Therapy is an integral part of psychology and one that is contentious in the American society. Treatment has been looked upon as something that is only useful to the mentally unstable or those in psychiatric institutions. Furthermore, it has been given added stigma through media, especially movies in the American society that repeatedly show therapy to be the last resort of some sort rather than a pivotal aid to everyday mental wellness (Leach, 2012). A fundamental question in ethical psychology code is that of; will the things I talk over in therapy be kept confidential? The practice of psychotherapy has come under fire because of the issue of confidentiality. Americans and beyond doubt the secrecy of the professionals involved in psychotherapy. This has cast a dangerous shadow on the practice and further hindered many patients from considering it as an alternative to mental health (Knapp, 2012). This paper thus discusses confidentiality in the preparation of psychotherapy. Massive literature research and interpretation of findings all assist the enhancement of the outcomes about the effect of psychological therapy.
Key Words : Therapy, ethics, employee assistance programs (EAPs),
Psychology and Ethics
Varying arguments can be put in place to answer the question of confidentiality in psychotherapy. Privacy is considered the basic rule with regards to a psychotherapist’s code of ethics or the practice of psychotherapy. Across the board, not only in psychology, it is known and understood that patients would feel more at home and secure if they are assured that all the private information they divulge will be used to improve their condition and above all will be kept secret. A patient will only disclose as much information as long as they are assured that the information will remain discrete and confidential. Americans of all people in the world take their privacy very seriously. The public believes that matters concerning their health and securities must be treated with the utmost discretion as it deserves. In addition to its being a fundamental rule in the code of ethics for psychologists, there are laws in place to ensure the privacy of patients is upheld. In some cases of irresponsibility, some nurses and healthcare providers end up divulging confidential information that they should not. The Health Insurance Portability and Accountability Act (HIPAA), is widely known by clinicians to contain a confidentiality rule that creates statewide standards to safeguard individuals' medical accounts and personal health information. This law also encompasses information about mental health and psychotherapy. It provides a guideline as to the steps and stages of psychological best practices that should be followed by all the healthcare providers.
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The HIPAA Privacy Law is intended to be a minimum level of protection, some states, however, have a new legislature to buff it up and ensure that the health information of their citizens remains private (Leach, 2012). Each state usually has a psychology board, these may or may not have additional laws that ensure the personal health of individuals remains private. It is necessary that all patients under any form of psychotherapy treatment know the legislature of both their governing institution and state about the confidentiality of their health information (Leach, 2012). As a professional measure, the first visit to a psychologist should be a briefing of all the procedures to be done and importantly, how one’s health information will be handled. Again, in these statements, should be a clause that dictates when or under which circumstances one’s medical information can be divulged to a third party or beyond. The psychologist should explain in detail under which cases, no exceptions to the confidentiality rule apply. The ethics of healthcare and psychology, therefore, dictate that all the custodians of the patients; information should and must always ensure the secrecy of the same. At the same time, health information can only be discussed on the permission of the patient themselves or in full agreement with the respective confidants or family caretakers.
There are circumstances, in the practice of healthcare that a patient’s information can be shared without the patient’s written or verbal consent. The most prevalent of these conditions include; Psychologists are required by law to report ongoing abuse domestic violence, or negligence of the elderly, children, or people with disabilities (Leach, 2012). This case, however, does not cover historical instances for example, if the patient was abused as a child unless there is a possibility of the abuser continuing to harm children or other people currently. Second is that psychologists or other clinicians are at liberty to disclose private data without consent to protect the public or the patient from grave harm (Neil, 2016). Such disclosure may be in the case whereby the patient’s condition may be a threat to the broader public. However, even in such cases, there must be proper and clear protocol to be followed. For instance, if the patient intends themselves serious harm in the form of suicide or to harm other persons, then such information may be released to the relevant authorities without the patient’s permission. The third instance is if the clinician/psychologist is under the order (from a court of law) to disclose the information of a patient. During legal proceedings, if a person’s mental health comes under question, then a psychologist can be compelled to reveal the person’s medical information or the person may be subjected to a psychotherapy procedure to ascertain their mental soundness.
Another concern about a person’s psychological information is if insurance companies that cover or have covered the person will have access to their medical records. It is expected that psychologists share certain aspects of a patient’s health information with their insurance provider, like diagnosis and treatment regimes, this is so that the company can determine the care plan to place the patient under. However, patients should note that at least in the USA, health insurance providers are bound by the HIPPA to keep the information provided confidential (Neil, 2016). Lastly, a psychologist can disclose a patient’s data to other psychologists, for them to combine expertise and coordinate the patient’s healthcare. Additionally, the additional psychologists are bound by the confidentiality rules.
Employers are also a faction to consider as far as health records are concerned. Unlike criminal history, employers are not entitled to one’s health information, even if the employee uses the company’s insurance. Some companies provide employee assistance programs (EAPs), which provide mental health facilities to staffs. Typically, the business offers merely the service but doesn't have access to information about how each employee uses it. However, employees should seek the policies involving privacy and their organization's EAP (Neil, 2016). This places them at an information advantage, with regards to decisions they make that affect their privacy or health information.
As a patient, privacy is your right. Hence what you choose to do with your health information and who you choose to divulge it to, is up to your discretion. If one wishes to disclose this information with their family, spouse or friend, they are at will to do so. Additionally, how much information they publish is also to their discretion. However, nobody should coerce you to disclose the information that you feel should remain discrete in your private capacity.
References
Calum, N. (2016). Ethics and Psychology: Beyond Codes of Practice, New York, Routledge Publishers.
Mark, M. L., Michael J. S., & Geoff Lindsay (2012), The Oxford Handbook of International Psychological Ethics, New York, Oxford University Press.
Samuel J. K. (2011). APA Handbook of Ethics in Psychology , Volume 2, USA, American Psychological Association.
