1 Feb 2008


As most of you know and for those that don't, I am currently training to become a counselor/therapist.

A big topic on this course is confidentiality.

Before I write about what I have learnt so far, I would like to ask you a few questions about this subject.

1.If you were going to counselling does the issue of confidentiality concern you?

2.Would it matter to you if this counselling was arranged through your place of work, would that sway your level of concern either way?

3. Do you wonder about the notes your counselor has or would make?

4. Do you know what would cause a counsellor/therapist to break confidentiality?

Thanks for reading this and any contribution you care to make. Any questions feel free to ask me and I will try to answer them.
Why do I want to know this? Well I will be going out and working with clients in the very near future and anything that will help me put someone at ease the first time they step through that door would be invaluable to me. If anyone has a had a horrible experience with a counselor/therapist I hope to learn something from that mistake and not through too many of my own.

I really appreciate you taking the time to answer my questions and I am working on the rest of the post :)

Some interesting things have come up in the comments.


  1. In response to your questions:
    1. Yes, confidentiality would be an absolute must.
    2. If my sessions were arranged through work I would not do it (not even the employee EAP which is designed to be completely anonymous)
    3. I would not be opposed to note taking as I would trust that the records would be securely maintained
    4. I suppose as long as I don't kill anyone or commit any felonies, my records would be safe???

    Hope this info helps. I wish you the best of luck with your studies. (Psychology has always fascinated me but that's probably 'cuz I am such a nut case myself).

    Post an update to the questions if you can. I'd be interested to see what the majority thinks.

  2. 1.On certain issues, most likely.

    2.Yes it would, because it would somehow get leaked out, it always does, and my work life is far from my home life. Even the CNA's I used to work with paid no mind to the confidentiality of their patients.

    3. The only thing I wonder is why we can't read them.

    4. If someone was in danger, or hurting themselves or others, or revealed innappropriate behavior, that needs an outside intervention. (?)

  3. Good questions.

    1. Yes, very much. Frankly, if there weren't things I needed to keep confidential, I don't think I would be seeing a counselor. I'd just talk to Brian or a friend.

    2. Yes. I have mental health coverage through my employer's health care plan but it limits my selection of counselors. So, instead I use a Flex Spending plan to pay for my own out of pre-tax money. (It's a US thing.)

    3. My doctor and I sit where I can see everything he writes so I don't really worry about it.

    4. I'm sure the legal status of the client-counselor relationship varies by region. I know that in my area, if you expressed an intent to harm yourself or others the counselor could break confidentiality to protect you or someone else. I assume that if you confessed to a crime there could be issues but I don't really know for sure.

  4. 1. Confidentiality is a major must! I think I would be hesitant about going to counselors or doctors if they didn't have to keep my business to themselves.
    2. Hmm, I dont know. It wouldn't matter since I know they can't tell what I express tothem
    3. lol, not really.
    4. If they thought I was capable of harming someone or myself. Or if I told them I commited a crime.

  5. 1. Yes
    2. I wouldn't do it.
    3. No
    4. No idea.

    All the best in what you are doing.

  6. 1. Confidentiality is an absolute must. If I thought what I discussed would be passed on, I would not be happy, and if I was arranging the counselling myself, I wouldn't go.

    2. Yes, it would concern me, and has. Last year my boss paid for four sessions with a life coach to help me sort myself out and see if a job he was offering was right for me. It turned out that the coach was a lady who he knew from his Tango classes and they got on quite well. Although they both said everything would be confidential, because of their friendship I always had doubts ... not I believe she would intentionally tell him anything, but you never know if something might slip out whilst they are socialising. And my boss does like to dig.

    3. I know that the notes are helpful for a counsellor as you think of responses to what the client is saying. If the counsellor is making notes openly and not trying to hide what they are writing, then no problem. If they tried to hide, then I would start wondering what they were writing and why I wasn't allowed to see it.

    4. My understanding is that a counsellor/therapist can break confidentiality if requested to by the police, or if they feel that the client is going to harm themselves or others.

    Oh, and something else you might want to think about. I was very aware of the life coach mimicking my movements, which I believe is supposed to help them create a rapport with the client, but I found it put me more on edge!

    It could have been that she was too obvious with it, as it was like she suddenly remembered it was something she had to do, but it just stood out as obvious mimickery which made me uncomfortable and distracted me from my thoughts, so subtlety is the key!

    Hope this helps, and good luck with your first counselling sessions!

  7. In answer to your questions:

    Yes, absolutely confidentiality would concern me.

    No, it wouldn't matter one way or the other to me.

    No I don't suppose I would really think about them making notes. But if confidential it shouldn't effect things anyway.

    No, I don't actually know the answer to that one - for Police matters??

    Btw, the nosy person in your cartoon looks like Princess Leia!

  8. 1: Confidentiality is very important.

    2: If it is arranged through work, confidnetiality is even MORE important.

    3: Note taking is fine, again, as long as confidentiality is maintained at all times.

    4: I believe that confidentiality is only breachable if I am a danger to myself or others.

