Boundaries are extremely important in therapy; they form a structure within which the complexity of the work can be contained in as safe a way as possible. Confidentiality is one these important boundaries.
Respecting privacy and confidentiality are fundamental requirements for keeping trust and respecting the client’s autonomy. It is a therapist’s duty to manage the confidentiality and protect personal identifiable and sensitive information from unauthorised disclosure. With a qualified and accredited therapist you can trust that what you say in therapy stays private.
The therapist’s duty of care towards their client is paramount, but there are sometimes complex medical or legal requirements around confidentiality which need to be discussed, particularly if you are at risk of harming yourself or others. The boundaries around these sorts of issues should be outlined early on in therapy.
If you have been referred by your GP or psychiatrist, communication between all the professionals caring for you will be an important part of your treatment.
It is important for your therapist to know if your medication has changed as this might impact how you are working in therapy. Similarly, you may benefit from some additional medical support if you hit a particularly complex and challenging issue in therapy. It is common practice for such communication to take place in order to provide a cohesive approach to treatment. You can be copied in on any such communications if you wish.
If you have been referred through work, either via an Employee Assistance Programme or Occupational Health service, then there is often an expectation that the therapist will complete a brief report for the referrer at the end of treatment.
These reports usually focus on the number of sessions attended and outline general issues, such as “performance anxiety explored.” Details of content and process are rarely required, but you can discuss any such reporting with your therapist. Nothing would be shared with a third party without prior discussion with you.
The parameters of confidentiality may depend on why you have been referred and should be discussed in detail with your therapist. You can ask to be copied into any communication if reporting is required.
There are a number of issues to be considered.
Working on the principle that the relationship is the “client” in couple therapy, both partners need to be present at all sessions for the work to take place.
The therapist’s role is to support an open dialogue between the two people and explore the conditions required for this to happen. A request by one partner to see the therapist on their own, or initiating a conversation with the therapist in-between scheduled sessions, could invite the keeping of secrets and create an imbalance.
Unless there is clarity about what happens in such a situation, these sorts of separate conversations can be counter-productive to the process. Similarly if one partner arrives for therapy and the other does not attend then it also compromises the work.