Confidentiality in counselling

Being a member of the BACP and obliged to abide by its code of ethics, I am mindful of confidentiality in every aspect of being a counsellor. In the client contract, I clearly state that I will not communicate client information with anyone unless compelled to do so by court order. Ethically, I am bound to not be maleficent to the client and here I feel my consideration should be focused. Sounds quite straightforward - but the devil is in the detail.

What if the client's solicitor sends a request to support the client's ongoing child custody hearings? What about a client's social worker asking for background information? Or if the police want to know when a client was in session? Or the manager where I work wanting to know “How is a client doing?” over a cup of tea? Seemingly simple examples but each one is real and nuanced.

Will the communication go towards being beneficent to the client, by not communicating will it be maleficent? And the contract...?

On occasion, I have been asked by clients to write to the DWP, the Housing Department, and even the GP! 

On each occasion, I have considered how to achieve the balance between beneficence and maleficence as well as how to be true to the contract I have with the client. When I have consented to write and/or share information, I have adopted the following method:

• Initially, I enquire as to the purpose - being in need or want, the client is frequently explicit and, worth noting, as honest as they can be.
• Secondly, I ask the client to sign a consent form, thus giving written consent for the sharing of the information with the parties the client wants to share it with.
• Thirdly, I offer the client a draft and, only when they agree on the contents, do I hand over a copy for the client to send.

With pro bono clients, I do not charge a fee but with paying clients I do charge a fee. This may sound harsh but considering that GPs charge a fee, as do solicitors, I feel justified in also charging a fee.

Tim Bond in his book Ethical Considerations and Decision Making in Counselling sets out how to approach issues just like the one I am describing. It offers a way of arriving at decisions that are in alignment with the BACP Ethical Guidelines and the Ethical Framework. I have not yet had these decisions questioned but considering Tim Bond and the role he was in at the BACP, I have confidence that I am doing the best I can to be ethical.

I have used a lot of words in trying to answer a seemingly simple question but they come from a place of unconditional positive regard for the client. Do I go too far? Indeed the counselling session only lasts for 50 minutes and what I am describing goes on outside of those 50 minutes.

My responsibility is to the client and not for the client, but I am a human being as well as a counsellor.

It would not sit well with me either seeing the client perhaps not achieving their desired outcomes, being estranged from their children, suffering financial penalties or being made homeless. Especially when, for the sake of a letter, I might be able to make a positive difference. None of those consequences, I feel, would be beneficial to a client.

So, perhaps I go above and beyond - that is a matter of opinion. I do know when I recall clients' presentations, that being not heard, ignored or so unwell that they cannot do their best to represent themselves is a significant contributor to their mental ill health and this is quite often a cause for them seeking counselling.

Finally, as for the manager wanting to know how the client is doing, I have a standard response. The response is always, “I cannot discuss the client with you.” As much as this rattles the person-pleasing part of me, it has served me well. I consider the regard for the counselling profession and myself to be maintained and perhaps even elevated. Casual conversations about clients should, I feel, not be conversations I take part in.