Confidentiality in Psychotherapy

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Introduction

Confidentiality entails secrecy and limited knowledge of personal information in clinical practice. The limited knowledge of personal information implies that clinicians limit the information that concerns their patients depending on sensitivity and privacy. In the field of psychotherapy, confidentiality is one of the primary elements that are significant in patients that therapists interact with on a daily basis. Imperatively, it is very crucial to ensure that the information that patients or clients relay to therapists is confidential since most of them relate to issues that affect their personal lives. Therefore, several individuals prefer to have the information private or confidential.

The concept of confidentiality calls for absolute secrecy on matters that concern the welfare of patients, and thus, medical practitioners need exercise great caution in their practice. In essence, confidentiality is one of the ethics that govern the character and conduct of medical practitioners. Hence, it is within this background that the paper examines conflicts, effects of breaching confidentiality, and the proposed solutions.

Potential Conflicts or Difficulties

Confidentiality is one of the major codes that govern the conduct of therapists and other individuals in the medical arena. However, some situations compel the therapists to seek attention from third parties, who may be the family members, relatives, or close friends of the patient (Lefley & Wasow, 2013).

During such scenarios, the therapists jeopardize the role played by confidentiality in securing personal information concerning the patient. Some of the factors that compel therapists to break the confidentiality regarding patient information include abuse, court orders, and life threatening problems. Irrespective of its vital nature, confidentiality may be broken and personal information disclosed, especially if the information is sensitive and requires legal or medical attention. It is advisable for therapists to seek the consent of their clients before disclosing any information that concern their personal lives. Conversely, therapists and medical practitioners overrule the concept of confidentiality and personal consent if the information requires urgent medical or legal attention.

When individuals share information that is life threatening, it compels the therapists to share it with others in the medical field or in concerned fields. The primary objective that compels the therapists to share confidential information is the need to save the life of the individuals or those around them. For instance, if individuals have contagious diseases, therapists must share the information concerning the disease to individuals around them, and thus, save them from the infections. Moreover, information concerning abuse or violence calls for legal attention, therefore, therapists and medical practitioners need to share them with the legal authorities.

Jackson (2013) explains that medical practitioners can only disclose personal information if the information calls for legal or medical attention. Issues such as abuse require both medical and legal attention, and thus, regardless of patient’s refusal to grant consent in sharing of information, therapists should share the information with the relevant authorities.

Whenever, therapists share personal information concerning an individual with the relevant authorities, it leads to conflicts. As a result, several therapists face legal suits filed by individuals, who become annoyed when they realize that the psychotherapist shared their personal information (Dutton& Sonkin, 2013). Medical practitioners and therapists face a dilemma when they come across information that requires legal or medical attention.

The dilemma relates to the need to share the information with the legal authorities or the medical officers and the need to uphold the confidentiality code that requires secrecy and limited sharing of information. Furthermore, the dilemma of sharing information and upholding the code of confidentiality creates some difficulties among the medical practitioners or therapists. The difficulties arise because, while psychotherapists practice confidentiality of information given by their clients, they must share information that has public interest with relevant authorities.

Effects on Client Well-Being

The effects that transpire when medical practitioners and therapists fail to share information about the client are diverse and have different consequences. Some of the effects include continued abuse, absence of justice, and death. Creek and Lougher (2011) explain that in cases where the life of an individual is in danger, there is a need to share the information with concerned authorities. Therefore, it is crucial for psychotherapists to weigh the information relayed by their clients, so that they can ascertain whether to share or treat as confidential. The type of information that an individual shares determines whether to retain them as confidential or breach the code of secrecy.

If the information concerns an abuse or contagious disease, medical practitioners or therapists must share the information with the relevant fields so that the welfare of the individuals and those around them is sustained or improved.

The well-being of the client is affected since the problem that requires medical or legal attention fails to receive the expected system of redress. As a result, the problem remains and continues to affect not only the subject individuals, but also those around them. For instance, if a psychotherapist receives information concerning sexual abuse and upholds the code of confidentiality, the perpetrators do not receive the required justice, and thus, continue with their heinous acts. It is imperative to highlight that the therapists and medical practitioners breach the code of secrecy with the intention of improving the welfare of the public or individuals at risk.

Lefley & Wasow (2013) elaborate that, in some cases, medical practitioners share personal information and breach the code of secrecy in the quest to improve the livelihood of the public. Essentially, therapists need to share information concerning an individual if it relates to their lifestyles since it helps relatives, friends, and the family to understand how to handle them.

