311 – Confidentiality Laws for Therapists

Personal Preparation Plan for Trauma-Informed Practice – Discussing Racial Identity Respectfully

In Episode 311 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly take us through this week’s three topics:

• Firstly, in ‘Ethical, Sustainable Practice’, we look at creating your personal preparation plan for trauma-informed practice.
• Then in ‘Practice Matters’, Rory speaks with Sarah Henry about discussing racial identity respectfully.
• And lastly, in ‘Student Services’, Rory and Ken talk about confidentiality laws for therapists.

Personal Preparation Plan for Trauma-Informed Practice [starts at 04:00 mins]

• Hope for the best, prepare for the worst.
• Transference – an emotional time machine. Transference describes when you meet someone brand new, but experience feelings and emotions from a past relationship or encounter.
• Parallel Process – classic parallel process is when a client is going through something similar to what you might have experienced and you begin to feel confused about whose frame of reference you’re in, and what emotions belong to who. A more contemporary form of parallel process might be when you begin to enact client behaviours in supervision.
• Be aware of what your own triggers are.
• Recognise the work you’re doing and the need to be present and well.
• Work can make us fatigued and irritable – it’s about planning how we’ll deal with these scenarios.
• What are you doing outside of your practice to relax and unwind?
• Implement self-care strategies that are unique to you.
• Use your supervisor to help you work through these.
• Grounding techniques can also work for you, not just the client.
• Personal therapy can be a great way to work through these feelings.
• Peers – talk with your peers about what you might be feeling.
• Personal reflection – understand how the self can influence how you are able to show up in the therapy room.

When it comes to working with trauma, it’s important to look out for yourself as well as the client. In this section, Rory and Ken describe some of the things to consider when it comes to having a personal preparation plan, and why it’s a good idea to have one in place:

Discussing Racial Identity Respectfully [starts at 30:18 mins]

In this week’s ‘Practice Matters’, Rory speaks with Sarah Henry about discussing racial identity respectfully.

The main points of this section include:

• It’s important to acknowledge differences and similarities in experiences because of race.
• ‘Colourblindness’, and treating everyone equally, while having positive intent, erases racial identity.
• Finding common ground consists of the ability to both share and receive
• There is a lot of fear around race: the fear of saying the wrong thing, fear of offending someone, and on the other side of the conversation, a fear of not being listened to, of daring to be vulnerable and that being exploited, and a fear of nothing changing.
• It’s important to make intentions clear, both in how something is delivered and in how it is received. Be open to understanding how something was received, regardless of the intent it was said with.
• As a therapist, having the courage to acknowledge your own racial identity and be vulnerable to a client who might say ‘actually, I’m not sure you’re the right person to work with me’, is a huge step.
• Your client will let you know if they are comfortable working with you or not, create an environment where that can be discussed and considered.
• Allow open communication, and be open to learning.
• Recognise and become aware of the mundane ways everyday things are racialised, e.g. plasters.
• Where do we fit in this racialised world and what impact does that have on us? Appreciate that there are people who are positioned differently in that structure.

Confidentiality Laws for Therapists [starts at 54:52 mins]

It can be daunting to learn about the laws around counselling, but it’s just as important as learning the skills and theory behind our practice. In this section, Rory and Ken discuss confidentiality laws for therapists:

• This discussion is centred around current UK laws. If you are from outside of the UK, or listening to this podcast in the future, be sure to check your local legislation and look into any updates that may have taken place.
• Confidentiality isn’t absolute and cannot be guaranteed.
• Informed consent – a client should be aware of the basis of confidentiality and the exceptions.
• In UK law, the two examples of when confidentiality needs to be broken are Legally Obliged Disclosures and Discretionary Disclosures.
• A legally obliged disclosure means you have no choice in whether confidentiality is broken, it is required by law. Examples of this are:
  • Acts of terrorism – if a client expresses plans, or knowledge of plans, to commit an act of terrorism, this must be shared. You’re not allowed to inform the client that you will be breaking confidentiality.
  • Drug trafficking and money laundering.
  • Subpoena e.g. a judge asking for your notes.
• Discretionary disclosure is when the decision to break confidentiality is at the discretion of the counsellor. This involves things such as:
  • Child protection and safeguarding.
  • Protection of vulnerable adults.
  • Risk of suicide
  • Risk of serious harm to self or others.
• When you’re building your contract, think about including these exceptions to confidentiality so the client is aware.
• Last in this discussion on confidentiality laws for therapists is a reminder that before breaking confidentiality, speak to your practice manager or supervisor unless it is an emergency.

Links and Resources

• Sarah Henry
• BACP – Confidentiality and the law
• Counselling Skills Academy
• Advanced Certificate in Counselling Supervision
• Basic Counselling Skills: A Student Guide
• Counsellor CPD
• Counselling Study Resource
• Counselling Theory in Practice: A Student Guide
• Counselling Tutor Shop
• Facebook group
• Website
• Online and Telephone Counselling: A Practitioner’s Guide
• Online and Telephone Counselling Course