Introduction
No profession operates without codes of conduct. It is from these codes that practitioners derive their extends and frames within which their decisions are made. It also grew up as a result of the efforts to standardize the service industry. It was also encouraged by the obligation and awareness stipulated by the privacy legislation. The main reason for the development of the codes could be attributed to the need to come up with a form of protection that would govern both the practitioner and the client. Accordingly, the counseling profession is also regulated by codes of conduct which are not only expected by the society but are strict regulations of which every practitioner must obey. However, these conducts have been marred by ethical conflicts that eventually leave the practitioner in a tight situation during decision making. As a result, this paper will identify confidentiality as a specification within the code of ethics for psychologists. This will be achieved by identifying the codes as stipulated by the American Psychological Association, the American Counseling Association and the SC Codes of conduct. The paper shall then wind up by giving a scenario of the case before summing up with a conclusion.
Geldard and Geldard (1998) underscored the importance of confidentiality in the counseling profession. In their argument, the client’s feeling of security is a determining factor in an effective counseling. This can be achieved when the client feels confident that whatever shall be revealed to the counselor will remain confidential. With the guarantee of confidentiality, the client is able to explore the darkest part of his world and open it to the counselor. In addition, they would feel free to share the most intimate parts of their thoughts.
Definition
Before embarking on any counseling instance, the practitioner must ensure that he discusses with his client the issue of confidentiality. This is among the most essential parts of relationship established between the two. The client must be assured of the confidentiality of everything that is to be discussed between the two. What therefore is confidentiality and how does it apply to the counseling profession and to the marriage counselor to be precise? There are several definitions and stipulations of confidentiality as offered by the different organizations that engage in the regulation of the profession. Among these organizations is American Psychological Association (APA, 2002).
Within the framework of APA (2002), confidentiality is part and parcel of the counseling profession. In its code of ethics, they explain that:
Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationships.
To attain this, several specifications have been put forward. Firstly, before embarking on any serious counseling activities, the counselor must notify the client, be it a person or an organization, of the confidentiality limits through which they will operate. In addition, the counselor must clearly specify the uses of the information that will be gathered during the counseling activity within the foreseeable future. The codes specify that the confidentiality discussions will be held prior to the onset of the counseling activities unless indicated otherwise. If the counseling is to be carried out online, the counselor must be sure to inform his client of the implications concerning his confidentiality online. The codes further stipulate that all forms of recording be it of image or sound must be done after the permission from the individual or his representatives who are legally recognized. The counselor is supposed to minimize as possible all forms of intrusions to private life of the client. All information to be recorded must be relevant to the intention of the communication. After obtaining information from the client, it should be used exactly for the scientific or professional purposes. If it must be revealed to a third party, he must be a person that is concerned with the information (APA, 2002).
However, there are occasions when the information must or could be revealed. This is referred to as disclosure. In this case, a counselor is allowed to disclose confidential information if he has the consent of the client or his legal representative. This is so except in the case where it has been prohibited by law. Without the consent of the client, a counselor can reveal confidential information if required by the law or if given permission by the law. The law permits the counselor to reveal information under such circumstances where the information is essential for appropriate services to be offered, if the revealing of information will act to protect possible harm for the counselor, the patient or any other person and finally if the information is necessary for payment for services (APA, 2002).
During consultations, a counselor is prohibited from giving details that would identify the client to third parties that have a close relationship. This remains stipulated unless the counselor is able to put in enough information to disguise the client, has written consent from his client or there is legally required to do so by the law. All these stipulations must be adhered to by any practitioner working under the codes of ethics as stipulated by the American Psychological Association. Failure to respect this means a breach of the professional ethical codes (APA, 2002).
The ACA Codes
Apart from the APA, the American Counseling Association also has its ethical codes that formulate the ethical conduct for practitioners within the profession. Confidentiality is also a very important issue under these codes of conduct for counselors. In the ACA, counselors must respect the privacy of their clients. This can only be achieved through avoidance of information disclosure under circumstances that are illegal or unwarranted. Just like the APA codes, the ACA codes also provide exceptions or instances where the counselor may be required to disclose private information of the client (ACA, 1995).
