Therapy Confidential Contradiction

[Jen12]

This week in therapy my therapist at the start of the session went through the normal checks to see if i was medically well enough to carry out the session & also check i was mentally well enough.......
She then went on to say i need you to understand that if you give me names of your abusers i have to divuldge this information as its a safe guarding issue?!?! Luckily were using the blind therapist technique to carry out the endr sessions but my worry is that i may by accident mention the names. This would be catastrophic and woukd be life threatening for me if the abusers are then reported by my therapist.

Im totally confused how sessions are 'confidential' but then my therapist is telling me if she gets their nanes she'll have to report then for 'safe guarding'?!?! So basically therapy isnt confidential, so what else will she divuldge without my consent?!

 

[Rumors]

Are you a minor or currently in danger of the abusers? I apologize I don't know your exact story so if you have stated this elsewhere I haven't read it. I would think there are laws in every country that sets forth a protocol for those who are in dangerous situations. There could be some liability on the therapists part for not reporting.
I'm really sorry that this has come up. I would have a conversation with your therapist about how that makes you feel and what issues that brings up for you.

 

[digger]

So basically therapy isnt confidential, so what else will she divuldge without my consent?!

My understanding of it in the UK is that a therapist can break confidentiality where there is a serious risk of harm to yourself or others. I think there are circumstances where they are required by law to do so. If she believes that someone you've named poses an on-going threat to children for example from something you've told her, then she is probably required by law to report that. The other times are if she thinks you yourself pose a serious risk to others, or to yourself.

The confidentiality thing should really be explained at your first meeting with a therapist. If it wasn't, or it wasn't clear, it would be good to ask your therapist now to clarify exactly when she is/isn't required to breach confidentiality.

 

[Suzetig]

If she believes that someone you've named poses an on-going threat to children for example from something you've told her, then she is probably required by law to report that.

There isn't a law in the UK which requires disclosure so it may be a requirement of the agency she works for but yes, you should have been told clearly at the start of your therapy.

Given that you have, understandable, concerns it would be worth properly talking to her about this, exploring what and why she would need to break your confidentiality and who to. For example depending on your age and who the abusers were they may not pose a current safeguarding concern, if they do who will she disclose to, or police or social services and would they then expect to be able to talk to you about it?

In the even that she did disclose, you can choose not to engage in any investigation if that's your preference. It's not at all unusual for someone to either not talk to police/social services or to withdraw/retract what they've said to other people, eg therapists. The starting point though is an open discussion about what she feels she might need to share, why she didn't tell you at the start and you can then decide to continue with her or to go to someone else with a different confidentiality threshold.

 

[digger]

There isn't a law in the UK which requires disclosure

I did a bit of reading around yesterday after replying to this, to try to find this out, although not in a huge amount detail, and most sites were using the Terrorism Act and the Childrens Act as examples of times where confidentiality may be broken?

 

[Suzetig]

With terrorism there's a requirement to break confidentiality but not with child protection - yet. The Children's Act and other legislation across the 4 nations allows for disclosure (ir if you do share you won't fall foul of data protection and privacy legislation) but doesn't force you to share, though very often the agency you work for (health, education, social work) will require you to act on abuse as part of your contract of emoyment. You could technically work independently, decide your own confidentiality threshold and decide to hold confidentiality when someone discloses abuse.

It's a bit of a minefield and there has been a lot of campaigning to change the law and create a duty to report but it's not changed so far and there's a fairly strong lobby arguing the need for safe, confidential space for children and young people to talk about their experiences, so who know what'll happen.

 

[digger]

@Suzetig - thanks :) I couldn't find anywhere that clearly stated things.

It is a very difficult one I think finding the balance between protection and like you said, giving people, children especially, a safe enough place to speak without the threat of that hanging over them. I know the potential repercussions of what I might say we're a huge influence on my decision not to talk about anything as a child.

