Counseling describes a method of relating and responding to other individuals with the aim of providing them with an opportunity to explore, discover, and clarify ways of living more satisfyingly and resourcefully (Bond, 2000). It depends on the context in which the word is used to derive the actual meaning. Generally, counseling is a service provided by a trained professional and it is a process that involves a series of steps. These include identifying the problem that needs to be addressed-such problems could be from the client who needs counseling help, consider the outcome of the decision (to the client and the entire society) understanding the client, assessing ones potential competence (skills that are required to solve the current problem), consideration of ethical standards in relation to the situation.
In counseling, information shared includes one’s body, mind and thoughts, beliefs, feelings and fantasies (Burnard, 2005) Confidentiality refers to the ethical principle of not revealing information known to a given party to unauthorized parties. This principle ensures secrecy among two or more parties who share information to them. In addition, confidentiality restricts giving information to third parties. Counseling involves so much classified information being revealed by the client. For instance, it may involve confessions and revelations of past and current situations of darkest and very sensitive high profile information of crimes, plans that are underway to achieve a given objective, secrets that could lead to arrests and prosecution by law and other forms of confidential information that should not be allowed to reach a third party.
Counseling takes on different forms depending on the situation, such as traumatic experience that has occurred in ones life, or information required on medical, career, legal, spiritual, and emotional situations that have affected a client either short or long-term. In either situation, the information shared between the client and the professional counselor should be kept and treated with the privacy and confidentiality that is deserved with regard to conformity to legal standards that describe confidentiality (Feltham and Dryden, 2006). Both confidentiality and privacy are integrally related. Privacy allows individuals to limit access to information about themselves whereas confidentiality allows individuals to control access of the information they have shared, hence enabling the development of client trust with the counselor (McLeod, 2004).
Counseling involves a variety of different age groups; matters that affects these groups and most of the groups that seek counseling services tend to assume that whatever they are divulging to their counselor, will be kept confidential – for children and adolescents, there are many critical issues that face them, which need that counselors maintain confidentiality in offering their services.
The adult clients are assumed rational in providing any kind of information to the counselors. Managing confidentiality in counseling minors tends to be very complex because most of them are frightened and have doubts that the information given out might be divulged to third parties, who might threaten the minors to the extent of causing more harm to them (McLeod, 2004).
Ethical dilemma and steps
Having a mentally disturbed patient who suffers from paranoia, at this point, the situation needing attention is a description of paranoia, the different forms, and symptoms with the patient and how to calm the effects of paranoia. The therapist decides on the best way possible to handle the patient. The decision made will affect both the patient and other colleagues in different ways-the patient should be informed of the measures to take when certain feelings of anxiety, fear, and or violent reactions come up. The psychologist should contact the patient’s family or friends and inform them about the consequences of the situation.
Consultations and information gathering about the issue of paranoia from other professionals, the internet, and medical literatures will enhance the process of decision making by the psychologist, in order to provide best assistance, the psychologist can also direct the patient to another professional colleague who has vast experience on such situation. In such cases, the ethical standard of confidentiality is breached so to allow extensive acquiring and dissemination of knowledge that will be helpful in assisting both the patient and the entire community, but privacy and anonymity of patients situation should be taken into consideration. In order to clearly understand and provide solution to the situation, the psychologist should analyze the links between family, behavior, culture, and relevant theories that correlate to the dilemma of the patient. In most cases, counseling jeopardizes a person’s feelings, rights, position, and judgment. In this situation, the psychologist should prioritize the patient’s dilemma, and consider performance to the best even if it breaches the legalities, provided it does not endanger the patient-community relation.
