Secrets or No Secrets: Confidentiality in Couple Therapy

Abstract

This paper discusses secrecy in couple therapy from ethical and clinical perspectives. The author explains what secrets mean in terms of therapy and then moves to what controversies are raised by revealing or withholding secrets. The author reviews and evaluates current approaches to handling secrets in couple therapy regarding the use of informed consent. Additionally, the manner of implementation serves as another variable. In this paper, the author presents several scenarios which are widely used. The article ends with a call for further research on how the change of formats in therapy affects confidentiality.

Ethical and legal issues in family and couple therapy.

“…It is important not to assume that one family member holds decisionmaking authority or to collude with existing patterns of family functioning that may be part of the issues that brought them to treatment. When sharing the ground rules of couple or family therapy with clients, a widely accepted technique is to avoid keeping secrets belonging to one family member from the others and to state that all individual communications in between treatment sessions will be shared with the other family members at the next treatment session (e.g., Kuo, 2009;Margolin, 1982). The therapist will inform all individuals involved in the treatment of this rule and obtain their acceptance of it during the informed consent process.…”

Between confidentiality policy and an obligation to denounce – does polish law ignore or protect professional secrecy of psychologists?

“…Z punktu widzenia uregulowań prawnych tajemnica zawodowa psychologa w Polsce jawi się zatem jako dobrze zabezpieczona zasada wykonywania działalności psychologicznej. Z uwagi jednak na fakt, że profesjonalna dyskrecja i poufność nie mają charakteru absolutnego, w swojej pracy psycholog napotkać może na trudne do rozwiązania problemy związane z koniecznością podjęcia decyzji, czy przydać prymat tajemnicy zawodowej, czy też tajemnicę tę złamać, w trosce o inne wartości (Gavaghan, 2007;Koocher, 2003;Kuo, 2009;Younggren, Harris, 2008;Mappes, Robb, Engels, 1985).…”

Ethical Practice in Couple and Family Therapy: Negotiating Rocky Terrain

“…A more extreme version of could be to treat each family member as an individual client, in which case the material from separate calls, emails, or sessions is not disclosed (Knauss & Knauss, ); The degree of confidentiality will depend on the therapist's discretion. However, this increases the power imbalance in the work, an issue that has been well critiqued in the literature (Kuo, , pp. 352–3).…”