    A. Caleb Hartley
    Vote for environmentastic!

  9. Good questions!

    1. Yes, it is the most important issue because trust has to be established and respected.

    2. I'm not sure, since I have no employer but I suppose it would depend on what sort of employer I had.

    3. I would wonder, yes, but not obsess over them unless I began to suspect that they were somehow not looking out for my best interest.

    4. Something illegal, I believe. :)

  10. Answers to your questions:

    1. Yes

    2. What do you mean, arranged by them? If they have a program/insurance that allows me mental health visits, that is different than them telling me that in order to keep my job, I have to see someone.

    3. Of course!

    4. My death. Or if I threaten to hurt myself or someone else. If they broke my confidence for any other reason, I would sue them until I had everything that they had and would ever have.

  11. I can't answer those questions like a normal person because I have issues :D

    Seriously, when I was a kid, I was sent to counselling because I my parents had split up and I was always sick so apparently that needed counselling. (Blah) Anyway, this counsellor (horrible woman - probably the least likeliest person in the world to get anyone to open up to them) told my mother every single thing I said in there. I rarely said anything at all to be honest but anything that did come out of my mouth went straight to her. How do I know? Because I got the crap kicked out of me every week over it. She was able to tell me word for word what went on in there.

    I wonder why I don't trust anyone lol

    So, yes confidentiality is important to me.

  12. I really appreciate everyone taking the time to answer these questions :)

    I am a bit overwhelmed this got any response at all, I thought you all came for the daft stuff :)

    I shall my time on the update post!


  13. 1) i'm sure there might be some issues on which i would insist upon confidentiality. however, up to this point, i have tried to waive confidentiality.
    2) if the counselling was arranged through work - hell yes, i would want confidentiality. the state in which i work, like most in the u.s., is an "at will" state and you can be fired for no reason at all. best not to give them any vague reason.
    3) i'm hopelessly curious, so yeah, i always wonder what the notes say.
    4) i have a good idea about what legal reasons there are for breaking confidentiality, yes. :)

  14. I would expect confidentiality.

    I would never go to a therapist arranged by my company.

    I assume they would have to keep notes but also assume they would be kept confidential except in the case of potential harm to self or others.

  15. Having worked under an assistant AG and currently being a Juvenile Dept. Director, confidentiality is perhaps the single biggest issue in behavioral science. State laws differ but what most folks don't understand is that HIPAA and other Federal Laws do not! They trump most State and Local Laws and should be your first stop, especially if drug and alcohol issues are concerned!

  16. you made that poor stick-person cry!
    oh, and if you're a head-shrink, why isn't your office decorated with shrunken heads?

  17. Working on the update post still!


    Thank you once again for the comments.

  18. 1. I drove to the other side of the city once a week for two years just so NO ONE in my community was likely to know (ok I was a bit over the top at the time) and didn't want my car to be spotted outside the place - so yes confidentiality is of the upmost.
    2. Probably wouldn't feel comfortable going thorough work arranged councelling - would always try to find my own if I ever felt I needed it again.
    3.My counselor had a great memory and didn't take notes. She wrote notes as soon as I left. Through the hospital setting (as a cardiac patient) I always ask to see my notes at regular intervals to ensure doctors continued to see me as human and consider how they write their notes.
    4.I would hope that someone would break the confidentiality if I was in a state of wanting to harm others or myself.

    Good luck on your studies and your future work. Really interesting and rewarding career I would think. Still considering child counsellings myself.

  19. I am a counsellor, holding an Australian diploma from AIPC. My thoughts will probably back up your own but here goes;

    1. Absolutely, it is inviolate, and even counsellors need counselling although we consider it to be more akin to debriefing.

    2. In the workplace it is even more important. How can the employee be expected to open up and address issues if they feel their words may escape to affect their job security? Only when an employee has gained enough personal strength from the counselling process should they be encouraged to speak about these within normal channels. However, counselling within the workplace begs the question how much should the counsellor disclose in their regular reporting to management on the success of the program. A counsellor who hints at dissatisfaction within the workforce will face pressure to disclose more and thus run the risk of alienating the very people they are working alongside in their professional capacity.

    3. My own notes were kept on a USB stick which was encrypted. I think counsellors in the workplace need to be quite firm with employers that the counselling session is private and will never appear in an employee's personnel record. Similarly, when a client requires that notes not be kept it is the counsellors duty to honour that request ahead of any rules that might be set by the employer. An interesting contrast to this however involved people who work with children or within the emergency services where counselling sessions are often part and parcel of their personnel record, and for good reason.

    4. As a counsellor, I will break confidentiality if I believe a serious crime is about to be committed. For example if a client talks of murdering another person, but I wouldn't break confidentiality if the client talks of petty theft such as shoplifting etc. That is more properly dealt with within the counselling session. Clients who have low morals and persistently break the law would of course concern me and I think I'd have to make a personal decision about continuing the sessions or suggesting the client finds another counsellor.

    As an aside, always keep your personal contact details private from clients, and if necessary, adopt an alter ago or pseudonym for online activities to protect your own confidentiality and privacy. Counselling can bring out the worst in some people who may come to think of the counsellor as their saviour or their enemy.