The first instance where the counselor is supposed to disclose confidential information is where the revelation is deemed important and essential for the safety of the individual, the counselor or any other person. In addition, the information could be revealed if required by the law. In the case of a client having a fatal disease that is at the same time communicable, the counselor is allowed to disclose the information to the person whose relationship with the client puts him in a position to contract the disease. Before taking this step, the counselor should be sure that the client had not and was not intending to reveal this to the third party in the near future. In a case where the court has ordered a disclosure, the counselor can request for a withdrawal of the request if the disclosure of the information might be detrimental to the well-being of the client or to the relationship between the client and the counselor (ACA, 1995).
When a disclosure is required, the codes stipulate that the information disclosed must be as minimal as possible. Only very relevant information should be revealed. In addition, the client must be notified before the information is disclosed. The codes further stipulate that a client should be continually informed of any probable changes in the near future where confidentiality is likely to be breached. Finally, the client should be informed of all the teams that will be involved in the counseling process and the compositions of each team. In family counseling, the information offered by one member cannot be disclosed to other members of the family unless consent has been given to the member. In the case where the client is a minor or any other person who cannot make individual decisions, or is unable to give informed consent that is voluntary, the parent or guardian is allowed to take part in the counseling process only where appropriate (ACA, 1995).
In terms of recording, the counselor is obliged to safely keep the records created during the counseling process. It involves keeping the records, transferring them or destroying them. In addition to this, prior notice to the client is required before any process of recording. The ACA codes stipulate that a client is free to access his records because the records are there for the client’s good. However, access to the records could be denied if they contain information that would be destructive to the client or misleading. In the case where the clients are multiple, a member will be accessible to information that is general. He will be able to view the information of the other members of the group that is not confidential. For the information to be disclosed to third parties, there has to be a written consent from the client (ACA, 1995).
In case of a need to use the data collected during the counseling process for training, research or publication, the information used should be that which does not reveal identity of the client. For a publication, the identity can be revealed if the client has the understanding of the content of the publication and gives the warrant to disclose the information. Finally, the ACA codes eventually purport that information offered during a consultation should be completely used in only professional duty. These are the codes that regulate the ethical aspects of counselors that operate under this umbrella (ACA, 1995).
The SC Codes
The SC Codes, just like the other codes, also advocates for confidentiality of the information offered by the client. The information has to be handled with utmost confidentiality. Equally, the codes also provide for exceptions where disclosures could be allowed. In the SC Codes, disclosure of the information can be allowed if the disclosure could serve as a salvation from danger likely to affect the client or any other person. Furthermore, the codes obligate the counselor in the effort of record-keeping in whatever format provided it was gathered during the counseling process. All interviews, recordings, test data, electronic data, correspondence and any other form of records must be kept confidential by the counselor (SC Codes, 2009).
The codes further enforce the security of the information by advocating for the security of all the electronic data. Other stored data has to be only necessary for the expected service and only the professionals that are to offer the service should be accessible to the information. Whenever the information ceases to be of value and when it is not needed anymore, the counselor must ensure that the information is destroyed completely. Like the other codes, the SC Codes also allow for use of the information in research, training and education. Equally, the information must be used in such a way that should not reveal the identity of the client. Data that contains information that cannot be concealed can only be disclosed under the direct consent of the client or his legal representative (SC Codes, 2009).
