Maintaining Patient Confidentiality

A therapeutic client who knows that personal, private and intimate information he/she shares with a counsellor or psychotherapist is held in confidence is more likely to feel at ease about self-disclosure. The client will also feel more able to trust their counsellor, and will want to open up and discuss their issues, concerns and difficulties more readily. Without this level of patient confidentiality the client-counsellor relationship has no firm foundation.

Confidential Matters

Patient confidentiality means maintaining private information about a client, and ensuring that no unauthorised person has access to this. A counsellor or psychotherapist must also seek a patient’s consent before discussing any disclosed matter with a supervisor or more experienced counsellor.

There is however, one instance where a client’s confidentiality might be breached, and that is when a client’s personal safety comes into question in some way. Before the confidential information is shared with another counselling professional, it is the counsellor’s duty to inform the client of his/her intention. In any situation that the counsellor feels in need to breach client's confidentiality, the counsellor or psychotherapist must ensure harm to the client is minimised, and ethics and institutional laws are correctly adhered to.

Special Precautions

Client information may be stored in a variety of different ways. Information stored in electronic records, on a computer for instance, must be strictly maintained to avoid the violation of a client’s privacy and confidentiality. Networking through company systems must also be strictly controlled. In short, all relevant paperwork and data, relating to a client, must be stored in a manner that preserves confidentiality, and is not accessible by any unauthorised individuals.

In order to maintain client confidentiality a counsellor must be aware of certain important procedures. These can only be maintained if a counsellor accepts full responsibility for a client.

Throughout the client-counsellor relationship it is the counsellor’s responsibility to:

• Ensure a client’s confidentiality is not breached.
• Provide the same level of care and support to a client, regardless of the client’s background.
• Maintain up-to-date client files and notes.
• Support the client, and where necessary request the additional support of colleagues or more experienced counsellors, to ensure the client’s counselling needs are fulfilled.
• Process, and provide, up-to-date additional information and resources that may be useful to a client.

Body Language

As with all forms of communication body language provides a useful additional assessment of a client, and their counselling needs. It provides information about an individual’s true feelings about a situation, issue or other person. Although the majority of body language occurs unconsciously, sometimes it decides the quality of the type of communication we have with another person.

Body language expresses feelings and is a useful tool for counsellors to use within a client-counsellor relationship. Hand gestures, posture, eye contact etc all communicate how someone is feeling. Whilst there are positive gestures that encourage openness there are also opposite body movements that signal impatience and lack of interest.

A counsellor’s skill at being able to read a patient’s body language will provide a further record of how the client is expressing and experiencing the counselling process, and noted down in a client’s documentation it provides additional information that must remain confidential at all times.