of firefighters suffered from intrusion symptoms 13 months after the earthquake. According to scores of selfrating scales including IES, even at 26 months after the quake, 21% were presumed to have PTSD. Schoolteachers also were disaster workers, for evacuee shelters were setup in schools, and teachers were obliged to manage them. We estimate about 13% of the school teachers suffer from PTSD at 26 months after the earthquake. Both in firefighters and teachers, critical incident stress (CIS) and the severity of tasks strongly related to their psychopathology. These rates are much higher than are those of ordinary citizens hit by the same earthquake.The Japanese often hesitate to express their emotions. Therefore, I also will offer some possible modification to methods of intervention or critical incident stress management (CIMS), e.g., debriefing, for Japanese disaster workers on the basis of cultural background. The goal of this presentation will be: 1) to acquaint the emergency medical personnel about the potentials for experiencing stress reactions while engaged in frequent emergency or disaster-assistance activities; and 2) to provide a brief overview of the critical incident stress debriefing frequently utilized in preventing the development of post traumatic stress disorders (PTSD). The presentation will include: 1) Types of critical incidents or disasters: a) natural disasters, e.g