Therefore, absence of information from the psychotherapists to relevant authorities can result in continued suffering and extended engagement of heinous and unlawful activities by criminals and abusers. In extreme cases, the suffering of an individual leads to death, especially if the therapists retain their confidentiality and disregards the need to share the information to medical practitioners or legal authorities. According to Jackson (2013), the need to share personal information is relevant if its magnitude is serious and requires urgent medical or legal attention. If a therapist gets information from a client concerning certain disease, which has a high mortality rate and keeps it confidential as per the will of the client, there is likelihood that the outcome can be the death of predisposed individuals. As a result, it is very significant for psychotherapists to ensure that they ascertain the effect that information shared by their clients has on their personal well-being.

Effect of Conflicts on Therapist’s Practices

Since personal information is very crucial and requires high levels of professionalism and confidentiality, therapists need to exercise outstanding levels of integrity and expertise. Remarkably, sharing personal information of a client leads to distrust and negative publicity among the clients. As a result, it is important for psychotherapists to ensure that they exercise professionalism in their daily activities so that they can win the trust of their clients, receive information from them, and administer the required solutions. Since therapists subject themselves to conflicting situations that need clear definitions on what is ethical and legal, they are always in a dilemma (Gillingham, 2013).

The dilemma exists since ethics dictate that the information shared by the client should be confidential and any breach is a violation of the law, whereas the legal framework of dictates that information concerning issues such as abortions or sexual abuse need medical and legal attention. These dilemmas affect the daily activities of therapists and modify how they undertake their operations.

The need to exercise professionalism is a dictation that occasion due to the dilemma between the obligation to share information and making it confidential in line with the ethical requirements of the society and the client. For effective psychotherapy, trust is very important as it facilitates sharing of information between the client and the therapist, and thus, delivery of the necessary solutions (Dutton & Sonkin, 2013).

Fundamentally, it is advisable that psychotherapists seek the consent of the client before sharing their personal information. While the client’s consent is important before sharing personal information, cases such as refusal of consent to share compels therapists to breach the secrecy code and give the information to the required legal or medical authorities. For example, if a person shares information concerning sexual abuse to psychotherapists, it is expected that the therapists relay the information to the legal authorities so that they can undertake the required legal procedure and deliver justice to victims.

Proposed Solutions

Although confidentiality is one of the important codes that govern the conduct of psychotherapists, some of the information require medical or legal attention, and thus, lead to the breach of this code. Some of the solutions include the consent of the client and empowerment of the society concerning countermand confidentiality. Since therapists need to sustain the trust of their clients, they need to execute the act of sharing information without compromising their rights.

Therefore, there is a need to engage in some activities that reduce the effect that the breach presents to both the clients and the therapists. When therapists receive information that needs medical and legal attention, or is life threatening, they must use the required expertise to explain the seriousness of the problem to the client. The therapists must undertake the explanation in a manner that does not only give the clients an assurance, but also makes them consent to the sharing of information. According to Lefley & Wasow (2013), all information given by the client to the therapists is confidential, unless the client consents to its sharing. Therefore, by getting the consent to share the information, conflicts and difficulties associated with the sharing of personal information reduce.

Empowerment of the society is another solution that helps reduce the effect of conflict among clients, the society, and the therapists. When the society achieves empowerment and receives the knowledge concerning what information goes beyond the code of confidentiality, it becomes easy to share the information with the relevant authorities, as they have a prior understanding. Imperatively, the society needs to understand that irrespective of the code of confidentiality, some information overrides the code and compel psychotherapists to inform medical practitioners or the legal authorities for their benefit and those around them. Gillingham (2013) explains that therapists need to apply professionalism and reason together with the clients so that conflicts that emanate from shared information reduce. It is significant to elucidate that reasoning together of the clients and psychotherapists can take place effectively if the clients have the required skills concerning what needs sharing and what calls for confidentiality.

Conclusion

In the field of psychotherapy, confidentiality of personal information is very crucial. The crucial nature of the shared information is due to its sensitive nature and the obligation to retain the trust of an individual. Conversely, there are situations that compel therapists to share the information given by their clients to medical practitioners or legal authorities so that they can administer the right system of redress. When psychotherapists share personal information, conflicts arise because subject clients become annoyed and sue them in court for breaching the code of ethics. Client consent and public empowerment regarding confidential information and delineation of what requires sharing are among the solutions that minimize conflicts related to sharing of personal information.

References

Creek, J., & Lougher, L (2011). Occupational Therapy and Mental Health. New York: Elsevier Health Sciences.

Dutton, D., & Sonkin, D (2013). Intimate Violence: Contemporary Treatment Innovations. London: Routledge.

Gillingham, E. (2013). LaFleur Brooks’ Health Unit Coordinating. New York: Elsevier Health Sciences.

Jackson, E. (2013). Medical Law: Text, Cases, and Materials. London: Oxford University Press.

Lefley, H., & Wasow, M (2013). Helping Families Cope With Mental Illness. London: Routledge.

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