ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Limits of Confidentiality in Counseling and Therapy: When Counselors Must Disclose

Updated on September 1, 2014

Confidentiality: Essential but not Absolute

Confidentiality is one of the cornerstones of the counseling profession. Because private counselor-client interactions facilitate stronger trust and thus, when the therapist talks to her patient under the legal and ethical protection of confidentiality, the pair develop a better therapeutic relationship—one built on trust and nonjudgmental. Professional counselors are bound by both state laws and professional codes of ethics, however. These laws and ethical codes, such as those adopted by the American Counseling Association (ACA), do limit counselor confidentiality in several limited circumstances. These laws limit confidentiality only in extreme circumstances and do so for the sole purpose of protecting the client and general public.

Source

Abuse and Neglect of Children and Vulnerable Adults

If a minor client discloses in therapy that she is being abused or neglected, the counselor has a responsibility to breach confidentiality and contact appropriate agencies, such as child protective services or law enforcement. Generally, the counselor will first talk to the child’s parent or guardian and help involve them in the process, provided that the parent or caregiver is not the alleged perpetrator. In such instances, the counselor will work closely with child protect agencies and law enforcement to protect the child, but only share those facts necessary to the case to protect confidentiality to the greatest extent possible.


Likewise, if an adult client admits to child maltreatment or abuse or neglect of the elderly or another vulnerable person protected under the law, the counselor must also report these unlawful actions, even if the client does not consent. In such cases, the counselor may need to refer the client to another mental health professional for further counseling, since breaking confidentiality without client consent may mean an irreparable breakdown in the therapeutic relationship.

Source

Suicide Risk or Risk of Self-Harm

In many cases, a counselor must breach confidentiality if a client poses a risk of suicide or serious harm to herself. Prior to breaking confidentiality, the counselor will generally try to resolve the issue with the client, such as asking the client to sign a no-harm contract or working with the client and his family to create a safety plan. Such safety plans usually involve a family member monitoring the client continuously and scheduling more frequent sessions. If the client does not have a strong support system, the therapist may recommend that the client voluntarily check herself in for in-patient treatment and monitoring until she is stable and no longer has urges to harm herself. In these instances, the counselor will generally work closely with hospital staff to share information and work collaboratively on a treatment plan, but generally, this type of collaboration will require client consent.


If the client cannot promise that he will not harm himself or does not have the resources to maintain his safety, the therapist must break confidentiality and seek involuntarily admission for the client in a hospital or other secure mental health facility. This may involve sharing information about the patient’s diagnosis and personal history, particularly as it relates to self-injury or suicide threats and attempts.

Harm to Others

State laws vary on whether counselors must break confidentiality if a client says that she intends to harm another person. Although ethical guidelines generally allow the counselor to breach confidentiality in such situations, some state laws do not require it. Other jurisdictions require the counselor to notify the party at risk or law enforcement, as this may be grounds for involuntarily hospitalization in some areas. Ultimately, in some states, the counselor may have the final judgment call on whether to report possible harm to others, but most will err on the side of caution, privileging public safety over confidentiality.


The most common cases in which a counselor will break confidentiality is when the client comes to therapy with a defined plan to harm a specific individual and has the intent to carry out such a plan. Feelings such as “I would like to punch someone” or “Sometimes I wish my wife was dead” will rarely lead the client to break confidentiality and contact law enforcement.

Court Orders for Counseling Records

Although laws generally respect the confidential nature of counseling, if a judge orders a counselor to testify in court, she may be required to do so or face criminal charges for contempt of court. In such instances, the counselor is only required to disclose as little as necessary to satisfy the requirements of the court. In other words, if the court case involves child custody, the counselor will not needs to discuss unrelated matters such as the client’s frustrations about his job and career path.


In instances where a client is court-ordered to comply with therapy, the counselor must generally disclose the patient’s therapeutic progress to the court or his probation officer. However, the client will be informed of this beforehand and according to the ACA Code of Ethics, has the option of declining services. If the client does choose to participate in services, the counselor will outline the limits of confidentiality before beginning therapy.

Minor Children and Adolescents

Persons under age 18 typically have limited rights to confidentiality in the counseling process. Although the counselor usually meets with the child or teen in private and will not share all of the details of the counseling session, parents or guardians have a right to know their child’s diagnosis and have updates on his therapeutic progress. Likewise, parents and legal guardians generally have the right to access their child’s confidential therapeutic records. Parents may also consent to release the child’s confidential records to third parties, such as schools. However, child therapists often provide parents and third parties with generalized information on the child’s progress toward his treatment goals. Counselors will not release every detail of what the child said during the counseling session. This, as in other cases, protects the therapeutic relationship and promotes and honest exchange of information.

Is confidentiality the most important factor for clients?

What is your greatest concern when selecting a counselor?

See results

How well do you know the limits of confidentiality in counseling?

view quiz statistics

Comments

    0 of 8192 characters used
    Post Comment

    No comments yet.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)