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Counselling Ethics FAQ

Will my Counselling be Confidential?

I abide by and adhere to the British Association of Counsellors and Psychotherapy’s Ethical Framework.

As part of that framework, I practice confidentiality with all of my clinical work.  This means that you can speak with me knowing that your friends, your family, your work colleagues and so on will not get to learn what you have said in a counselling session – and neither will my friends, family, work colleagues and so on.

But … what confidentiality also means is that I will discuss your case with a strictly limited number of other professionals for sound ethical reasons.  All clients and patients of therapists should be made aware of this (as you will be during our initial meeting), but unfortunately this is not the case with some other professional therapists.  I make it a particular point to discuss what confidentiality means – and what are its boundaries – with all of my clients at the start of counselling.  During our initial meeting I will also give you a printed copy of our counselling agreement.  After all, there’s a lot to remember during our first sessions.

Because confidentiality is not just about not talking about our therapy work, our written agreement explains what confidentiality means.

For example, in addition to the ‘not discussing what we say in the room’ part of confidentiality, I will have made you aware that:

  • I meet with my choice of clinical supervisor one a month to discuss my cases and my work.
  • During my yearly quota of continued professional development (eg training courses), I may refer to certain casework in order to review of reflect upon the case  (you details will be anonymised, meaning I won’t use your name nor other identifying information).
  • UK law may require of me to break our confidentiality if I learn of something that is unlawful.

The rest of this article expands upon these matters.

Confidentiality & Supervision.

As a private practising therapist who is a member of – and accredited by – the British Association for Counselling & Psychotherapy, I meet with a qualified supervising counsellor once a month for a minimum of 90 minutes. This is to discuss my practice and my case load and to check that I’m working to my best, keeping with ethical principals, and dealing with dilemmas that come up in most every case.

I will, from time to time discuss your case and our work together with my supervisor – but I will have first made sure that my supervisor does not know you, or is likely to come in contact with you (say, for example, though the workplace).  I will refer to you only by your first name (or another name if you prefer).  If I cannot assure your confidentiality in this manner – for example if my supervisor knows you in the work place or socially – then I will seek supervision from another supervisor for the duration of our work together.

Confidentiality & Continued Professional Development (CPD).

In seeking additional knowledge to keep me up to date with therapeutic thinking, it is sometimes useful to refer to an aspect of a case whilst attending a training course.  If, when we discuss our agreement, you request that I do not refer to you during my CPD then I will respect this.  Even so, it’s rare to-the-point-of-never-happens nowadays for me to bring up casework willy nilly, and I make sure that anything I discuss within the confines of other therapists in the context of CPD still keeps your identity anonymous and our casework vague enough to never identify you.

Confidentiality & UK Law.

Confidentiality sometimes has to be broken if I am required to do so by law (for example if you disclose to me your intent of harming yourself or others (including children) or if you disclose intent of committing a serious criminal offence or terrorism).  This may also apply if I learn of someone else who may be being harmed or in danger, or is planning to harm others.

This does not mean that I will go running to the police the moment that I hear about something illegal, but it is part of my ethical commitments to you to inform you that the law may not protect your confidentiality.

I will intend to discuss with you of my (admittedly very rare) intent to break confidentiality of our work before I do so, but you need to be aware that the law may require that I take action first and without your consent or knowledge.

Declining your request to break confidentiality.

I have been discussing where confidentiality is maintained but expanded in the form of supervision and CPD, and have discussed UK Law where I may not be able to keep knowledge confidential.

There is another aspect: your request to reveal information about our counselling work.

Confidentiality is very important – even to ensure it is not broken in situations where you request it (for example, giving your permission to a solicitor to request that I give a report about our case work).

If we are still working together it is best for us to have a sufficiently detailed discussion of the consequences of such events before I decide how I will respond – and I will not automatically respond with a ‘yes’.  What has been, up until this moment, vital to protect needs a serious conversation about why this need has now changed.

Should our counselling work have been completed, and we are no longer in contact, if I receive a request to reveal the contents of our counselling work with a third party… even having received your permission (eg written) to do so … I may decline [if I am unable to discuss the request and its consequences with you directly].

Confidentiality – In conclusion.

Counselling is not to be taken lightly – neither by therapist nor clients.  Clinical work such as counselling and psychotherapy requires ethics, respect and the highest form of protecting both the therapist and the client’s right to feel safe during the work.

I take a particularly thoughtful approach to protecting confidentiality – and this may surprise a number of clients who may assume that (a) nothing is ever revealed about the case to anyone … or conversely (b) I will summarise our casework to anyone when the client wants me to.

Confidentiality is vital.

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Articles

How to Find & Vet a Counsellor

How to Check if a Counsellor is Legitimate.

Counselling, Therapy & British Law.

A current problem (2011 when I wrote this article, and still current in 2014) in British Law is that counselling, psychotherapy, hypnotherapy, spiritual/religious counselling, alternative therapies (and so on) are not regulated by law. 

Anyone can set themselves up as a “therapist” or use the word “counsellor” without (legally) requiring any formal therapeutic qualifications to prove their ability to practice as a counsellor.

This situation leads to counsellors not being required have to have any insurance.  They don’t have to be answerable to a professional body to oversee their practice.  These therapists can advertise themselves as a “counsellor” without actually having any training, qualifications, nor any actual experience as a professional intended to help you therapeutically.

Some organisations use ‘counsellor’ in forms such as “Travel Counsellor” or a “Debt Counsellor” – and by the true definition of the word counsellor they’re not intending to mislead the public into thinking they’re offering a therapeutic approach to your mental well-being.

