Confidentiality in Counselling

Confidentiality in counselling creates a space where the client can explore sensitive subjects in the knowledge that the counsellor will not repeat or misuse the information discussed outside of the counselling room. For the counsellor, maintaining confidentiality within certain limitations is an ethical responsibility, and it is part of what makes counselling different from other relationships.

The Purpose of Confidentiality in Counselling

When a client seeks consultation with a therapist, it is important that they feel able to trust their counsellor, so they can speak freely and openly about what is troubling them. The assurance that their feelings, thoughts and stories can be entrusted to the counsellor may allow for deeper exploration of areas of experiencing which feel particularly difficult or shameful. This safety helps to build relational depth and facilitates the work of therapy.

When to Break Confidentiality in Counselling

There are certain limitations to confidentiality in counselling, and there are circumstances where a counsellor may need to break confidentiality, either because of a legal obligation, or an individual or organisational policy requirement. It is important that both the counsellor and the client are aware of the circumstances where confidentiality may be broken.

Here is an outline of some of the main limitations of confidentiality in counselling in the UK:

Legal Limitations

• If a client discloses involvement in, or information about acts of terrorism, the therapist is legally obliged to inform the authorities, and cannot inform the client of their intention to do so.
• If a client gives the therapist information regarding money laundering or drug-trafficking offences, the therapist is obliged to pass this information to the police.
• A judge or coroner can legally order the release of client notes.

Other Common Limitations

• Supervision – Most professional bodies require that counsellors undertake regular, ongoing supervision of their client work. This is anonymised, and the focus of supervision is on the therapist’s work rather than the client’s material. Nevertheless, this is a limitation of confidentiality which the client needs to be made aware of.
• Risk of harm to self – If a client is expressing suicidal thoughts or intent, the counsellor will have policies to follow regarding when and how confidentiality will be broken. It is important to be aware of policies within any organisation you are working in, and act in accordance with them.
• Risk of harm to others – Most organisations and therapists in private practice have policies in place designed to protect children and vulnerable people. Although there is no legal obligation to report abuse, safeguarding is an ethical responsibility, and, in some cases, confidentiality will have to be broken. In circumstances where there may be an increased risk to a child or vulnerable person, clients are unlikely to be informed that the therapist intends to break confidentiality.

As well as the above limitations, some organisations have additional policies around the disclosure of historical sexual abuse, drug and alcohol use or other areas, which will be outlined in their policies and procedures. It is vital to be aware of your organisational policies and to inform clients of all the limitations of confidentiality, as discussed below.

Client Rights – Contracting is Key

So that a client is able to make informed decisions about what they wish to disclose, it is important that they fully understand and agree to all of the applicable limitations of confidentiality from the outset of their therapy – this is where contracting is paramount.

A contract should outline all the limits of confidentiality in counselling and additionally should provide clarity about the way client notes are produced and stored, including the length of time they will be kept, and any circumstances in which they would be disclosed.

The client also needs to have a clear understanding of how their personal information is stored and used, in accordance with the new GDPR laws. The contract should ideally be written, signed by both parties and discussed carefully to ensure the client fully understands and agrees with the terms.

Unless there are legal and/or defensible reasons for withholding the information (such as risk to national security, or risk to a child or vulnerable person), clients usually have the right to be informed when confidentiality is going to be broken.  Organisations may have specific policies and procedures on the requirement to break confidentiality, and it is important to familiarise yourself with your organisational policies as well as the ethical framework for your professional body.

This article was written for Counselling Tutor by Erin Stevens.