Clinical Writing About Clients: Seeking Consent and Negotiating the Impact on Clients and Their Treatments

Abstract

The author discusses her experiences seeking consent from 16 clients to use clinical material for publication. Sharing case examples from her practice, she elucidates her process with clients and focuses on the beneficial and detrimental effects on the therapeutic relationship. Seeking consent raises issues of confidentiality and stimulates wide‐ranging, layered, and linked emotions and meanings for clients, including feelings of closeness, envy, and shame. If the counselor actively employs this process as a therapeutic tool with openness to unexpected meanings, it may advance the therapeutic conversation and developmental possibilities. When there is a negative effect on the client or the process, counselor's shame and guilt may be stimulated and consultation is recommended.

Obtaining clinical writing informed consent versus using client disguise and recommendations for practice.

“…A request to use a client's experiences for purposes other than direct service may result in the client feeling obligated to give permission, which may be in direct conflict with various ethical principles and standards (Bridges, 2010). Principle B, "Fidelity and Responsibility" of the APA (2002) Ethics Code, discusses the importance of psychologists establishing trust with those with whom they work.…”

Writing About Clients: Ethical Considerations and Options

“…It is not surprising that this shift has influenced prevailing attitudes about the ethics of clinical case material. Accordingly, counselors and therapists are now more likely to seek a client's consent, disguise case material, or develop composite cases than in the past (Bridges, 2007). However, at the same time, a noticeable shift in clinician advocacy of the rights of others in the community over the rights of the client has also been observed (Donner, VandeCreek, Gonsiorek, & Fisher, 2008).…”

Commentary: Critical Reflections on the Ethical and Professional Considerations in Writing About Clients

“…Shifting from the general to the specific, Kantrowitz (2010) narrowed her discussion to psychoanalytic case studies, aptly reviewing the advantages of and the hazards of disguising identities in this therapeutic context. Similarly, Bridges (2010) Seattle, WA 98119-1907 (e-mail: csink@spu.edu).…”

“…Shifting from the general to the specific, Kantrowitz (2010) narrowed her discussion to psychoanalytic case studies, aptly reviewing the advantages of and the hazards of disguising identities in this therapeutic context. Similarly, Bridges (2010) centered in on the challenges of seeking consent from psychotherapy clients to use their clinical stories in professional publications. The authors, to varying degrees of success, provided helpful ethical guidelines relevant to many counseling and mental health settings.…”