Monday, 4 March 2013

Confidentiality & Safeguarding

This blog is about what breaches of confidentiality or what safeguards in confidentiality, would a counsellor and therapist put in, in terms of what agreements would you have with the client about breaks in confidentiality.  So I just want to share with you some of my ideas from a transactional analysis point of view and probably from a integrated relationship point of view, as well in what breaks I would have in confidentiality.  

So I’m working with a client and you know, I see him for the first time and of course, confidentiality is the bite word for them to feel secure and safe and building up a trusting relationship with me.  They need to know that confidentiality is in place.  So they need to know what confidentiality means so I tend to spell that out with them and talk that  through.  So confidentiality means whatever stays here, stays here.  It doesn’t go anywhere else, but I did have some breaks in confidentiality which I want to share with you which I think is important for any beginning counsellor or psychotherapist to think about so that they don’t trap themselves in a confidentiality mire or trap themselves in some ethical problems which is going to be very challenging for them to break free from in some ways.  So, the first break in confidentiality would be that if the client disclosed something that was of a criminal nature or against the laws of the land, I would have the permission to break that.  Of course, I’d talk with my client first about this to say that as this is a criminal act and you’ve given me something which is of criminal nature and it is in my duty to report this, and I’d give them the option first to be the person who actually went to the police or whatever this nature is about rather than me having to do it or perhaps even I’d go to the authorities with them, but certainly I would definitely flag that up.  Now of course there are degrees of criminality so that’s something else I’ll probably be talking about at the beginning of the counselling session but I’d certainly have that break in the confidentiality system and that is if they share something that is criminal then I would have the space to take that further if need be but I certainly would talk to them.  

Secondly would be if I deemed they were to harm themselves or in fact they were going to harm other people.  So, you know, if I thought that they were going to go away and kill themselves or if they were going to really harm other people then I would have the confidentiality space to do something about that and take that further.  Now of course, all these three actions would be talked through with the client.  I wouldn’t just go ahead without talking it through.  

This is a really important process and is talked about a lot with the client before I start therapy with them so they know exactly what my thinking is in terms of confidentiality breaks and what confidentiality actually is.  It’s a really important area I think for beginning counsellors and therapists, and even experienced counsellors and therapists to actually consider what confidentiality is and when they would break that and have they discussed that with their client, so there’s a sense of security in holding a containment in the therapeutic process.

1 comment:

  1. Hi Bob_i do agree with you of the importance of the above but would like to add I also add 'in case the client falls I'll and the emergency services need to be involved, my supervision requirements and how my notes are kept. I do this for mutuality, ethics and safeguarding not only the person I am seeing but also my self.