Be it in a medical setting or everyday conversation, confidentiality is something we each expect to a certain extent. However, not many people actually give any thought as to what confidentiality means to them, and why it is valuable. In this post we will discuss why confidentiality is important, how to practice it healthily and also explore some of the core reasons we may have to breach this. Before we discuss these topics though, we must answer the most fundamental question: What is Confidentiality?
What is Confidentiality?
If you search online or have a look in the dictionary, (if you still have one of them laying around dusty somewhere), you’ll most likely see a description for confidentiality along the lines of ‘creating a private or secret environment’. Whilst that is pretty clear, it’s always nice to break things down into layman’s terms.
Confidentiality is not only about privacy and secrecy, but about creating a situation of trust between two or more people. In counselling and therapy for example, whether you are the client or the professional, confidentiality is absolutely essential to create the desired atmosphere. I recently started my own training to become a counsellor and the first thing we covered in the training was the importance of confidentiality and boundaries during sessions. This brings us to our next question:
Why is Confidentiality important?
In a medical setting, be it for a physical or mental ailment, it is essential to create a safe and secure environment for many reasons. Firstly, if you are dealing with a professional then there has to be an element of trust that they won’t share any of your private information to strangers without your consent.
In therapy and counselling this is so important simply due to the types of conversations a client may have with their counsellor. If sensitive topics arise, be they about intense trauma or sexual issues, it can be extremely difficult to actually have the client fully open up in the first place. Ensuring that confidentiality is acknowledged will allow this process to become much more comfortable and allow better and clearer access to those areas, which can be needed as part of the healing.
It is worth noting that this practice doesn’t just exist in a professional medical setting. Confidentiality is a perfectly normal concept that each of us apply to our day to day lives without much notice. For example, if a close friend or colleague comes to us with some harmless but private information and then asks us not to share it, they are invoking confidentiality and privacy. Obviously it is our choice as to whether or not we honour this but not doing so can lead to very negative outcomes in some cases.
Having someone you can trust enough to be fully open with is something we all hope to find, be it in a family member, close friend or partner. It is an important part of life and your own boundaries as to what level of trust you place on others, but usually any level of confidentiality creates a stronger and more empathetic bond. However, breaking this confidentiality doesn’t always mean you’re in the wrong, and sometimes, is actually the correct step to take.
Reasons for Breaching Confidentiality.
There are a few different reasons someone may breach your confidentiality, and all of them are justifiable due to the extreme circumstances that warrant them. That being said, due to each situation being unique, it is your own decision as to whether or not you think it is necessary to disclose private thoughts or feelings. These reasons are as follows:
of the core examples of when confidentiality is broken, is whenever a person, be it a friend or a client, discloses that they’re severely harming themselves or contemplating suicide. It may be a difficult decision to make due to the issues that arise with trust, but disclosing this information to a professional or the authorities can end up saving a life. Opening up about this information can also lead the person to the help they need in dealing with their underlying causes or issues.
- Harm to Others
Similarly, as above, another time that it is deemed ‘ethically acceptable’ to breach confidentiality is when someone confesses thoughts or plans of harming another person. I put ethically acceptable in inverted commas here because it’s hard to say what is ethically acceptable unless you know the ins and outs of the entire situation. If you are a professional dealing with a client who has confessed these thoughts or plans, then approaching the conversation honestly and carefully can be enough to make you feel like their thoughts have changed, but if you have any serious concerns it is recommended that you contact the authorities or professional help for the individual.
- Ongoing Abuse
With therapists and counsellors in particular, there is a requirement to report any confirmation or disclosure of abuse, be it domestic or the mistreatment and neglect of a dependent such as children, the disabled or the elderly. With this one in particular it is worth noting that this refers to ongoing abuse or neglect. In therapy, childhood abuse or trauma can be a common source of mental health problems, however if this isn’t happening presently or there are no others in threat of the same abuse or neglect, it isn’t usually disclosed by your therapist.
This one may seem like a given after reading the others above, but it was actually one that I didn’t fully realise until my own counsellor told me about it. If someone you know plans to or has committed a serious crime, it can lead to confidentiality being breached and the authorities being contacted. This has become even more common due to the rise in terrorism in the 21st century, meaning professionals have to be on the lookout for any suggestions or confessions of a client being involved in these acts.
- Legal Requirement
This one is exactly what it says on the tin. In some situations, people may be asked to disclose private information in a legal setting such as court. If the confidential information is pertinent to the case for instance, then disclosing it may be the deciding factor in the verdict. With trained counsellors it can also be common to disclose some information if a client’s mental health becomes relevant in a trial.
With all of these exceptions to confidentiality, it still doesn’t make it any less important in our lives, yet many of us still aren’t exactly sure on how to practice this in a safe and positive way, which brings us to our final thoughts before we end the post:
How to Practice Confidentiality Well?
First and most importantly: Communication. In a personal setting, it helps to be clear on what you would find acceptable to keep private and where your boundaries and limits are. This is were communication comes into the mix. If a friend tells you a secret that you’re not comfortable keeping, it helps to be honest with them regarding it, or better yet, setting your boundaries in the first instance so people know how much they should share.
In a therapeutic setting, it comes down to being professional and bringing this concept up right away. If you’re a therapist or counsellor, discuss with your clients what confidentiality is and how it works within the sessions. Explain to them when it can be breached without their approval. Ask them whether or not they are comfortable with this and answer any queries they may have around the topic. If you’re seeking therapy, be sure to make use of this opportunity and ask any questions you may have around the concept.
Another way you can practice confidentiality in a professional and healthy way is to educate yourself. Read over the laws around professional confidentiality and their limitations and practice them when you can. This obviously would apply more to those in relevant positions than keeping secrets for a friend, but can be useful none the less.
Practice discretion. Whilst it is healthy to be clear on your limitations regarding confidentiality, it can sometimes be necessary to seek advice from those with more experience or expertise than you have. If this is the case, you may be able to get this help without disclosing clearly identifiable information such as names, addresses etc. If you are in a counselling/psychotherapy position, just be sure to get the consent of your client beforehand if this issue isn’t as severe as the ones listed further above.
Finally, though equally as important, you should always keep private and confidential documents stored away safely. This also applies to online documents these days more than ever. Using secure digital back-ups can prevent this information from being leaked or accessed maliciously.
To conclude this post, I just want to make clear this discussion is not supposed to make you a professional in confidentiality, but is more of an overview of the concepts and how to practice them a little more safely. If you find yourself struggling with a piece of serious and potentially dangerous information as listed above, there are professionals who can help you, be it the authorities or many other helplines.
If you enjoyed this article, be sure to check out my blog for more mental health awareness and training posts. Let me know below if there is anything I forgot to mention or any other tips you think are worth noting!
If you’re experiencing any of the feelings described in this post, or know somebody who is, then there are many things you can do to help. Talking to somebody about how you or they are feeling can be very beneficial. If you’re not sure what to do but need urgent help, there are many emergency hotlines that provide support and encouragement such as Mind.org and Samaritans.org. You’re not alone in feeling this way, others are there to help.