The Problem of Therapeutic Privacy

Mariner, Allen S.

doi:10.1080/00332747.1967.11023495

Cited by 5 publications

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“…The clinical literature suggests that there is considerable variation among mental health professionals as to their attitudes and behaviors in situations in which confidentiality becomes an issue. Some advocate absolute confidentiality, even when the client is threatening harm to others (Goldstein & Katz, 1962; Kubie, 1950; Mariner, 1967; Siegel, 1979; Uchill, 1978). Others believe that confidentiality should be relative, allowing for exceptions to be made in emergency situations (e.g., Appelbaum, 1978; Karasu, 1980).…”

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Clinical management of confidentiality: A survey of psychologists in seven states.

Baird¹,

Rupert²

1987

Professional Psychology: Research and Practice

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Psychologist'! in seven states were surveyed regarding their management of confidentiality in general and in specific situations that challenge confidentiality. The 188 respondents indicated a high regard for the confidentiality of the psychotherapy relationship and a reluctance to disclose information without the client's consent. In response to only two situations, consulting a colleague and dealing with a potentially dangerous client, were psychologists willing to consider disclosure of information without consent. There was considerable variability in how respondents inform their clients about confidentiality, with hall' either alluding to or mentioning specific limits of confidentiality from the outset of the psychotherapy relationship and the other half either saying nothing at all or indicating that everything is confidential. Previous experience with breaches of confidentiality appeared to influence psychologists' general approach to informing about confidentiality. In a situation relating to potential dangerousness, theoretical orientation and potential target of harm emerged as important factors in determining information given about confidentiality.Although the concept of confidentiality is central to the provision of psychological services, the client's right to privacy increasingly has been called into question as various forces in society seek access to and disclosure of confidential information. Of particular concern are pressures exerted by the legal system to reveal information in order to protect society from potentially harmful people. In this regard, probably no legal event has raised more questions about the confidentiality of the psychotherapy relationship than the Tarasoffcax in California (Tarosoff v. Board of Regents of the University of California, 1974). This case, in which a therapist was held liable for a murder committed by a former client, poses a challenge to the confidentiality of the psychotherapy relationship by establishing a legal precedent for requiring a therapist to break confidentiality if he or she assesses danger to another person.The profession of psychology does not have clear guidelines for dealing with the increasing challenges to confidentiality. The Ethical Principles of Psychologists (American Psychological Association, 198 la) states that psychologists should reveal KEITH A. BAIRD received his doctorate from Loyola University of Chicago in 1985. He is currently a staff psychologist at the Illinois Masonic Medical Center in Chicago and in private practice in La-Grange, Illinois. He provides training to interns in professional issues and ethics.

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confidence: 99%

Clinical management of confidentiality: A survey of psychologists in seven states.

Baird¹,

Rupert²

1987

Professional Psychology: Research and Practice

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“…A number of scholars have decried the erosion of confidentiality in mental health relationships (Epstein et al, 1977; Rubanowitz, 1987; Siegel, 1979). Written more than 30 years ago, Mariner's (1967) analysis and exhortation to psychotherapists remain valid today. In particular, Mariner argued that mental health professionals must realize that uncritical cooperation with blanket requests to release mental health records indicates, at one extreme, approval of such transactions, and on the other, unwillingness to meaningfully question them.…”

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confidence: 99%