 

[Lucycat]

"Restrict breaches of confidentiality to those exceptional
circumstances under which there appears sufficient
evidence to raise serious concern about:
(a) the safety of clients;
(b) the safety of other persons who may be endangered by
the client’s behaviour; or
(c) the health, welfare or safety of children or vulnerable
adults."
Of course this only applies if the therapist is a member of the BPS.
Others are right that if you are employed by a public body such as the NHS or local authority there is a duty of care that obliges any Safeguarding risks to be reported via the appropriate channels. For the NHS in Scotland this would firstly be with a Child Protection Officer to see if it meets the criteria for Police and Social Work involvement.

In all cases there must be a serious concern of safety. It is not an option for a therapist to have a serious concern that children are at current risk and then do nothing about it. I am not sure that naming names is the grounds for determining that risk. I would think that if the client said "I was abused and the person is currently involved with other children who I think might be abused" that would be sufficient to raise serious concerns. On the other hand if you went along and said "I was abused by Mr X 20 years ago" there is less concern because of time lapse and lack of further information.

It is not clear cut. But it shows how important that first discussion with the therapist is. Also the therapist should repeat it, as often the first appointment goes in a flash and not a lot is heard and understood. Confidentiality is important to the therapist and they do not take breaches lightly. I don't think anybody should be worried about 'accidentally' naming someone in therapy. It would detract from the freedom of expression and prevent a good bond with the therapist if you are holding something back in fear. I would suggest a frank discussion with the therapist to clear this up and understand the boundaries better.

 

[Sandstone]

This would be catastrophic and woukd be life threatening for me if the abusers are then reported by my therapist.

This sounds a very serious situation to be in, and certainly one that would affect your therapy. It is hard to recover with a current threat hanging over you. How aware is your T of your position? Are you in current, ongoing danger?

 

[Sideways]

The comment about the situation being "life-threatening" for you seems to have been slipped into a query about a much smaller issue.

If you are in serious danger from your abusers, that needs to be resolved first. Your safety is absolutely paramount. It comes first, before EMDR or anything else.

Sometimes our abuse makes our heads convince us that threats to our safety aren't such a big deal. Actually, it is a big deal. And the thing is, therapy is only going to take you so far if real safety concerns continue to hover over your head.

It may be a good thing that the confidentiality issue came up, if it's brought to light the fact that currently, you're actually not that safe. It's given you a potential opportunity to reassess the priority of the stages of your recovery. Always, always, we need to be safe in the real sense of the word before any other healing can be effective.

Short version: if you're not safe, take a rain check on the EMDR, and get yourself and your life into a situation that is genuinely safe. Your T can help you with that, if you let them.

 

[EveHarrington]

I think it's a good idea to get a written copy of the policy that your therapist abides by. A verbal "warning" does not suffice as if she oversteps her bounds your in a you said-she said situation and in such cases, authorities will most likely side with the therapist. Knowledge is power, so IMHO it's best to know the nuances of what we're dealing with so that we can make informed decisions about how to proceed. I hope it's a workable situation. Good luck!

 

[Jen12]

@EveHarrington @Ragdoll Circus @Sandstone @Lucycat @Suzetig @digger @Rumors

Thank you to each and everyone of you for replying to my post. Im currently in medical hospital quite poorly so im struggling to take in all your wonderful information in your comments.

I know a few of you have asked about my age, im an adult of 25yrs so she cant use my age as a reason to breach my confidentiality.
Ive also seen replies around my life being in daner if the therapist does breach my confidentiality and make people aware of my abusers. Ive briefly touched upon this with her, however i dont think she realises to what extent the seriousness the danger my life would be in. Which is a very scary thought for me.

When it comes to safe guarding she is aware that two of my abusers where members of staff from my school. One has left and no longer works there, im not sure if the other still has a job there. Would this be where ths safe guarding issue comes from?
But even if she did contact the relevant people to report the individual working at the school i cant imagine anything woukd be done without evidence which i wont be able to give due to my life being at risk, plus this happened 10 years ago!


Once im feeling better & not so dosed up on medications, i will thoroughly read your replies as they all seemed very helpful and had some great information in.