Research about Confidentiality

One of the key reasons that clients enter into a counseling engagement is confidentiality. Clients are always willing to reveal their secrets, inner concerns, and wishes with a neutral party who cannot and will not expose the client's information to anybody else if secrecy is guaranteed (Morris, 2014). However, what is said in a session does not always remain in a session since the therapist may be obliged to breach confidentiality by disclosing the client's private information to others (Morris, 2014). This paper attempts to answer an ethical quandary concerning the breach of confidentially of a topic discussed during a session.

 Therapist confidentiality forms one of the essential aspects of establishing a healthy relationship with clients in a counseling environment. That is why it is the responsibility of a counselor to notify the clients of their privacy policies, as well as explain to the clients the circumstances under which the counseling confidentiality agreement may be broken (Foster, 2014). One of the ways in which the counselors can develop a good relationship with the clients by sending out all their privacy policies, including confidentiality disclosures, in a client’s welcome letter (Morris, 2014). Additionally, during the review and processing of all the previous session's paperwork, it is essential for the counselor to review and raise questions to the client so as to ensure that the client understands the privacy policies correctly (Foster, 2014).

Therapists value the trust that they work too hard to build with their clients. However, they must also ensure that they comply with the regulations of any state or licensing board regarding the kind of information that is appropriate or pertinent to disclose, as well as when such information should be disclosed (Liegeois, 2014). Therapists also need to know the best way to explain confidentiality disclosures to the clients. The conditions under which counselors can break the confidentiality of something discussed in a session varies from one place to another depending on the set state and federal regulations, as well as the counselors’ licensing board’s ethical code regarding handling the client’s information shared during a session (Liegeois, 2014).

Confidentiality does not only entail the therapy contents but even the fact that a client is undergoing therapy (Foster, 2014). It is a common practice that therapists, for instance, will not recognize their clients if the clients approach them outside a therapy session in an effort to protect the confidentiality of the client. Therapists may also prevent the disclosure of clients' confidentiality by avoiding leaving revealing information on voicemails, not informing outside parties of their appointments with clients, and not discussing the therapy contents with a third party without the client’s explicit permission. Therapists who break the confidentiality without the client's permission can be sued by the client or may get into trouble with various state licensing boards (Foster, 2014).

Circumstances Under Which Therapists May Have to Break Confidentiality with a Client

A therapist may decide to break the confidentiality about something discussed with a client in a session if the clients pose an immediate danger to themselves or others (Liegeois, 2014). Therapists may also break the confidentiality with a client if the client appears to be endangering a helpless population, such as the circumstance of elder or child abuse (Morris, 2014). Sometimes, therapists may threaten to share clients’ diagnosis information as a means of obtaining payments for service in the case that the client defaults. Additionally, therapists may disclose the clients’ information if they are obliged to do so by the state or federal laws (Liegeois, 2014).

However, the best way for the therapists to ensure that their profession honors client-counselor confidentiality, but at the same time complies with any permissive or mandatory regulations, is to read, review, analyze, and, comply with any federal, state, and association rules and regulations (Foster, 2014).

As required by the American Psychological Association's Code of Conduct Standards and Ethical Principles of Psychologists, therapists may reveal clients' confidential information without the client's consent only when demanded by law, or when permitted by the law for a valid, specific purpose. Such purposes may include; when providing necessary professional services, or when obtaining professional consultations (Morris, 2014). The law may also permit psychologists to break the confidentiality with a client when protecting themselves, others, or the clients from harm, as well as when obtaining payment for services from clients. However, the confidentiality disclosure should be limited to the possible minimum that is required to attain the purpose (Morris, 2014).

According to the National Association of Social Workers' Code of Ethics, social workers have the sole responsibility to protect the confidentiality of any information acquired in the course of the professional session, except for various convincing professional reasons (Foster, 2014). The clients’ general belief that psychologists will always keep the discussions during a session confidential does not apply in circumstances where information disclosure is necessary to prevent foreseeable, serious, and looming harm to the client and other identifiable individuals (Morris, 2014). In all cases, psychologists need to disclose the least possible content of confidential information necessary for the achievement of the desired purpose. Besides, psychologists should only disclose the information that has direct relevance to the purpose for which the confidentiality disclosure is made (Foster, 2014).

Additionally, according to the Code of Ethics of the American Counselors Association, the general obligation that counselors maintain the confidentiality of client's information does not apply when breaking the confidentiality is necessary to protect the clients from predictable danger. It may also not apply when various legal requirements mandate for the disclosure of confidential information (Liegeois, 2014).

In some instances, psychologists who have no legal requirements to keep confidentiality may be compelled to break confidentiality by various circumstances outside the session. For example, in a rape situation, a non-licensed mental health professional may be forced to attest against his or her client (Morris, 2014). Licensed therapists may also be forced by circumstances to testify against their clients. However, it is always much harder to compel a licensed therapist to give evidence against his or her client than it is for a non-licensed mental health practitioner because the laws guiding the licensed psychologists are much stricter on matters of confidentiality (Foster, 2014).

Conclusion

Confidentiality forms one of the most critical aspects of building a lasting relationship between the therapists and their clients. Therefore, it is always important for the psychologists to focus on protecting and maintaining the client’s’ confidentiality regardless of the mental health profession they belong to, or the state laws that apply to them. All mental health professionals have to take the confidentiality of clients’ information seriously to build the trust that is embedded in the mental health profession. However, therapists may break the confidentiality with a client when it is vitally necessary.

References

Foster, S. (2014). Confidentiality and Patients’ Rights. International Journal Of Mental Health And Capacity Law, (7), 229. http://dx.doi.org/10.19164/ijmhcl.v0i7.378

Liégeois, A., & Eneman, M. (2014). Conditional shared confidentiality in mental health care. Medicine, Health Care, And Philosophy, 18(2), 261-266. http://dx.doi.org/10.1007/s11019-014-9597-2

Morris, F. (2014). Confidentiality and the Sharing of Information. International Journal Of Mental Health And Capacity Law, (9), 38. http://dx.doi.org/10.19164/ijmhcl.v0i9.318