Anonymous asked realsocialskills:Not precisely a boundary violation, but boundary related — it’s always helped me when therapists are willing to outline exactly what their legal responsibilities are. For example: when they are required to contact medical personnel. This makes it easier to discuss certain topics without worrying about medical interference.That makes a lot of sense.I don’t know how much what they say matches what they do, though. Do you know?
well, i’ve seen psychologists on and off since I was a kid and was even studying to be one so i can say with absolute certainty there is a very strict code of ethics psychs are expected to abide by. I can also say with absolute certainty that this high standard in practice virtually never happens in reality and I haven’t met a single person who *hasn’t* had a psychologist breach confidentiality with such severity that if it was reported they could lose their license to practice.
I don’t know where the real lines are. But I do know they’re not where everyone says they are.
I’ve never had a therapist break confidentiality, but I know several people who have, and their therapists are still practicing. The existence of widely cited rules does not, in itself, cause those rules to be followed. Rules aren’t magic.
And then there’s the thing where, it’s not breaking confidentiality exactly, but they make helping you contingent on you agreeing to let them discuss things with someone else. (eg: a disability support professional, your medical doctor, a parent, etc).
This is exactly why I am too scared to continue going to a therapist:
The existence of widely cited rules does not, in itself, cause those rules to be followed. Rules aren’t magic.
while I’ve never experienced this, I know just how common it is. from reading the above comments, my suggestion to anyone concerned about the confidentiality of their therapy would be to discuss the exact boundaries your therapist has. and if you want something binding (and have the means,) consider drawing up a contract which details exactly how your therapist should treat your information. some things to consider:
- what information your therapist is and is not allowed to share with others
- with whom your therapist may share this information
- consulting professionals? your parents? your other doctors?
- under what circumstances can they share your information, if any?
- is your therapist required to retain your anonymity if/when sharing your info with consulting professionals?
- is your therapist allowed to discuss you, your treatment, or your mental state in any publication? (books, scholarly journals, scientific journals, etc.)
- if they are allowed to use your information in publication, must they retain your anonymity through omission or changes in identifying information?
also, do some research on the laws and code of ethics for therapists/psychologists/psychiatrists to see if there are any other concerns you might have.
It seems like the kind of thing that could really easily make someone feel safer without actually changing anything or making it any clearer in which cases someone would violate confidentiality.
But I can imagine that it might work sometimes, too. I personally haven’t seen it, but that doesn’t mean it’s never worked.
Have any of y'all used this effectively, or know of it being used effectively?