Psychologists' perceptions of legal and ethical requirements for breaching confidentiality

Abstract

This paper outlines the legal and ethical du ties of psychologists in relation to preserving as well as breaching confidentiali ty in therapeutic relationships. It an alyses the resul ts of a questi onnaire examining psychologists' percep tions of the legal and ethical constraints on confi d entiality and their likel ihood of breaching confide ntiali ty in di ffe rent situations. The vast majority of participants indicated that the law permits them to d isclose confidential information an d that there is an ethical duty to disclose information to a third party when the patient is perceived to be dangerous. The results suggest that there is some uncertainty as to when confidentiali ty should be breached in practi ce and it is argued that the law is overly co mplex in thi area an d that guidelines are need ed to ass ist psychologists in their clini cal practice.

The Elephant in the Room: Dealing with an Unprosecuted Criminal Disclosure in a Therapeutic Setting

“…Scenario one was the most reported circumstance as it presented an explicit and more immediate risk to a third party. Factors such as the severity of the crime [34] and an immediate risk to a third party [29] have been found to increase reporting behavior.…”

“…Limited international research has explored the implications of therapist's ethical and legal obligations relating to the disclosure of unprosecuted criminal offences. In Australia, a research team highlighted therapists' confusion regarding their legal duty to report clients they believe to be in danger, and also suggested that therapists are more comfortable with their ethical obligations in contrast to their legal obligations [29]. Similarly, in the United States of America, Pabian et al [24] found over seventy-six per cent of respondents were misinformed about their state laws, although respondents felt confident in the knowledge of their duty to warn obligations.…”

Adolescents, Risk Behaviour and Confidentiality: When Would Australian Psychologists Breach Confidentiality to Disclose Information to Parents?

“…McMahon and Knowles () argue that although obligations of confidentiality are well known, they are complicated by a range of factors such as legal protections, ethical beliefs, institutional practices, and professional codes. The complexities associated with obligations of confidentiality are therefore numerous, and it is perhaps not surprising that previous research indicates psychologists are confused about when to breach confidentiality (Kampf et al., ).…”

“…However, psychologists have also described confidentiality as the cause of their most serious ethical dilemmas (Haas, Malouf, & Mayerson, ; Pope & Vetter, ). Although fundamental, confidentiality between therapists and clients can never be absolute, and it is this stipulation that creates scope for ethical complexity and confusion (Jain & Roberts, ; Kampf, McSherry, Thomas, & Abrahams, ). Determining appropriate limits to confidentiality, and making decisions about which cases require a breach of confidentiality, can be highly challenging and ethically fraught.…”

A Matter of Trust: Confidentiality in Therapeutic Relationships during Psychological and Medical Treatment in Children and Adolescents with Mental Disorders

“…The maintenance of confidentiality and its limits has been posing ethical dilemmas to psychologists, psychotherapists, and related health professionals for decades (see [ 8 , 9 , 10 ]). Those providing medical care to children and adolescents are faced with challenges that differ from those encountered in adult care [ 11 , 12 ].…”