Confidentiality Limits in Psychotherapy

Can therapists keep their patients' secrets? Should they?

Psychotherapists are careful to safeguard information about their clients, but in some instances, they may be legally or otherwise compelled to disclose information, even without client consent. This little confidentiality manual walks readers through this complex topic, using the author's easy-to-follow six-step Ethical Practice Model.

The checklist format enables therapists to inform themselves systematically about ethical options and relevant state and federal laws, so they can decide if, when, and in what respects they will limit their protection of clients' confidences — and then discuss these limits with prospective clients.  The chapters and case studies are full of useful information, making this the most convenient guide available to therapists on the topic.

Resource lists and appendices for further reading are included.

An essential tool not only for practicing therapists but also for ethics professors in clinical training programs, supervisors of students on internships and practica, and peer consultants, this handy reference belongs on every practitioner's desktop.

Introduction

The Ethical ABCs of Conditional Confidentiality

• Step 1. Prepare to Protect Confidentiality Rights
• Step 2. Tell Prospective Clients the Truth About Foreseeable Limits of Confidentiality
• Step 3. Obtain "Truly Informed" Consent Before Disclosing Confidential Information Voluntarily
• Step 4. Respond Ethically to Laws That Require "Involuntary" Disclosures
• Step 5. Avoid Preventable Breaches of Confidentiality
• Step 6. Talk About Confidentiality: Educate Each Other and the Public

Appendix A. Online Sources for Professional Ethics Codes and Listing of Ethics Texts

Appendix B. Definitions and Clarifications

Appendix C. Laws and Regulations Affecting Confidentiality

Appendix D. Client Handout Template — "Limits of Confidentiality"

Appendix E. Elements of One-Way or Two-Way "Release of Information" Forms

Appendix F. Ethical Responsibilities in Legal Contexts

Appendix G. Protecting Clients' Confidentiality Rights — An Annotated Version of the Ethical Practice Model

References

Index

About the Author

Mary Alice Fisher, PhD, is founding director of the Center for Ethical Practice, a member of the adjunct clinical faculty at the University of Virginia, and a clinical psychologist in private practice in Charlottesville, Virginia. Dr. Fisher provides workshops, seminars, and consultation on topics related to ethical issues in clinical practice.

Discussing and reviewing this manual with peers is perhaps the best way to put these valuable checklists into action. The same can be said for using the manual as text or curriculum in graduate school courses, training seminars and continuing education workshops.
—New England Psychologist

This book is a must-have desktop resource for all mental health professionals.
—PsycCRITIQUES