Confidentiality Case Study – Marital Secrets

Reflection Paper One Silva Redigonda Ethics for the Practice of Psychology provides a case study regarding a psychologist who after many months of providing marital counselling to a couple has since been contacted by the husband asking him to testify at a custody hearing. The psychologist contacts his client’s lawyer to learn that the wife’s numerous affairs will be used to deem her unfit as a mother. The psychologist also contacts the wife who insists that the confidentiality of the counselling sessions be maintained (Truscott, 66). For the purpose of this reflection paper, I am the aforementioned psychologist. (I am in reality a psychotherapist) I will reflect by examining the facts of this case, my ethical values, my theological reflection and my conclusion based on Truscott and Crooks readings. Examining the Facts As I examine this scenario, questions come to mind. What kind of documentation do I have regarding this case? Did I articulate clearly the confidentiality of our sessions? Informed consent means that the client understands the benefits and risks that a psychologist provides and agrees to the conditions (Truscott, 56). In accordance with (IAW) The Canadian Code Of Ethics (Code of Ethics) 1.24, one is to “ensure in the process of obtaining informed consent that at least the following points are understood …. Confidentiality, protections, and limitation…’’ (Truscott, 57). Confidentiality is stressed and standard documentation clearly reveals that, though there is nothing legally binding for the clients to not reveal what is discussed in counseling. The Code of Ethics 111.14 reveals that one should “be clear and straightforward about all information needed to establish informed consent including mutual responsibilities, possible conflicts….” (Truscott, 58). But to what degree is it possible to provide “all” information? Though clients have access to their files which has been established by Case law, McInerney v. Macdonald (1992), the Supreme Court stipulates that there is “not an absolute right to access; a client may be refused access to the records if it can be established that doing so would result in harm to either the client or to a third party”(Truscott, 72). In this case the harmed party would be the wife. The female client clearly does not want anything in counselling to be revealed. The lawyer in this case does not mention a subpoena. This may be a ploy to get information. I would consult a lawyer to determine how I should be phrasing my responses to not accidentally reveal anything that may breech confidentiality or that may incriminate me in the process (Code of Ethics 11.30) (Truscott, 68). My female client who I have reached has requested that I keep the information from the sessions confidential. This is in IAW the Code of Ethics, 1.43 (Truscott, 67). However, if my client did agree to this would I not have a responsibility to advise her that it may not be in her best interest? Should I not recommend a lawyer for her in this situation? Though both husband and wife were my clients and I have a responsibility to them both, at this point my female client is in the most vulnerable position since any release of information occurring in counselling may be used against her by her husband. The Value Statement of Principle 1 indicates that the psychologists have a greater responsibility to one in the most vulnerable position (Truscott, 71). Even if my client has had numerous affairs, she may be a wonderful mother to her children. Therefore, her extra marital affairs are not an indication of her motherhood. My Ethical Values As a Roman Catholic I do believe in the sacrament of Holy Matrimony. However, I also believe that when two people can no longer live together and their souls are darkening perhaps it is best to divorce. I think the children in this scenario are being used by the husband in his attempt to get sole support, or to hurt his spouse. This is merely speculation. Things can get very messy in court and though marital affairs can have an effect on the children, in this situation it is unknown what the children know and if it is damaging to them. Does divorce or affairs affect my judgment? No. My concern would be the professional ethics of this situation surrounding confidentiality. Theological Reflection I think of birds that mate for life as an example of God silently telling us his wishes. I marvel at the animal kingdom that make their young such a priority. Dear Lord, please continue to guide me in your wisdom. Help me make the right choices with the free will that we have been given. Conclusion There are many complexities that may occur regarding confidentiality. It is best to be very clear and have signed documentation by all parties so that when confidentiality is in jeopardy for whatever reason it should not be a surprise. I think we need as a profession to re-examine our existing documentation and revise and update wording on a continuous basis resulting from amendments in court. In this scenario, I as a psychologist (remember I am a psychotherapist. This was a class assignment and is not my case. It is hypothetical) did not release any information to the lawyer. There was no court order and even if there was, I would not be providing any information without my own lawyer present, or in a court room. Neither would I, in a real situation contact my client’s lawyer. There would be no need for me to do so. That the lawyer is not contacting me in this situation is interesting. The lawyer has no legal obligation to contact me and knows very well that I cannot divulge information.