Confidentiality is at the foundation of safe therapy because it promotes open and candid communication between the therapist and the counselee. This right to confidentiality has been repeatedly reaffirmed in judicial system, with the case of Jaffee v. Redmond (1996) serving as a key example. In that ruling, Justice John Paul Stevens of the US Supreme Court wrote expressed that “effective psychotherapy depends upon an atmosphere of confidence and trust in which the patient is willing to make frank and complete disclosure of facts, emotions, memories, and fears.” (Corey, Schneider-Corey, & Callanan, 2007, p. 214) Justice John Paul Stevens couldn’t be more correct, because without a measure of confidentiality, the process of mental health treatment would not be possible. Clients themselves would need to be constantly concerned about the ramifications of divulging sensitive information. It is extremely important that we communicate a client’s right to confidentiality to promote that free flow of communication. Not only are we ethically and legally responsible for disclosing it at outset, in the form of an informed consent document, but we should also endeavor to continue to have candid conversations around confidentiality as the relationships continues to develop.
We, as mental health professionals, should seek to protect the image of the larger profession and give our clients every reason to believe in our pledge of confidentiality. That integrity aside, we also need to be candid and forthcoming regarding the limitations of that confidentiality, because it is not without exceptions. If the client is a danger to self or others, we are bound by mandatory reporting procedures to report the incident, as well as “warn and protect” other people from potentially dangers clients. In cases where abuse is detected, be it with children, elderly, or dependent adults, we are mandated by law to report such cases to proper authorities. Furthermore, we should follow up on such cases to be assured that proper action has been taken. In the case of counseling a minor, an underage client should be aware of specific limitations regarding disclosure of information to parents, particularly when he or she is a danger to themselves or others. We also much acknowledge that confidentiality is the client’s right, and they also have the ability to waive that right.
I would hope that clients really believe what they say is confidential. I would also hope that they understand the implicit limitations on that confidentiality before the process of counseling begins… so, they should also understand that some of what they may say is not confidential. In any case, it very much depends on the context, the situation, the content of the disclosure, the professional judgment of the clinician, and the ethics codes, laws, and agency policies that govern our practice.
Corey, G., Schneider-Corey, M., & Callanan, P. (2007). Issues and ethics in the helping professions (8th ed.). Belmont, CA: Brooks/Cole.