In offering the professional services, the psychologist should consider the role of other aspects in the community towards the decisions undertaken in the entire process, how paranoia is perceived within the cultural, religious, and social contexts, and corrective steps taken should such aspects result into conflicts, by either seeking legal assistance. In case of unexpected results in future, the psychologist should develop alternative courses of action-if for example the services given to the paranoia patient fails, or face prejudice from community, prescription of other professional services should be advised accordingly. The situation at hand should be looked at and advised within a larger perspective in consideration to the effects and those affected by the decision; the process should accommodate and harmonize the perspectives of all the members involved in counseling. All the decisions made by the professional counselor should be undertaken in consideration of personal responsibility to the latter, through reconciliatory means in consideration to ethical code, response, and actions. The possible outcome and the eventuality of the results should be evaluated by the psychologist in terms of the overall action taken in providing counseling services to the paranoia patient and the results, if negative, other cause of action should be prescribed to correct the situation of either the patient, conflict from society, legal issues, and other areas. The above processes should be followed by the psychologist to ensure that the decision taken in order to assist the paranoia patient does not compromise the safety of all the parties involved. In addition, the services provided help the patient’s life in future; it will ensure that future challenges are overcome in a conflict free environment while guaranteeing better professional services to patients (Pope, Vasquez, 2007, p.
Challenges facing Confidentiality
Sometimes, in the counseling process, not all the information is availed by the client and such information could be needed for different issues to take place. For example, a client who has been severally abused sexually by his/her parents, or a stranger for that matter could hide such information from the counselor due to the relation that exists between the client and the perpetrator.
This hidden information is required by the counselor and medical practitioners to prescribe medication and other measures for the client. Hence, the counselor might opt to get the information from a third party to be able to ensure the success of counseling. Such a situation breaches confidentiality of the information for both parties. Parental consent – Parental consent is needed from parent or guardian before entering counseling relationship especially in cases where the minors are considered not to make informed decisions about certain issues. However, their inclusion in the counseling process might restrict some information form the minors and as a result breaching confidentiality of the entire process. Competency (Age limits) – where the client is a minor, an adult has a great influence towards confidentiality. For minors who are seen as irrational in terms of revealing information and making decisions, the confidentiality is not guaranteed to some extent because a third party has to be involved in such a context to reveal or confirm certain information. The competency of age determines the confidentiality of the counseling process.
Legal issues – Matters concerning the various laws of any given state influence confidentiality in a way; for example, in cases of minor pregnancy, the minor might refuse to inform her parents about the plans for an abortion or even the pregnancy. Thus, if the abortion goes out of hand, the counselor is held responsible by law as for not informing the parents. Moreover, privacy rights influence confidentiality in counseling. Decisions making models – Several models are used by counselors to promote the clients welfare depending on the situation at hand. Here, complexity of the situation and information provided by the client would influence the use of a third party. Privileged communication – This refers to the rights that protect clients from disclosing information during legal proceedings without informed consent (Pat, 1998). Confidentiality in various situations is breached, such as where it has involved notifiable diseases and the entire society has to be informed of the disease and its dangers.
Other situation involve the births and deaths of individuals by the clients, information given to the police officers due to accidents and or crime, court orders which would require that certain information be made available to third parties, and where the professionals have to share certain information. All these forms result in breaching of confidentiality in any cases of counseling (Palmer, 1997).
Benefits of confidentiality
The client benefits from confidentiality during the counseling process in that, the client has a secure environment to give a full and frank account of issues pertaining to the problems they are facing. In other words, the client has someone whom he or she can accord trust for counseling services. Confidentiality supports public confidence and trust in both counseling and the general healthcare services. It expresses mutual respect for the client or patient, and the autonomy of the patient is guaranteed. Confidentiality also guarantees the clients’ beneficence, non-maleficence (no intentions of harming the client whatsoever), justice and equal treatment and fidelity (loyalty, reliability and action in good faith).
In certain cases, confidentiality reduces chances of the client being vulnerable to certain risks that may arise if the information revealed is made public and or relayed to a third party. Confidentiality ensures that the clients’ situation is dealt with, however nasty it may look to the client, and hence reduces chances of certain solvable situations worsening and becoming catastrophic in future. Clients are able to access professional assistance without the fear of victimization, and hence the reduction of the guilty conscience in the clients’ lives (Poon, 2003).
