Addressing Secrets in Couples Counseling: An Alternative Approach to Informed Consent

Abstract

This article presents an alternative approach to informed consent that addresses unique concerns regarding confidentiality in marital and relationship counseling. Professional ethics codes rarely provide therapists with specific guidance on how to respond to clients who wish to keep secrets from their spouse or partner. Moreover, scholars writing about confidentiality frequently offer contradictory advice on how to ethically treat those couples presenting with secrets. This article suggests that regardless of one's viewpoint on the issue of secret keeping in counseling, therapists best serve couples by advising them at the onset of treatment of the counselor's policies regarding confidential communication. In addition to discussing issues regarding privacy and confidentiality in couples counseling, this article presents one example of an informed consent document designed to address this important concern.

Treating Infidelity: Considering Narratives of Attachment

“…Issues pertaining to confidentiality are further complicated in situations that involve or are likely to involve a client's spouse, especially in the event that an undisclosed affair has occurred or is occurring. This is because a counselor in such a case is placed in a conflicted situation, at once obligated to protect the confidentiality of one client by withholding information relevant to the well-being of another (Bass & Quimby, 2006). For example, if during an individual session a spouse discloses the presence of an affair but states that he or she is not yet ready to inform his or her partner, then the counselor is placed in a situation in which he or she must choose between withholding the information from the naïve spouse (a potential breach of the moral obligation of fidelity) or disclosing the secret (a breach of the affair spouse's right to control what information is shared about him or her as well as the counselor's ethical obligation to maintain confidentiality).…”

Secrets or No Secrets: Confidentiality in Couple Therapy

“…Gottlieb, Cooper, Margolin, Vangelisti, Caughlin, and Timmerman suggest establishing clear policies concerning confidential communication in dealing with secrets in the systems-oriented therapy setting (Gottlieb & Cooper, 1993; as cited in Bass & Quimby, 2006). Karpel (as cited in Weeks, Odell, & Methven, 2005), Gottlieb, and Cooper (1993) further propose several approaches regarding making the policy of secrets in informed consent.…”

“…3. If the individual refuses to confide to the partner, the therapist will share the information and may refer the couple to other alternatives (Bass & Quimby, 2006). 4.…”

“…It is obvious that this action fails to live up to beneficence in terms of aspirational ethics: Therapists are dedicated to promoting the best interests of the clients (as cited in Corey, 2007). Additionally, some secrets are related to illegal activities, such as adultery in some states (Bass & Quimby, 2006). Disclosing them may trap the unfaithful partner into unwanted legal disputes.…”

An Invitation to Between-Session Change: The Use of Therapeutic Letters in Couples and Family Counseling

“…Without some assurances of the maintenance of confidentiality it is unlikely that many clients would be willing or able to engage in counseling. It is worth noting here that this issue is usually further complicated in couple and family counseling, a situation in which family members may disclose information to the counselor in individual sessions that they do not want shared with other family members (see Bass & Quimby, 2006, for a full discussion of this issue).…”