An essential part of the therapeutic relationship is the confidence that is shared between therapist and client. That confidence and trust is essential in creating a safe space where therapy can take place and breakthroughs can be made.
However, there are occasions where you may be asked to break that confidentiality. This can pose a significant dilemma for a therapist juggling pressure from different people and agencies.
In recent years the UKCP complaints team has dealt with a number of queries and complaints about confidentiality. There are some themes and common scenarios that have emerged which we have discussed below providing some talking points and tips about how you might want to respond if you are faced with a similar situation.
If you work with a client who may have committed a criminal offence, or someone who has been the victim of an offence, you might be contacted by the police asking for copies of their client notes. This is a difficult situation to face as you may feel pressure to provide the information to help with a criminal investigation. You may want to consider the following when making your decision about sharing information:
It is important to remember that unless you receive a court order you can refuse to share your client’s notes if you feel it would be appropriate to do so.
If you suspect that this may be an issue you will face with one of your clients, you should discuss the potential limits of your confidentiality with them at the outset of therapy.
Subject Access requests or SARs give individuals the right to request a copy of their personal data. The comes from the General Data Protection Regulation (GDPR) – a piece of legislation designed to protect privacy and give people more rights over how their information is used.
The most common kind of SAR request you’re likely to receive is a client or former client asking for the information that you have about them.
It can sometimes be difficult to spot a SAR:
Someone saying I want everything you’ve got on me could be a subject access request.
You can’t charge a fee for responding unless you have large amounts of documents, which as a therapist is unlikely.
You may be dealing with clients who are receiving therapy at the request of a court or on the instruction of lawyers. In which case you may be asked to provide reports about their therapy. The two most common complaints that we receive about reports are:
If you are writing a report here are some useful tips you may wish to take into account:
With all of the above scenarios please remember that you should treat each request for information individually and exercise your professional judgement. Because the decision is a judgement call it’s important that you document your decision making process, including who you spoke to for advice, how you considered the request (what factors you took into consideration) and why you made your decision.