Counseling involves numerous services that are provided to the clients by professional counselors.
These services concern and influence a persons taste, beliefs, thoughts, and fantasies. Confidentiality greatly influences the entire process of counseling, as the client and the professional counselor have to build and maintain trustworthy ground of access to information from both parties for the entire process to be successful. Different groups influence the extent of confidentiality during the counseling process, hence resulting into variation of management of confidentiality among the different groups. There are situations where confidentiality needs to be breached in order to get specific information about certain issues, and also to solve and prevent the occurrence of catastrophes in the entire society from the influence of information provided by the client.
The clients benefit from confidentiality in many different ways. In counseling, the professionals should adhere and strictly maintain and ensure that privacy and confidentiality of the process is maintained to the latter, as this ensures the success of the counseling process.
Bond, T. (2000). Standards and ethics for counseling in action.
London: Sage. Retrieved May 7, 2011, from http://books.google.com/books?id=yVx3LkOQA8YC&pg=PA150&dq=confidentiality+in+counselling&hl=en&ei=XtLDTeb0DtHLswaM9_WHDw&sa=X&oi=book_result&ct=result&resnum=4&ved=0CEEQ6AEwAw#v=onepage&q=confidentiality%20in%20counselling&f=true.
Burnard, P. (2005). Counseling skills for health professionals.
London: Nelson Thornes Ltd. Retrieved May 7, 2011, from http://books.google.
com/books?id=xQIqC-_49wEC&pg=PA188&dq=confidentiality+in+counselling&hl=en&ei=XtLDTeb0DtHLswaM9_WHDw&sa=X&oi=book_result&ct=result&resnum=8&ved=0CFUQ6AEwBw#v=onepage&q=confidentiality%20in%20counselling&f=true. Feltham, C., and Dryden, W.
(2006). Brief counselling: a practical, integrative approach. Berkshire: McGraw-Hill International. Retrieved May 7, 2011, from http://books.
google.com/books?id=ak_sybCOn-gC&printsec=frontcover#v=onepage&q&f=false. McLeod, J. (2004). The counsellor’s workbook: developing a personal approach.
Berkshire: McGraw-Hill International. Retrieved May 7, 2011, from http://books.google.com/books?id=GpZsUxLdgvYC&pg=PA102&dq=confidentiality+in+counselling&hl=en&ei=eDLGTdvuAsXNswbsm7SXDw&sa=X&oi=book_result&ct=result&resnum=4&ved=0CEUQ6AEwAw#v=onepage&q=confidentiality%20in%20counselling&f=false. Palmer, S. (1997). Handbook of counseling. London: Routledge.
Retrieved May 7, 2011, from http://books.google.com/books?id=Hloe33OCZqEC&pg=PA525&dq=confidentiality+in+counselling&hl=en&ei=XtLDTeb0DtHLswaM9_WHDw&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDcQ6AEwAQ#v=onepage&q=confidentiality%20in%20counselling&f=true.
Pat, L. (1998). Counseling Minors: Ethical and Legal Issues.
Counseling and Values, Vol, 42, Issue 3. Retrieved May 7, 2011, from http://www.pc3connect.org/otherdocs/COUNSELING%20MINORS-%20ETHICAL%20AND%20LEGAL%20ISSUES.PDF. Poon, S, M. (2003). Counseling “for life enrichment faith, hope, and love.
” Singapore: All Nations Enterprise Ltd. Retrieved May 7, 2011, from http://books.google.com/books?id=VJD3mdqSk6oC&printsec=frontcover&dq=counselling&hl=en&ei=-9bDTa7NJY_CtAbakvHIDw&sa=X&oi=book_result&ct=result&resnum=6&ved=0CFwQ6AEwBQ#v=onepage&q&f=false Pope, S, K., Vasquez, T, J.
(2007). Ethics in Psychotherapy and Counseling. CA: John Wiley & Sons, Inc.