Trust is an essential factor in the helping process. Without it, clients will not feel free to share their most intimate thoughts and feelings. They will not be completely honest or forthcoming in conversations which will hinder the professional’s ability to truly help the client. For this reason, the promise of confidentiality becomes critical to the process. It is the “secret keeping duty” all helping professionals have an ethical obligation to observe (Younggren & Harris, p.589). It protects the client’s right to privacy and fosters an atmosphere in which one feels safe, facilitating trust and allowing one to feel comfortable enough to share their inner most feelings and thoughts. Most helping professionals agree that confidentiality is key to the healing process and it is their primary obligation to protect it (Fisher, p.1). It is a standard included in the American Psychological Associations Ethical Principles and Code of Conduct (2002) and it is regulated by law in many states. The importance of preserving confidentiality was highlighted in an article published in the Lancet in February of 2006 titled, “Pressures on Confidentiality”. Several reasons were given on why its preservation was necessary including protection of individual privacy and retention of personal autonomy. Additionally, maintaining confidentiality implies a degree of secret keeping, instilling a feeling of trustworthiness and faith in the doctor-client relationship (Rogers, p. 553). Furthermore, the importance of confidentiality was highlighted in a land mark decision by the Supreme Court in Jaffee v. Redmond (1996) which states:
Effective psychotherapy, by contrast, depends upon an atmosphere of confidence and trust in which the patient is willing to make a frank and complete disclosure of facts, emotions, memories and fears. Because of the sensitive nature of the problems for which individuals consult psychotherapists, disclosure of confidential communications made during counseling sessions may cause embarrassment or disgrace. For this reason the mere possibility of disclosure may impede development of the confidential relationship necessary for successful treatment. (Younggren & Harris, p. 590)
Clearly, confidentiality is essential to the healing process. However, though it may appear to be a relatively easy concept, its application in the therapeutic atmosphere has proven to be quite complex (Younggren & Harris, p. 589). One issue that causes confusion for many professionals pertains to the differences between confidentiality and legal privilege. Quite often, ethical obligations overlap with the legal requirements. Frequently, the practitioner is not well informed about these particular limits on confidentiality and this lack of knowledge can place both the client and the helping professional at risk (Younggren & Harris, p.590, 598).
Exceptions to confidentiality arise in a variety of ways. One way includes when confidentiality conflicts with...