Psychologists (and other therapists, such as social workers and counselors) obviously take the trust of their patients very seriously. It is crucial for psychologists to do whatever they can to keep any information shared between themselves and their patients during therapy sessions confidential. However, psychologists must also protect the health and well-being of their patients, which means protecting them from hurting themselves, inflicting injury upon others, or being hurt by someone else.
According to the American Psychological Association's Code of Ethics, therapists should let their clients know that in the event the client discusses inflicting or being the victim of child abuse, inflicting or being the victim of elderly abuse, or posing a serious danger to themselves or to others, and the therapist believes these threats or allegations of violence to be valid, the therapist will have to report such discussions to law enforcement officials. Also, therapists may be asked to release confidential information shared by their clients during therapy to the judicial system if served with a court order, though they are bound to only reveal information that is absolutely mandated by the judge in the case and nothing more.
Though some people may think that anything goes in a therapy session, confessing or discussing plans for violent crimes cannot necessarily be kept confidential by therapists. As stated in their code of ethics, they have a duty to protect their clients from hurting themselves or others. However, it is also important to note that any misconceptions someone being treated might have about this should be cleared up at the beginning of therapy when the therapist discusses with the client the exceptions to their confidentiality privilege.
Interestingly, the APA's Code of Ethics does not apply to therapists employed by the U.S. military and their clients. Instead, soldiers and veterans are asked to sign a special waiver before therapy with a counselor or psychologist provided by the military. The waiver states that under certain circumstances, such as the discussion of military law violations, discussions between a soldier/veteran and his therapist may not remain confidential. Because of the suspicion that this waiver has generated among military personnel, many have admitted to not completely opening up to their military-appointed therapist, according to a New York Times article published in late 2009.
According to the APA, if a therapist is unsure of whether a discussion with a client should be reported to law enforcement or not, she should consult with other professionals in the mental health field or appeal to state or national mental health professional associations for advice on the matter. The code of conduct states that therapists are expected to reach out to others in the field whenever they are not clear about whether a client discussion goes beyond the protection of patient-therapist confidentiality.
- blue police lamp image by green308 from Fotolia.com