The confidential nature of counselling
Most people are aware of confidentiality in counselling. It means that you can speak freely during a counselling session and be confident that what has been said will not go beyond the counselling session – it is between you and your counsellor only. Confidentiality is a part of a counsellor’s duty of care to a client and it is taken very seriously.
But what lengths do counsellors go to, to ensure clients’ information is kept confidential? And are there circumstances where confidentiality needs to be broken?
When you first start having counselling, a counsellor will provide you with a contract, which explains the counselling process and forms an agreement between the counsellor and client. Confidentiality is part of this agreement. It is vital that a client is aware of the limitations of confidentiality when having counselling and these should always be outlined in the contract, so that it is transparent.
How is my information kept safe?
Counsellors will never talk about their work with anyone else. However, every counsellor has clinical supervision, where they speak to a highly experienced counsellor about their work with clients to ensure they are providing the best possible service. Clients’ names or other identifiable information is not shared during supervision. This information remains confidential.
Counsellors will usually keep basic handwritten or digital notes on counselling sessions they have with clients, which helps them to keep a record of the work being done in counselling. These notes are limited to what is necessary, which means there will not be substantial information written about you and your counselling work. Also, many counsellors will use pseudonyms in their notes, which means clients’ real names will not be noted, but a fictitious name will be used so that the information is not personally sensitive and is anonymised (pseudonyms are often used in supervision too). Counsellors may also keep other documentation relating to clients, such as the client/counsellor contract. Notes and other documentation are always kept securely. For example, all my client notes and contracts are stored electronically only, on an encrypted, password protected hard drive, which is kept in a lockable cabinet when not in use.
When could confidentiality be breached?
There are exceptions to the duty of confidentiality and a counsellor will always discuss with you any concerns they have that could lead to a breach of confidentiality. Probably the most commonly known exception is where a client is at risk of suicide or serious harm, or another person(s) is at risk of serious harm. A client’s safety is a counsellor’s priority and responding to a client who is suicidal or at risk of serious harm is one of the biggest challenges a counsellor will face. Risk, ethics and immediacy all have to be considered and decisions to breach confidentiality to try to keep a client or others safe are highly complex. Decisions are not made lightly, with the counsellor consulting with their clinical supervisor to balance a client’s wishes with safety.
A counsellor may breach confidentiality without informing the client in certain circumstances, such as in cases of terrorism, child protection situations or mental incapacity. Again, a need to breach confidentiality is never done lightly and a counsellor will do everything they can to discuss any breach with the client.
Other exceptions to the duty of confidentiality include: in order to assist the prevention or detection of a serious crime; legal obligations to disclose confidential information; court orders; and requirements to produce counselling records.
The reality of confidentiality in counselling
The above exceptions to the duty of confidentiality are not everyday occurrences, but they do arise. For most people who have counselling, there is rarely a need to breach confidentiality and if there is, it is often negotiated with the client so that the client understands and consents to their information being disclosed (with how much information and to who being agreed upon). A counsellor has your best interests at heart so if you are ever worried about breaches of confidentiality, just ask your counsellor. They will be more than happy to make things clear for you so you can get the most out of your sessions.
The main thing to understand is that a counsellor will keep your information safe and not share it with anyone, unless serious circumstances arise. A counsellor will want to build up a strong, trustworthy therapeutic relationship with you to support you through your problems. To enable this, they have to be transparent about confidentiality so that they can provide a professional and safe service to you.