Confidentiality in counselling means, to me, providing a secure, trusting relationship with a client who knows that, within certain limits, he or she can speak to you about anything at all in the knowledge that whatever has been said will go no further. It is an intrinsic and imperative part of the trust that is required to develop a good working relationship between a counsellor and their client.
My client will know that, excepting those limits noted below, I will hold safe everything they share with me; their thoughts, their worries, their deepest secrets, their life story and they will leave our counselling sessions with the surety that they have a safe haven within which to explore their issues or problems. Similarly, if I speak to a friend, relative, or work colleague ‘in confidence’ I expect that what I have said will go no further than between ourselves unless I have told the listener otherwise and, by the same token, what they choose to tell me confidentially will not be shared by me with anyone else.
If any acquaintance of mine, in any capacity, chose to talk to me about issues that may appear to be of a confidential nature, then I would implicitly consider that communication to be confidential unless that person advised me otherwise. In a work situation or in any other role where I may have access to confidential information, e. g. pupils, personnel, various group members, governing body discussions; I need to be aware of the confidential aspects that are a part of that information and ensure that I do not ‘share’ with any other person or agency that does not have access to the same details.
When I am given confidential information the person or organisation giving it to me needs to feel sure that it will be kept as confidential and not imparted to a third party. “Confidentiality is fundamental to the trust and integrity of the counselling relationship. It creates a safe space for the client to explore difficult and challenging issues and clearly signals that the client has control over any subsequent disclosures of that information or insights derived from it. ” (Bond P152 Para1 Lines 7-10) The following is an extract from the current BACP Ethical Framework: “Fidelity: honouring the trust placed in the practitioner
Being trustworthy is regarded as fundamental to understanding and resolving ethical issues. Practitioners who adopt this principle: act in accordance with the trust placed in them; regard confidentiality as an obligation arising from the client’s trust; restrict any disclosure of confidential information about clients to furthering the purposes for which it was originally disclosed. ” There are, however, situations that may arise which would create exceptions to the basic rule of confidentiality in counselling. “Confidentiality becomes the professional management of personally sensitive information disclosed in confidence.
” (Bond P152 Para 1 Line 1). The very nature of counselling means that a client may make disclosures which would lead me to consider breaking confidentiality and passing details of the disclosure to supervision. “In actual practice all the national professional organisations for counsellors stress the importance of confidentiality but do not suggest that it should be absolute. To make it absolute would prohibit disclosures made in order to prevent serious harm to clients themselves or to others and would frustrate the requirements to receive counselling supervision.
” (Bond P153 Para 2 Lines 1-5) In such cases I would feel ethically and/or legally bound to report such a disclosure keeping the client informed of the process. The limits of confidentiality will have been explained to my client during my initial presentation of the contract between us, so that he or she would already be aware that what they tell me may be discussed with my supervisor, although their name will not be used. The following guidelines taken from the current BACP Ethical Framework note the need for such an action to be: i)where there is risk of harm to yourself or others;
ii)under the Prevention of Terrorism Act (Northern Ireland); iii)if the counsellor is subpoenaed or summoned as a witness in a Court of Law. “Some threats to the public interest are considered sufficient to require a statutory obligation to disclose. These include matters concerning the prevention and detection of terrorism concerning Northern Ireland (Prevention of Terrorism (Temporary Provision) Act 1989), and drug trafficking (Drug Trafficking Offences Act 1986). Not to make a disclosure is an offence.
Notifying people that you have made a disclosure about them constitutes a separate offence. ” (Bond P159 Para 4 Lines 1-8) The decision to take such action is not likely to be straightforward or obvious and I would have to be as sure as I could be that I was making the correct choice for all involved. Breaking confidence to protect the well-being of either my client or another person, perhaps myself, because I considered the possibility of that danger to be real, is a difficult and crucial decision to make and I must feel that there is significant danger of harm.
