Confidentiality in Psychoanalytic Psychotherapy

Lee, Moo Suk

Abstract

If we apply the traditional medical ethical principles of beneficence and non malfeasance, psychotherapy, like any other medical treatment, should aim to help patients with their problems, make them feel better and do no harm to them. But this is not as simple as it seems. Some specific types of harm could be possible during psychotherapy, which are not so common in other medical fields: Such as threats to confidentiality and boundary violations. In principle, all patients are entitled to have their information be kept confidential, and psychotherapists have the duty to protect patients' confidentiality during the course of treatment. However, it is hard for therapist to maintain the principle of absolute confidentiality in specific situations. The author reviewed the issues of confidentiality breach in various psychotherapy situations. And this includes therapist's intentional breach of confidentiality, 1) when other people are at risk; Miss Tarasoff Case, 2) for the purpose of public good, research and teaching; supervision. For therapists, greater attention should be paid to understanding and coping with the legal requirements governing the practice of psychotherapy in order to make provision for good patient care. This should facilitate avoiding unduly defensive practices that can inhibit the therapist's ability to conduct effective psychotherapy.