When studying a career in psychology, professors repeatedly insist on the rules to be followed in the therapist-patient relationship. Among many of these rules is the confidentiality pact and, of course, the code of ethics reflects this set of rules.
Our patient has the right that the information he gives us and everything that happens in the therapeutic setting is something confidential, and this is perhaps what repeatedly puts us “between the sword and the wall”. And this is it there are situations in which psychologists offering therapy must break professional secrecy. Let’s see what they are.
Exceptions: when to break professional secrecy as a psychologist
We must first understand that professional secrecy is a very important element of the therapeutic framework. Simply letting the patient know that they can fully trust you, as a therapist, and that everything discussed and done during the session will be confidential, strengthens the foundations for a positive and productive therapeutic relationship.
That said, exceptional situations leading to breach of professional secrecy of the psychologist are as follows.
1. Sexual and physical violence
Being prepared to deal with all kinds of cases is something that only experience can provide. But some cases are more difficult than others, and in students the therapist must position himself beyond the scope of therapy and its goals.
Sexual, physical and psychological violence is quite common; the problem is that silence and fear usually dominate most of the people who suffer from it. In the office, those who put the therapist in a more difficult situation are boys and girls, because there are cases that are suspected of sexual abuse. In these situations, the psychologist to investigate, collect and verify if the abuse is real.
When the therapist finds out that this abuse is taking place, it is his or her duty to warn the parents, however, what if the abuser is someone from the nuclear family and no of them does not act on it? This is a very serious problem, because this is where we have to break this confidentiality beyond the family framework. It will depend on the country in which this is happening, but in most cases the psychologist he must immediately report it to other relatives and to the competent authorities. Note that you only need to break confidentiality beyond the family setting if none of the educators do anything to stop this situation.
2. Suicidal patients
Another very common case in the practice concerns patients with depression, especially severe depression. In summary, people with major depressive disorder often exhibit certain characteristics such as sadness, hopelessness, loss of energy, loss or increased appetite, difficulty falling asleep, and thoughts. or suicidal acts.
These patients usually have seizures if they do not take appropriate psychotherapeutic treatment and if they do not take antidepressants from a psychiatrist. It is best to write down suicidal thoughts, plans or actions working with the family and preparing them to be the target of the patient.
What happens when no one in the family knows that the patient wants or is considering suicide? This is the time when you need to break the privacy rule and let your parents, siblings or closest relatives know.
3. Legal proceedings
Sometimes we will attend patients referred by a court or a judicial institution. This means that at some point our presence in the process may be necessary, thus breaking professional secrecy.
There are many situations that can come to this, and they put all psychologists in complex situations. That is why I suggest knowing the laws and the responsibility that psychologists have towards them, depending on the legal framework of the country.
4. In risky situations
any situation that endangers the life of the patient or other people close to him (Or not to close if the matter is serious), will force the psychologist or psychotherapist to break that professional secrecy, whether or not it happens in the context of a lawsuit.
Remember that …
These situations are very specific, and for the same reason the psychotherapist infringes professional secrecy, in order to protect and provide the best service. Otherwise, the psychotherapist must not break this commitment.