“One of the great weaknesses of the current ethical and legal arrangements with regard to confidentiality is that the complexity must create a degree of uncertainty for counsellor and client. ….. The law has taken the view that confidentiality cannot be justified as an absolute principle. ……” (Bond P166 Para 2 Lines 1-3 & 11-12) Whenever possible my first course of action would be to discuss my decision with my client and encourage him or her to inform the authorities themselves.
If they were unable or unwilling to do this then my next step would be to take their story to supervision and if I was still convinced that, in this case, confidentiality needed to be broken, then I would take the necessary steps to report the situation. The law suggests I exercise “reasonable care” in my judgement and I would need to keep detailed records of my discussion with my client regarding this course of action so that I had evidence should a complaint be made against me.
Another possible situation in a counselling session which could require that confidentiality be broken is where a disclosure has been made regarding child abuse or incest. It is a contracted condition of some agencies that their counsellors take to supervision any such child protection issues and again this will have been explained to my client when discussing our contract. “The Children’s Act 1989 is of a much more limited jurisdiction than is commonly understood. The statutory obligation to report and investigate incidents of child abuse is largely confined to social services.
” (Bond P159 Para 5 Lines 1-4). The limits of confidentiality need to be made explicitly clear during the initial meeting with my client so that if a breach should become necessary he or she will already be aware of the possibility of such an event and hopefully, therefore, be less affected by it than may otherwise have been the case. There could be negative consequences as a result of my having made the decision to breach the confidentiality of out client/counsellor relationship. They may feel let down and (even having given their permission for me to pass on their story) betrayed.
However, if I have handled the situation correctly, gained my client’s trust with an assurance that whatever I do is still with the intention of helping them, that I am not passing judgement and will not be abandoning them, then, hopefully, they may be able to see that passing on their story is intended to be a positive step forward. I would try to show them that the positivity would be in meeting the need for them to take on the responsibility of their actions in order to gain autonomy in their own life.
“The counsellor’s commitment to confidentiality marks a boundary that supports ethical principles of respect for client autonomy and fidelity and places the client in control of decisions about the client’s best interests and the avoidance of harm outside the counselling relationship. ” (Bond P152 Para 1 Lines l1-14) Although I could not feel uninvolved in a serious disclosure I would have to keep myself detached enough that I would be seeing the path I needed to follow clearly, without allowing my own emotions to cloud my judgement.
The weight of this burden of responsibility may lay very heavily, however, I need to be clear headed in my duty to disclose information which I know I am legally bound to do. In a more serious situation, even though the correct procedures have been followed and my client has been made aware of my intention to break confidentiality, it is possible that they may decide to make a complaint or even to instigate legal proceedings against me.
Under any circumstances breaching confidentiality is a very serious step to take in the relationship between counsellor and client and should never be taken lightly or without the “reasonable care” that is the counsellor’s responsibility. “A breach of confidence is defensible where: (a) The client has consented to disclosure. Obtaining the client’s consent is often the best way of resolving legal and ethical disclosures over confidentiality (Cohen, 1992);” (Bond P158 Para 3 Lines 4-7)
Notwithstanding all of the above there are then my own limits of ability, understanding and knowledge to consider within a counsellor/client relationship. I would be doing any client a disservice if I were to continue to counsel them when I was aware that the interaction had reached a stage where I was unqualified, unable or unwilling to deal with it well and/or appropriately. It would be unethical for me to continue without consulting the client and offering them alternative options which would necessitate my breaching confidentiality.
I would assure them that this breach would be limited to passing on their story to my supervisor, with their permission, and that I could continue to see them whilst another, better suited or more qualified person was being found for them. It is of paramount importance that I am aware of the various alternatives of help that are available for my client so that I can signpost quickly and positively, thereby making the transition as ‘painless’ as possible. Confidentiality forms the basis of counselling.
It is what bonds client and counsellor on their journey together and helps them to work openly and honestly with trust and respect for each other. If the client has a firm belief that confidentiality is at the base of the consultation process then he or she can feel empowered to explore any issue they need to that will enable them to go forward into a more autonomous future. Bibliography Tim Bond 2000 Standards and Ethics for Counselling in Action Second Edition Sage Publications