Military clinical psychologists may find themselves caught between apparently contradictory requirements of the Department of Defense (DOD) and the American Psychological Association (APA). Two cases involving confidentiality are presented for illustration: Case 1-an active-duty Army officer was referred for psychological consultation after expressing suicidal ideation at the work site; Case 2-a self-referred long-term psychotherapy patient reported having been sexually assaulted by a DOD physician. This article discusses and analyzes these cases, raises issues and dilemmas presented by the demands of DOD and APA, and presents recommendations.Confidentiality of communication between patients and Department of Defense (DOD) health care providers is protected by agency directives (e.g., DOD, 1975) and Army, Navy, and Air Force regulations (e.g., Department of the Army [DA], 1987). Although federal statutes, DOD directives, and service regulations are written so as to respect the privacy of individuals, they also mandate access to confidential material by federal employees with a "need for the record in the performance of their duties" (DA, 1982(DA, ,1985a DOD, 1975). Consumer consent is not required for such a release.Military psychologists must follow DOD directives while adhering to the standards, principles, and guidelines of the American Psychological Association (APA). Often these psychologists have little opportunity to influence the rules and regulations of the DOD. As a consequence, practices regarding patient confidentiality that are acceptable as defined by military regulations sometimes conflict with standards of the APA. This article presents two such cases (with disguised identifying information) in an attempt to sensitize military clinical-counseling psy-UMOTHY B. JEFFREY received his PhD from the United States International University in 1977. He is Director of
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