Confidentiality in Marital and Family Counseling - Essay Example

?Confidentiality in Marital and Family Counseling/Psychotherapy Confidentiality is an important aspect of marital and family counseling. More often, secrets or information revealed in confidence are shared by participants to a family and marriage counseling and/or therapy to the psychotherapists or therapists. Individuals in the therapy have rights to information but the therapists are given information by participants in a therapy in confidence. The confidence was the basis why information was shared to the therapist in the first place. For therapy to work, we must uphold confidentiality and share information gathered in confidence when clients gave us permission to do so through a written consent form or in writing. . Confidentiality in Marital and Family Counseling/Psychotherapy Confidentiality is often prescribed in many articles on marital and family counseling and psychotherapy, research, and with how professional counselors and psychotherapists should deal with couples and families. What does some of the current literature say about confidentiality? Butler et al. (2009, p. 125) pointed out that one challenge facing marital and family therapists is whether to facilitate partner disclosure or accommodate nondisclosure after a disclosure of marital infidelity by one of the couple to the therapist. According to Butler et al., many therapists accommodated the infidelity secret because doing so is both “efficient” and “compassionate” in view of the possible repercussions of a revelation on the couple’s relationship (p. 125). In assessing the appropriateness of the accommodation, Butler et al. considered the ethical, pragmatic, consequential, and implications of the accommodation and concluded that facilitating voluntary disclosure of infidelity is the most ethical response to the revelation done confidentially (2009, p. 125). The 2009 study of Butler et al. cited Brock & Courfal (1994) who reported that a large majority or 94% of marriage therapists had kept secret a confidentially disclosed infidelity. According to Butler et al. (2009, p. 127), the non-disclosure of infidelity can be defended based on the principle of nonmaleficence or the principle of doing no harm. On whether harm was done to the other party in a relationship in a non-disclosure, Butler et al. (2009, p. 127) pointed out that many marriage and family therapists defend non-disclosure as non-maleficent because the marriage or couple relationship benefits the couple. However, Butler et al. (2007, p. 127) contradicted this view because “accommodating a secret has a strong potential to harm the relationship and the potential for benefits is doubtful.” In other words, the Butler et al. argument is that non-disclosure has a doubtful beneficence in addition to being a maleficent. Butler et al. (2009, p. 127) also argued that justice and equality ethics imply that each in a partnership or relationship should be fairly treated by both the partner and the therapist. For Butler et al. (2009, p. 127), “providing false information, withholding essential information, or otherwise obscuring the true conditions of the association, or even failing to provide information in a timely manner may represent exploitation, as it defrauds the other partner of his or her essential right of informed relationship choice” or that he or she is drawn in a relationship based on wrong, incorrect, or false information. Butler et al. asserted that a partner’s right to correct information on a relationship exists from the time of relationship formation (2009, p. 127). Further, Butler al. (2009, p. 127) argued that “without the provision of all relationship-relevant information, essential individual rights in relationship are denied.” Butler et al. (2009, p. 130) continued that false information or even inability to provide information in a timely manner deprive the other party of his or her rights and, therefore, unethical. Moreover, Butler et al. (2009, p. 134) argued that secrets or the information of infidelity provided by one of the partners to the therapist is an obstacle to intimacy between couples and a therapist that withholds information of infidelity becomes an obstacle to the couple in their search for intimacy and attachment to each other. Given the foregoing, Butler et al.’s solution (2009, p. 136) is for the therapist to facilitate a healing ordeal in which while painful for the couple can lead them to an opportunity for “increased knowing, acceptance, and belonging.” This involves the revelation of the infidelity in which the therapist assists the couple as the partner involved in the infidelity is led by the therapist to reveal his or her infidelity to his or her partner (Butler, 2009, pp. 130-142). Based on Bass and Quimby (2006) that will be discussed later, note that the Code of Ethics for Marriage and Family Therapy require a written permission from the individual before anything shared to the therapist in confidence by the individual is shared to another. Butler 35 al. (2009, p. 128) asserts however that more important to the healing ordeal is the basic right personal rights in a relationship to be informed on the status of one’s relationship. Thus, for Butler et al. (2008, p. 128), the benefit-cost considerations in revealing any infidelity “are superseded by basic personal rights in a relationship” to information. Further, for Butler et al. (2008, p. 128), “privacy rights of offenders are superseded when they violate their partner’s right to choose their relationships, which right depends on the possession of all relationship-relevant information.” Butler et al. (2009, p. 130) emphasized that “providing false information, denying the true conditions of the association, fabricating information, withholding essential information or even failing to provide information in a timely manner all represent