Client confidentiality in a nutshell
All counselling is confidential subject to the constraints of English law and ethical practice. Your counsellor has a legal duty to report anything to do with terrorism or acts of terror.
If you were to disclose matters involving a serious/life-threatening risk of harm to self or others, they might have to act on it. If something like that came up, they would talk with you about it. Where possible, we would not break confidence without your prior knowledge and, ideally, consent.
We do not tell your GP or anyone else that you are coming to counselling unless you ask us to. So, attending private counselling would not go on your medical records. Occasionally clients ask us to make a GP referral or write a letter to give to their GP. We would discuss and agree on the contents of the referral letter with you before sending it.
Couples and family groups
If you are coming as a couple or family group, there are occasions we might see you as individuals, too; for example, as part of the assessment process.
Almost anything said in the one-to-one session stays confidential between us. Some things, however, are too big to contain without damaging the couple/family work. An example might be a current affair unknown to your partner. If something like that came up, you would need to bring it up in the larger group, or we could continue to work together.
We can only work with younger children with parental consent. Having a safe space is a vital part of counselling so we would discuss nothing a child says with their parents (unless the child was at risk).
Older children might self-refer, depending on age and understanding. We would give them exactly the same level of confidentiality afforded to an adult client.
Counselling is confidential, even if a third-party (such as an employer or family member) is paying for it. So, you have the same rights to confidentiality, whoever foots the bill.
We have to share some information to get paid. Typically, this is a confirmation of your attendance and participation (or otherwise). We are sometimes required to complete a discharge summary. If that is the case, we would tell you at the beginning of therapy. We would discuss the report with you and agree on the content.
All professional bodies in the UK require counsellors to have regular clinical supervision. Your counsellor might discuss their work with you in supervision, without breaking confidentiality. They would not identify you to their supervisors.
Abuse and risk of harm
At present, there is no legal duty on counsellors in independent practice to disclose any form of abuse, even child abuse. However, we do have an ethical and moral responsibility for your wellbeing and the wellbeing of others.
If we felt that you or someone you told us about was at imminent risk of serious harm, we might have to act on that. Should something like this come about, your counsellor would discuss it with you so you could agree on a way forwards. Only in the most exceptional circumstances would we make a report without your prior knowledge and consent. We would much prefer to empower you to make the report yourself, even if that takes a little longer.
Self-harm and suicidal ideation
We do not report self-harm (including drug use and eating disorders) or suicidal ideation, except in the most extreme situations. For example, if you said you would leave and jump under a train. We would much prefer to work with you, helping you to find more helpful coping strategies.
Track and Trace
If, as a result of developing COVID-19, we are required to give details of those we have been in contact with, we might have to pass on your contact details. In such event, we would give the minimum required information and would not identify you as a client.
There are some things we have an absolute legal duty to disclose. For example, if you were to disclose anything to do with terrorism or acts of terror, we have a legal obligation to report this.
If we receive a court order or coroner’s request, we have to comply. We would not release your notes without such order, or your written consent.
The rules and guidance around client confidentiality are complex and developing. If you have questions regarding client confidentiality, please complete the contact form, call us on 0151 329 3637, or email firstname.lastname@example.org. We would be very happy to take your call.
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