Add To Cart

Privacy and Confidentiality in the Therapeutic Relationship

Section 2
Code of Ethics

Question 2 | Test | Table of Contents

Read content below or listen to audio.
Left click audio track to Listen; Right click to "Save..." mp3

The correct answer is A, you may not reveal the information about Sharon's award. The NASW code of Ethics (Standard 2.02) states that you should respect confidentiality shared by colleagues in the course of their professional relationships and transactions.

Answer B, may reveal the information about Sharon's award, is incorrect because as just indicated, the NASW code of Ethics (Standard 2.02) states that you should respect confidential information shared by colleagues.

C, may reveal the information because it is favorable, is incorrect because the confidentiality of information is not limited to derogatory information. As you know, it applies to any information received from a client or colleague about a client.

D, may reveal the information, but only after contacting the client for her permission, is incorrect because neither you nor your colleague should be contacting the client about this issue. If you were to contact the client, it could damage the trusting relationship between the client and your colleague. Your colleague should not seek the client's consent because such action would involve a dual relationship. Your colleague's purpose with this client is to help her resolve her psychosocial problems and achieve her treatment goals and objectives, not to develop an agency's board of directors.

Incidentally, as you will note, the course articles contain the Confidentiality portion of the Code of Ethics from the National Association of Social Workers, American Association of Marriage and Family Therapists, National Board for Certified Counselors and the American Psychological Association. For the purposes of brevity the basis of the Case Study examples will be the National Association of Social Workers Code of Ethics. The NASW, AAMDT, NBCC and APA codes are very similar.

"Who Needs Ethics?"
This first section, Who Needs Ethics?, is based upon an article written by Anthony Weston. Why isn't it enough to follow our feelings or "fly by instinct" when we are thinking about what we should do or how we should live?

Feelings are essential, of course. A life without love, excitement, and even pain is no life at all. No livable ethic denies this, but feelings are not the whole story. They may be the beginning, but they are not the end. A certain kind of thinking must also be part of the story.

Take prejudice. To be prejudice is to have a strong negative feeling about someone who is of a different ethnicity or gender or age or social class (or . . . ) from yourself. If ethics were just a matter of feelings, then there would be nothing to say against such prejudices. It would be perfectly ethical to discriminate against people you don't like.

Instinct says yes. But ethics say no. Ethics instead may challenge these very feelings. "Prejudice" literally means "pre-judgment;" It is one way of not really paying attention. But we need to pay attention. We need to ask why we feel as we do, whether our beliefs and feelings are true or fair, how we would feel in the other person's shoes, and so on. Only by thinking these feelings through carefully can we begin to recognize their limits and then, if necessary, change them.

So ethics asks us to think carefully, even about feelings that may be very strong. Ethics asks us to live mindfully: to take some care about how we act and even about how we feel.

There is another contrast with "flying by instinct." Instincts and feelings may oversimplify complex situations. We want things to feel clear-cut even when they are not, so we may persuade ourselves that they are. Mindful thinking by contrast is more patient. Where things are really unclear, feeling may even have to wait. Premature clarity is worse than confusion. We may have to live with some questions a long time before we can decide how we ought to feel about them.

Our feelings are also easily manipulated. For instance, it is easy to be swayed either way by "loaded" language that plays upon our emotions. Define abortion as "baby killing," and you create a negative feeling that closes the case against abortion before it can even be opened. But fetuses are not babies (look the words up). On the other hand, if you guessed that it is both unintrusive and even healthy. It isn't. Either way, we are led into a prepackaged emotional commitment without ever thinking it through. Habit and conformity take over.

Mindful thinking, by contrast, is more complex and open-ended. It is in this spirit that ethics approaches controversial issues of the day, like abortion or professional ethics.

These questions cannot be intelligently answered by just consulting your feelings. There are too many different possibilities, too many different "uses," too many different opinions and prejudices (on all sides) that need to be carefully sorted out. Again, it takes some time and care, maybe even some degree of compromise.

Every ethical issue discussed in this series is an example. As you know, much more creative thinking is needed about issues in the "gray" areas than we usually suspect. But the key words are "creative thinking." Ethics invites us to explore the "gray," fuzzy edges of issues.

♦ Summary of What the Code of Ethics Contains:
(a) Respect your client's right to privacy. Do not solicit private information unless it is essential to providing services or conducting research. Once private information is shared, standards of confidentiality apply.
(b) You may disclose confidential information with a written consent from the client or other person legally authorized to consent on behalf of the client.
(c) Protect confidentiality except for compelling professional reasons such as
-to prevent serious, foreseeable, and imminent harm to a client or identifiable others
-when laws or regulations require disclosure without client consent

The three key ethical issues are the right to privacy, protecting the client or others from harm, and laws of disclosure. Let's look at privacy first.

- Barker, R. L. (1998). Milestones in the Development of Social Work and Social Welfare. Washington, DC: NASW Press.
- National Association of Social Workers. (2017). NASW Code of Ethics. Retrieved from

Peer-Reviewed Journal Article References:
American Psychological Association. (2016). Revision of Ethical Standard 3.04 of the “Ethical Principles of Psychologists and Code of Conduct” (2002, as amended 2010). American Psychologist, 71(9), 900.

Cleveland, K. C., & Quas, J. A. (2018). Parents’ understanding of the juvenile dependency system. Psychology, Public Policy, and Law, 24(4), 459–473.

Erickson Cornish, J. A., Smith, R. D., Holmberg, J. R., Dunn, T. M., & Siderius, L. L. (2019). Psychotherapists in danger: The ethics of responding to client threats, stalking, and harassment. Psychotherapy, 56(4), 441–448.

Franeta, D. (2019). Taking ethics seriously: Toward comprehensive education in ethics and human rights for psychologists. European Psychologist, 24(2), 125–135.

Sinclair, C. (2017). Ethics in psychology: Recalling the past, acknowledging the present, and looking to the future. Canadian Psychology/Psychologie canadienne, 58(1), 20–29.

You see your client, Mildred B, at the mall. You should . . .
a. say "hello" to the client and continue walking
b. say "hello" and ask how Mildred feels about this accidental meeting
c. act as if you do not see the client
d. carefully observe the client's social functioning in this community setting
To select and enter your answer go to Test.

Section 3
Table of Contents