behaviors that defraud the other party of their essential rights in either the execution or continuation of the business relationship.” Going further, Butler et al. (2008, p. 130) has stressed that “fraudulent failures to inform provide a basis for legal action terminating the relationship and/or claims for damages.” For Butler (2009, p. 130), “confidentiality is also based on individual rights.” Thus, they recommended that” therapists address exceptions to confidentiality prior to or no later than the initial visit and that disclosure of infidelity be included in the list of exception” (Butler, 2009, p. 131). In an earlier work, Bass and Quimby (2006) addressed the key concern confronted by Butler et al. (2010) in an entirely different way. While Butler et al. (2009) emphasized that an individual’s right to information is prior to or more important than confidentiality in cases where one or both of the partners have committed acts of infidelity, Bass and Quimby (2006) proposed that a family or marriage therapist address the issue of confidentiality through an informed consent form that provides a wider elbow room or discretion for the therapist to make a judgment on how confidentiality should be handled in a case. Essentially, this means that the therapist would be given the leeway to determine whether information on marital infidelity will be shared with the other in a partnership and in what time and manner. For Bass and Quimby (2006, p. 77), “a carefully constructed confidentiality agreement becomes essential when therapists agree to treat clients individually as well as conjointly with their spouse or significant other.” Bass and Quimby (2006, p. 77) pointed out that there are ethical pitfalls in doing conjoint or group counseling such as in a marriage or family setting. They observed that “although marital and relationship counselors encourage open and honest communication, they occasionally compromise and concede to requests from their clients to keep certain information secret” (Bass and Quimby, 2006, p. 77). Citing the works of two set of authors, Bass and Quimby (2006, p. 77) agree that this means “withholding important, sometimes critical data involving highly charged topics such as infidelity from the innocent or naive partner or spouse” Other than infidelity, the secrets in a family or among couples can involve illegal activities (Bass and Quimby, 2006, p. 78). They pointed out that the Code of Ethics for family therapists of America required that prior written permission of the individual for a therapist to reveal a person’s confidences (Bass and Quimby, 2006, p. 78). Bass and Quimby (2006, p. 78) pointed out that they do not believe that that there is one right or ethical way to handle confidentiality. More important, they stressed that it is important for therapists to act in the best interest of the clients, implying that it is sometimes in the client’s interest for a confidentiality to be upheld rather than upholding a person’s alleged right to be informed if his or her spouse’s infidelity (Bass and Quimby, 2006, p. 78). In the informed consent form they have developed to facilitate a written document that gives right to therapists to decide whether or not to reveal confidential information. For example, the consent form of Bass and Quimby emphasizes to the couple or family that a therapist can learn a secret such as infidelity and seeks the couple’s consent to be given the right to share or withhold from the couple the information he or she may acquire given that the role of the therapist is to assist the couple or family in “having the kind of relationship” that they desire. The position of Pazaratz (2006) however, stressed the ethical considerations in counseling in addressing confidentiality in counseling involving the marriage or the family or divorce. In addition to ethics, however, what is emphasized is that the therapist’s role is to promote trust, empathy, and passion among the couple and their families (Pazaratz, 2006, p. 37). Unlike Bass and Quimby (2006) and Butler et al. (2009), the emphasis of Pazaratz (2006) are on the ethical dilemmas but emphasized that “confidentiality of each individual member in a couple or family counseling must be protected” and that at the start therapists must acknowledge that information will not be disclosed without the family members’ written permission. In conclusion, it seems that it is fair to conclude that while Butler et al. (2009) made a pitch for an emphasis on the right of individuals to be informed on the status of his or her relationship given a partner that committed acts of fidelity, earlier works discussed in this write-up have emphasized the information elicited by a therapists should be shared only when there is written consent from the one who provided the information in confidence. On review, this seems to be a sound approach because otherwise we will not be able to start the ball rolling in a therapy. It is also good that a majority of the marriage and family therapists have respected the right of therapy participants to confidentiality. References Bass, B. and Quimby, J. (2006). Addressing secrets in couples counseling: An alternative approach to informed consent. The Family Journal, 14 (1), 77-80. Brock, G., and Coufal, J. (1994). A national survey of ethical practices and attitudes of marriage and family therapists. In G. Brock (ed.), American association for marriage and family therapy ethics casebook, pp. 47-48. Washington, D.C.: American Association of Marriage and Family Therapists. Butler, M., Harper, J., and Seedall, R. (2009). Facilitated disclosure versus clinical accommodation of infidelity secrets: An early pivot point in couple therapy. Journal of Marital and Family Therapy, 35 (1), 125-143. Pazaratz, D. (2006). Ethical considerations in marriage and divorce counseling. Journal for the Professional Counselor, 21 (1), 37-46. Read More