Ethics Final draft

1 Confidentiality in Psychotherapy: An Analysis of Ethical Concerns Crystal Costa Liberty University GRST501 Dawn Strickland February 16, 2024 2 Confidentiality in Psychotherapy: An Analysis of Ethical Concerns Introduction As a way to protect clients’ privacy and build trust in the therapeutic relationship, confidentiality is an essential ethical concept in psychotherapy. It means not sharing any client data without their permission. It’s bad for clients, therapists, and therapy places when confidentiality rules are broken, even if they are not done intentionally. The receptionist at a counseling center told her husband that a customer was there, which may have been a breach of confidentiality. This paper will look at that case. For the sake of argument, it will say that the violation may seem small, but it could still hurt the client and the coaching firm. The receptionist’s well-intentioned but unauthorized disclosure of a client’s counseling attendance to her abusive husband violates confidentiality and risks psychological, legal, ethical, and reputational harm to the vulnerable client and the counseling institution. The Case In this case, the wife had been going to a nearby treatment center without telling her husband that she would discuss problems in their marriage. The husband called the therapy center one day and asked to speak to his wife. But he did not know she was there. Someone picked up the phone and said that the wife wasn’t there but that they would leave a message to let her know that her husband had called. The front desk worker told the wife’s teacher that her husband had called to find her when she left class. She was furious right away about this. The wife made sure her husband didn’t know she was going to therapy since they were arguing about who would get the kids when they split up. She was afraid that if her husband found out she was seeing a therapist, he would try to use the fact that she had bipolar disorder against her in the divorce process to get an advantage and make her look bad. The front desk worker probably thought the husband already 3 knew that his wife was going to therapy for some reason. The clerk told the husband that his wife was at the therapy center by mistake when she told the wife that her husband had called. The only thing that was said about her was that she was at the facility. Her husband was distraught that he could now tell the divorce court that she was in therapy. Even though the clerk only meant well when she talked to the husband, the wife thinks it could hurt her chances of getting custody because it could be seen as a breach of privacy. So, this small, unintentional invasion of privacy by the front desk worker could significantly affect the person’s mental health, reputation, and the law. Potential Harm to the Client One of the scariest things that could happen because of this breach of secrecy is that the vulnerable client could now be hurt mentally or physically. According to Avasthi et al. (2022), breaking client confidence often puts the client at significant risk for harm in many areas of their health. It is true even if only a tiny amount of information is shared. For example, in this case, abusive partners like the controlling and volatile husband could easily use and abuse the seemingly simple fact that the client went to therapy (Avasthi et al., 2022). Just proving that she went to the therapy center gives the husband evidence to use in court to say that his wife is mentally unstable, which could have a direct effect on the decision about who gets to keep the kids. If her angry husband knew she was going to therapy, he could use that information to get rid of her child custody (Avasthi et al., 2022). Since he now knows that his wife is actively looking for outside help, he may also step up his psychological abuse and threats. The fact that her husband knows she is going to therapy may make him even more angry and unstable. By telling the abusive husband that his wife was going to counseling meetings against her will, the counseling center may have put her mental health, physical safety, and parental rights at risk. The receptionist’s unauthorized revelation caused the client and wife a lot of fear, anxiety, a sense of not being in 4 control, and a loss of personal agency. It is severe emotional and psychological harm that could happen in court or in an abusive home. Legal and Ethical Implications The counseling center’s breach of trust hurts the client directly and has significant legal and moral consequences for the counseling center itself. Wheeler and Bertram (2019) discuss how breaking established ethics rules about client privacy and confidentiality, like what happened here, can put mental health professionals and their institutions at greater risk of being sued and create legal loopholes (Wheeler & Bertram, 2019). The center broke the American Counseling Association (ACA) Code of Ethics by sharing information about a client without their permission. The ACA Code of Ethics is very strict about protecting client privacy. Because of this breach of ethics, the upset client has a good reason to sue the center for damages caused by their violation of privacy standards. Even though going to court would be the worst thing that could happen, it is still an option that the center needs to consider and assess (Wheeler & Bertram, 2019). However, even if there is no case, the center’s disclosure is still against professional ethics, which says strict privacy rules must always be followed. Not following these rules automatically hurts the counseling institution’s morals, image, and public trust, even if the case goes to court. Impact on the Counseling Institution One crucial thing that Ewuoso (2021) points out is that breaking client privacy can hurt an institution’s image and people’s trust in it. If you break a client’s confidentiality and reveal their weaknesses through unauthorized statements, other people may be afraid to go to therapy for fear of hurting their privacy (Ewuoso, 2021). People already getting treatment at the center may stop before their sessions even start if they hear about the breach because they will have much less faith in the institution’s privacy protections. Losing current and potential customers cuts into income 5 directly, but it also has indirect costs related to damage to the business’s image. Clients whose privacy has been violated are understandably angry and suspicious, and they can quickly spread wrong opinions about the center through word of mouth (Ewuoso, 2021). Bad reviews on online review sites make these complaints even stronger. This damage to the institution’s image makes people less likely to trust it, making it harder to hire new people or grow. It is hard to put a dollar amount on the indirect costs of losing trust and respect, but they may be higher than any direct legal damages to the center. But in either case, flaws in an institution’s privacy protections that hurt its image can seriously hurt its results and ability to stay open. Counterarguments and Perspectives Some other points of view downplay how bad the possible outcomes of this particular breach of secrecy could be. As Appel (2022) points out, the exact effects of any accidental disclosure rely on what kind of information was made public. In this case, the husband only knew that his wife was attending counseling sessions at the counseling center. He didn’t know anything about her treatment or what she talked about in those sessions (Appel, 2022). One could make the case that just knowing she’s at the center is much safer than telling details about her diagnosis or the focus of her therapy. The husband might have found out about her participation in other ways, like following her one day. Some people say that the overall effect on the case may not be huge because the receptionist only gave a small amount of information. People who agree with this point of view say that while knowingly breaking a big secret is wrong, minor mistakes like this might not have as big of an effect on ethics and practicality in the long run. But these other points of view probably do not consider how far-reaching effects even simple statements can have (Appel, 2022). The wife’s concern, when she found out her husband had called, showed that she was afraid he would use the fact that she was going to therapy against her. When partners are deceptive and try 6 to control their partners, even small pieces of information can be used to hurt their victims’ reputations in court. The wife’s decision to hide the fact that she was going to therapy shows how important it was to her abusive husband. Even though accidental ethical mistakes are not as bad as intentional ones, they still hurt clients and institutions and must be fixed. Because psychotherapy makes people more vulnerable, organizations and staff must look at even small disclosures through the lens of how they might hurt clients who are already weak. Conclusion Overall, this study shows that the receptionist’s actions, even though they were done with good intentions, still violated privacy and could hurt the client and the institution. The disclosure confirmed that the wife had gone to therapy against her will, which let her abusive husband control the divorce procedures. It breaches the center’s ethical duties, leaving the door open for psychic harm and lawsuits. The breach hurts clients’ trust and puts the center’s image and ability to stay open at risk. Even though people have different ideas about how bad the breach was, everyone agrees that an ethical reaction is needed to fix the problem immediately and stop it from happening again through training and policies. The center’s actions must be criticized, held accountable, and changed because they put a fragile client’s well-being and interests at risk. With care and oversight, this breach could lead to reasonable changes in the institution and a reminder that privacy is essential in psychotherapy. References Appel, J. M. (2022). Breach of Confidentiality. Malpractice and Liability in Psychiatry, 113–120. https://doi.org/10.1007/978-3-030-91975-7_15 7 Avasthi, A., Grove, S., & Nischa, A. (2022). Ethical and Legal Issues in Psychotherapy. Indian Journal of Psychiatry, 64(7), 47–61. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_50_21 Ewuoso, C. (2021). Patient Confidentiality, the Duty to Protect, and Psychotherapeutic Care: Perspectives from the Philosophy of Ubuntu. Theoretical Medicine and Bioethics, 42(1-2), 41– 59. https://doi.org/10.1007/s11017-021-09545-0 Wheeler, A. M., & Bertram, B. (2019). The Counselor and the Law: A Guide to Legal and Ethical Practice. John Wiley & Sons.

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