Unfortunately, by the lack of British law, that the responsibility lays on the client who is seeking counselling/therapy to find someone who is appropriate for their treatment.

Going through a GP may not be enough (limited to offering only NHS IAPT treatment … often with a waiting list) to gain access to suitable counsellor. 

All of this can leave a person at risk when trying to find a counsellor who is not an unqualified fake.

Help in Finding a “safe” counsellor.

There is good news, though.

Finding a qualified, experienced, professionally accredited and insured counsellor can be straightforward if you know some helpful things to look out for. This article describes how to find a suitable counsellor – and offers some topics to check out with your potential therapist.

At your first meeting with your counsellor, most – if not all – counsellors should not be phased by you asking about any of these topics (in later sessions, however, certain therapists may not answer questions about themselves, but be interested with you in the purpose of your question – keeping the focus upon you.  This is a legitimate approach to some forms of counsellor (i.e. psychodynamic / psychoanalytical) but I mention it here for your knowledge).

Search Counsellors’ Professional Bodies’ Online Directory.

An easy way to find a suitable therapist is to use a professional counsellors’ body that offers a “find a counsellor” type of service. The counsellors listed may have had to pay for an entry, but would also have had their qualifications checked before being allowed to pay for an entry in the list.

… however, if you wish to find your own counsellor – or you would like some advice on what to check out about your potential counsellor – then click the next page for…

“The iCounsellor’s Guide to Finding a Counsellor“.

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FAQ

I need Paperwork Completing by my Counsellor

Confidentiality is vital to the counselling work and to our professional therapeutic relationship.  Even when a client believes that breaking that confidentiality might assist them in some way, I will still have a say on whether or not I will comply with the client giving their permission. 

Ideally, the client(s) and I will discuss such matters before the client(s) take such action.  Where no such discussion takes place, the client may wish to be aware that operate with certain boundaries in these matters:

  • Solicitors letter – If I receive a letter from a solicitor asking to give information on our case, I will – for reasons of protecting confidentiality – decline to comment on our case.  This will be so even if you give your authority for me to discuss our clinical work with a third party. Due to the paramount of the confidential nature of our therapeutic relationship I will not reveal any contents of our work, nor will I confirm nor deny if you have been in counselling with me.  It is important that a client is aware of my position in these matters as to assume that giving your permission to your solicitor for him/her to contact me may surprise you by my response if you are unaware of my position. If I am required to write a response to your solicitor I will make a charge for doing so – even when it is to decline to respond to the request for information about your therapy with me.
  • Attendance forms for a Student-of-Counselling‘s Therapy Hours – I will co-sign a form that you have prepared/completed that shows the number of sessions that you have attended.  I will not reveal any information about our counselling work.  Attendance forms that I am required to complete on your behalf (e.g. noting dates of your attendance)  I may agree to complete this with you after first discussing it with you, however  I will make a charge for completing the form and I will not reveal any information about the content of our work.
  • Sponsorship/application forms – if I am asked to co-sign a form on your behalf (e.g. housing application form) I will decline.
  • Summary of Sessions (eg Insurance) – Some insurance companies that fund counselling on your behalf may request that I summarise our work for them (eg a treatment plan, measurements & a written summary of each session – or an overview of the counselling work).  It is important that you are aware that I will decline to do this.
  • Receipt – if you require a receipt for your payment for counselling I will provide one that only shows your name, the amount the session cost, that the receipt is for counselling, and my name.
  • Most other letters and/of forms that you (or a third party on your behalf) ask of me will require a discussion between you and I before I make my decision, but I will still not break our agreement with respect to confidentiality.  Should I not invited to discuss this with you, my position will be to decline to give a response to any such requests.  My position is that I will not choose to break the confidentiality of our work.

Charges for completing forms.

Should we have discussed, and I have agreed, to complete forms as discussed within the boundaries above, my charge will be my standard hourly rate for the type of therapy offered to you – rounded up to the nearest hour.

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FAQ

What can I Talk about in Counselling?

Counselling focuses on you and the problems that you’re bringing into therapy.  So, it may not be such a surprise that you can talk about anything you wish to in counselling.

[iC_leaflet type=”bacp_c1″]You might be worried that your therapist may be shocked or distressed about what you might need to talk about.  This is usually not the case, but many trained counsellors also focus on keeping their feelings and responses contained so that the counsellor does not distress you.

You may even discuss your concerns about your counsellor if you wish; what they might think about certain topics.  Different therapists will respond differently, but they’re all focussed on the benefit of you.  Be assured that your counsellor is ready to hear what you need to talk about.

Counselling and the Law.

You should be aware that there are some subjects that would come under the law.

For example if you wished to talk about your part in terrorism, intended harm to self or others, you talk about a child who is in distress, not being looked after well or is being abused, or any other criminal activity, then your counsellor would be obligated by British law to break confidentiality.

This does not mean to say that your counsellor will immediately run out of the room to dial 999.

Again, different therapists will treat different matters with different approaches.  Most counsellors should inform you about confidentiality before the therapy begins (usually the first session).  Some therapists will give you a document that has everything written down.  Some therapists will remind you, if you begin to stray into legal subjects like these, about the law and confidentiality.

Sometimes, the law requires a counsellor to take action without informing the client – matters such as terrorism or child abuse can fall into this category.  Again, the client should have been informed at the start of therapy about this  – and whilst a counsellor may always wish advise clients beforehand that a subject which has been brought for discussion requires the counsellor to take action, the counsellor may be legally bound not to tell the client of the action before it is taken.