The boundaries of confidentiality: what and to whom can a psychologist tell about you?

The success of psychological counseling largely depends on how the therapeutic relationship develops between the client and the psychologist. The foundation of these relationships is trust. Thanks to him, the client shares with the psychologist what is important and dear to him, opens his experiences. The well-being and health of not only the client and his family, but also other people sometimes depend on how the specialist manages the information received during the consultation.

Let’s take an illustrative example. Victoria, 22 years old, seven of them, at the insistence of her mother, goes to psychologists. Symptoms — increased anxiety, attacks of fear, accompanied by suffocation. “I come to the session just to “chat”, about nothing. Why would I open my soul to psychologists? They then tell my mom everything! I didn’t know I had a right to privacy!» For seven years, Victoria suffered from attacks of acute anxiety, the girl’s family wasted money, the anxiety disorder became chronic — all because the psychologists who advised her violated the principle of confidentiality.

As a result of such actions, families can be destroyed, career and health damage can be done, the results of work are devalued, and the very idea of ​​psychological counseling. That is why confidentiality is present in all ethical codes of psychologists and psychotherapists.

The first code of ethics for psychologists

The first code of ethics for psychologists was developed by an authoritative organization — American Psychological Association, its first edition appeared in 1953. This was preceded by a five-year work of the commission on ethical standards, which dealt with many episodes of the behavior of psychologists from the point of view of ethics.

According to the code, psychologists must protect confidential information received from clients and discuss issues of protecting it at the beginning of a therapeutic relationship, and if circumstances change during counseling, revisit this issue. Confidential information is discussed only for scientific or professional purposes and only with persons related to it. Disclosure of information without the consent of the client is possible only in a number of cases prescribed in the code. The main points of such disclosure are related to the prevention of harm to the client and other people.

Among practicing psychologists in the United States, the ethical approach is also very popular. code of the american consultants association.

In the US, violation can be punished with a license

“According to the code of ethics of the American Association of Consultants, the publication of a case is possible only after the client has read the text and given written permission, or the details have been changed beyond recognition,” says Alena Prihidko, a family therapist. – The consultant should discuss with the client who, where and when will have access to confidential information. Also, the therapist must obtain the client’s permission to discuss his case with relatives. Taking the case to public space without permission threatens at least fine, maximum — revocation of a license. Psychotherapists in the United States value their licenses, because getting them is not easy: you must first complete a master’s degree, then study for an internship for 2 years, pass exams, undergo supervision, know the laws and codes of ethics. Therefore, it is difficult to imagine that they would violate the code of ethics and describe their clients without permission – for example, on social networks.”

And what about us?

In Russia, a law on psychological assistance has not yet been adopted, there is no code of ethics common to all psychologists and there are no large prestigious psychological associations that would be well known.

Russian Psychological Society (RPO) attempted to create a unified code of ethics for psychologists. It is published on the website of the society, and it is used by psychologists belonging to the RPO. However, while the RPO does not have great prestige among professionals, not all psychologists strive to become members of the society, most do not know anything about this organization.

The RPO code of ethics says little about confidentiality in counseling relationships: “Information obtained by a psychologist in the process of working with a client on the basis of a trusting relationship is not subject to intentional or accidental disclosure outside the agreed terms.” It is clear that the psychologist and the client must agree on the terms of disclosure of confidential information and then adhere to these agreements.

The ethical codes of psychologists, created at the level of Russian associations in the areas of psychotherapy, are also mandatory for use only by members of associations. At the same time, some associations do not have their own ethical codes, and many psychologists are not members of any associations.

It turns out that today in Russia among psychologists there is no common understanding of the principles of professional ethics. Often, professionals have a very superficial understanding of ethical principles., including little knowledge of the principle of confidentiality. Therefore, it is increasingly possible to see how popular psychologists describe sessions without obtaining the permission of clients, make lists of ridiculous client requests, and diagnose commentators in comments to posts.

What to do if your case becomes public

Let’s say that information about working with you was posted by a psychotherapist on the Internet — for example, in social networks. Find out what professional community your psychologist is in (if you didn’t find out before the first consultation).

If the psychologist is a member of a professional association, you will be able to prevent breaches of confidentiality with respect to other clients, as well as damage to the professional reputation of the specialist. Find a professional community site on the Internet. Look for the Code of Ethics section and read it carefully. File a complaint and contact the community ethics committee. If you can’t find the code and ethics committee contacts, please file a complaint directly with the community president.

Under pressure from colleagues, the psychologist will be forced to reconsider his attitude to professional ethics. Perhaps he will be expelled from society, but in any case he will not lose his practice, since the activities of psychologists in our country are not yet licensed.

How to prevent privacy violations

To prevent ethical violations, you need to take a number of actions at the stage of choosing a psychologist.

It is important that the counseling psychologist not only have a basic psychological education, but also professional retraining in one or more areas of psychotherapy. He also needs to undergo personal therapy and regular supervision with more experienced colleagues, be a member of professional communities.

When choosing an expert…

…ask for copies of the diploma on higher education and certificates of professional retraining.

…find out what professional community the psychologist is in and who his supervisor is. Visit the association’s website, look for your specialist among the members of the society. Read the association’s code of ethics.

… ask how your psychologist understands the principle of confidentiality. Ask specific questions: “Who other than you will have access to confidential information? Who will be able to know what we will talk about during counseling?” The appropriate response from a psychologist in this case would be: “Perhaps I would like to discuss your case with my supervisor. What do you think about it?»

These precautions will help you find a truly professional psychologist whom you can trust, and as a result of working with whom you will receive effective psychological help.