Confidentiality And Ethical Considerations

Confidentiality is a necessary aspect of creating a safe and helpful environment for therapeutic work to occur. Yalom and leszcz (2005) state: “Confidentiality...is as essential in group therapy as in any therapist-client relationship” (pp. 301-302). This is one reason why all of the professional organizations in the field have a section on confidentiality in their code of ethics. It is a complex topic and this discussion will focus on the aspect of privileged communication. Corey, Corey, and Corey (2010) mention that this term refers to the fact that professionals do not break confidentiality unless there is concern about safety of the patient or others. Vermont also has a mandatory duty to warn if someone threatens to destroy property. I believe that law came about because a patient threatened to burn a barn down during a session, the therapist did not report it, and then the patient followed through with the threat.

The American Counseling Association’s Code of Ethics (ACA, 2014) makes this statement: “The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm” (B.2.a).

I understand this to mean duty to warn in the event of a possible suicide, murder, serious property damage, and reporting child and elder abuse. This standard also covers when a counselor must disclosure information if court ordered to. I work for a community mental health center that works really hard to not to release information. I have been involved in numerous cases where the administration and legal team has prevented the unwanted disclosure of clinical information. Crespi (2009) further states that “parents not minors, own privilege” when dealing with children and adolescents (p.

276).

Privileged communication is a difficult thing to content with in a group setting. I have dealt with this personally while working with corrections and adolescent populations in a group setting. There are times when patients will discuss information that a counselor is bound by law to report such as child abuse. This can result in loss of trust from the other members and a resistance to talking about anything that may be reportable and clinical disrupting the group process. Sometimes patients were not allowed to go home to their families and adult patients lost custody of their children. At the same time, if the counselor doesn’t demonstrate that they are trust worthy by making the report that can have the same disruptive effect. Confidentiality is about instilling trust and safety through having excellent boundaries. The counselor would face legal consequences for not following this standard. More importantly, not reporting child abuse could result in a tragedy that could have been prevented.