I have to breach confidentiality – part 2

Disclosures requiring that confidentiality be breached are rare. A little preparation should permit you to focus upon supporting your client through the process, preserving your therapeutic rapport.

In part one, we considered how to react when a breach of confidentiality seems necessary, how to prepare for such an eventuality and what to say to the client.

Now we will consider how to continue your involvement with your client once you have had to breach their confidentiality. We will also consider how to proceed when your decision to breach confidentiality is reached outwith the session, whether independently, directed by your supervisor or required by law (eg: by a court order).

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I have to breach confidentiality – part 1

Disclosures requiring that confidentiality be breached are rare. A little preparation should permit you to focus upon supporting your client through the process, preserving your therapeutic rapport.

For UK therapists there are three occasions on which it is mandatory that confidentiality be overridden for the greater good: when the client is a risk to themselves, when the client is a risk to others and when there are children at risk; respectively, the therapist must inform the Responsible Medical Officer, the Police and the Social Services.

Particular services and professions may offer more specific guidance and place additional duties upon therapists, but it is likely that you will encounter at least one, if not all, of these eventualities.

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Tell clients confidentiality has limits

Therapists often assure clients that the information they provide is confidential. Confidential is defined as “intended to be kept secret”. Whether the information will be kept as secret as the client (or therapist) imagines depends upon the therapist and the service.

Confidentiality in the strictest sense implies that only the therapist will be privy to the information provided by the client. In practice this level of confidentiality is impossible to offer, as therapists have professional and legal obligations to uphold.

Most professions and services require that clients give informed consent to all assessments and treatments, which includes basic information gathering. Clients must therefore understand the limits upon the confidentiality you can offer before beginning to discuss their case. Clients who provide information which necessitates breaking confidentiality may feel betrayed by their therapist if not first advised of their therapist’s obligations.

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