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Counseling/Psychology Confindentiality


Have you ever had to breach confidentiality with a client?  Can you tell me a little bit about this situation?
2.   Have you ever considered breaching confidentiality with a client, but decided against it? If so, can you tell me about this situation?

3.   Some people in the field of psychology feel that the rules for confidentiality are too strict while others think they are too lenient. What are your thoughts?

4.   What is one piece of real world advice you can give me about confidentiality?

5.    In your opinion, what is the most important thing I need to know about confidentiality?

Hi, Marie.  Is this for a course?  Just wanted to know.  Anyway, in answer to your questions:

1) No, I don't recall having to breach confidentiality with a client.  
2) Yes there have been occasions where I wondered whether the circumstances required a breach in confidentiality.  I think most therapists have worked with individuals who have expressed hopelessness and helplessness.  There have been clients that initially I was concerned that the situation warranted possible hospitalization.  I have been lucky, in most of those cases (and they have been rare in my 35 years in the filed),the client agreed to go to the hospital on their own.  If you are not aware of the Tarasoff decision, I suggest you take a look at:  
3)  I am a champion of individual rights to privacy and the need to preserve the client/therapist alliance.  I think the current rules of confidentiality are just right.  However, I do also think that there are many who make assumptions about what it means rather than finding out what it means.  For example, the current HIPPA laws were never meant to restrict the flow of information between providers, yet many act as if HIPPA does restrict provider to provider sharing of information, and therefore they refuse to communicate what may be crucial information.  The client is then possibly caught in the middle between two contradictory treatment plans.
4) Find out what it really means and don't listen to those who think they know what it means.
5) If you begin with respect for and acceptance of the client, confidentiality will probably fall into place.  Doesn't it all come back to the Golden Rule?  

Good luck.  Joel


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Joel Simon


General questions about counseling, psychotherapy and mental health.


Over 30 years as a therapist, clinical supervisor and solution-focused trainer. I've worked in a variety of settings including adolescent day treatment, inpatient psychiatric hospitals, community mental health clinics, and hospice. Further information is available on my website:

A founding member of the Solution Focused Brief Therapy Association, Academy of Certified Social Workers, Board Certified Diplomate in Clinical Social Work, Licensed Clinical Social Worker (LCSW) in New York State.

Co-authored "Solution-Focused Brief Practice With Long-Term Clients in Mental Health Services: I'm More Than My Label." Authored: "Solution-Focused Practice in End-of-Life and Grief Counseling" Several articles published in professional journals including 2 with Insoo Kim Berg. Further details are available at

Masters of Social Work (Yeshiva University 1978). 5 years training in Transactional Analysis, certified in Advanced Ericksonian Psychotherapy and Hypnosis with the New York Society (NYSEPH), Advanced training and advanced supervision seminar in solution-focused brief therapy with the co-developers of the approach, Insoo Kim Berg and Steve de Shazer

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