Vignette
In an instance in the South Carolina, a TV station had shown its interest in video record the progress of a psychological treatment being carried out in a correctional institution by a psychologist for research purposes. As part of the agreement, the TV station offers to ensure confidentiality by obscuring the faces of the clients through distortion. While the psychologist deems this unethical, her university was encouraging her to accept the offer so that she could gain popularity after her psychological treatment was aired on air. This issue remains a controversial issue in the ethical realm. While some might see it as a breach of the ethical codes, others would see it as a well-indented activity without any breach of ethical codes. In case the doctor had to go ahead and allow for the recordings by the TV station, an ethical issue again arises. Who among the role players in this case had to be consulted for consent? Was it to come from the client, was it to be attained from the correctional institution’s senior staff, was it to be attained from the fellow researchers or from the University’s ethics department? (PRBN, 2000)
These are some of the instances that face psychologists each passing day. They are usually forced to come up with a decision that seems unethical from one side while the other side finds the decision completely ethical. This leaves the psychologist in a dilemma. As for the case shown above, the psychologist could remain at a standstill not knowing whether to accept the airing of the treatment process or deny the TV station the rights to air the process. But what are the stipulations of the codes? What do the codes stipulate concerning correctional psychology? (PRBN, 2000)
Just like any other field of psychology, correctional psychology has its stipulations that must be observed by the practitioner. Accordingly, the field is marked by ethical dilemmas like the one mentioned above about confidentiality. According to Decaire (2000), the primary objective of correctional psychology is to, “…assist in offender rehabilitation and reintegration.” It is also the role of the psychology to ensure that safety of the inmates and the staff are ensured through formation of the institutional environment that is healthy. These specified roles of the psychologist concerning the branch of psychology have thus resulted in several unique dilemmas.
The involvement of the criminal justice system within this field of psychology brings with it unique challenges. This causes the involvement of the court from the word goes to the end of the case. While the other cases would allow for disclosure under special circumstances, the data in correctional institutions are always available for third parties. As a result, the confidentiality of such a counseling session is completely questionable. As mentioned earlier, this causes a great limitation in the chances of the client opening up and giving the intimate information and most secret episodes of his life. In addition, the client would feel that the information might be used against him. This will lead him to give inaccurate information so that he salvages himself from being judged from his thoughts as opened to the psychologist (Stone, 1984). This leads to a great drawback in the therapeutic intervention in the correctional departments. It also leads to the clients receiving the wrong treatment.
How does this apply to the case mentioned above? In this case, the TV station has shown its interest in recording and airing the proceedings in the psychological activities within the correctional institution. The psychologist’s decision will carry great a weight with it. By allowing the TV station to go ahead and air the proceedings, the information of the client will be being provided to the open scrutiny of the public. As specified by the codes of ethics, the intended use of information in the foreseeable future must be communicated to the client before the process of counseling is embarked on. This means that the client will be informed that whatever they were going to discuss would be used not only for his treatment but also for research purposes and finally for public viewing. With the knowledge of this, the client will most likely not open up to the psychologist. He will not offer deep-seated secrets because of the public nature of the use of his information. In addition, the client is very likely to deviate from the truth because he fears being judged from the same.
From this point of view, it is responsible that the psychologist denies the TV station the rights to record the process. This will be in accord with the specifications of Geldard and Geldard who pointed out that without confidentiality, the effectiveness of the counseling process will be tempered. They argue that confidentiality is the determining factor in an effective process of counseling. While ethically this could not be restricted because in correctional psychology, the client does not offer consent, the primary objective of the process will be lost. Nothing constructive would be achieved through false information or parts that would be offered by the client when he finds out that his information is going to be made public. While the University would push her to allow the TV station to record and air the process for the sake of her popularity, she could fail to gain popularity when the results fail to provide any fruits. She would not be popular, instead, she would be deemed as a failure by the public.
Conclusion
As clearly viewed from the information above, it is clear that codes of ethics are very essential for the regulation of the relationship between the counselor and the client. Confidentiality, which is one stipulation found in all the codes of conduct for psychologists is found to be very essential because it is what determines the effectiveness of the counseling activity. All of the codes of conduct however point out the exceptions by which confidentiality might be breached. This comes in terms of requirement by the law, safety of the client and other people, consent from the client and the legal representative, training and research and finally for consultations. However, the information offered must be as minimal as possible.
While this is inevitable, there arise chances of ethical dilemmas. Each branch of psychology identifies with its own unique ethical dilemmas. Whatever the case, a decision has to be made. As a result, the practitioner has to consider all facets of the dilemma and come up with one decision that will be par with the primary objective. Decisions that would deviate from the primary objective should therefore be avoided. This would not only contribute to positive results but also will improve the image of the profession.
References
- American Psychologists Association. (2002). “Ethical Principles of Psychologists and Code of Conduct.”
- American Counselor’s Association. (1995). “ACA Code of ethics and Standards of Practice.”
- Decaire, M. (2000). Ethical concerns in correctional psychology. Lakehead University.
- Geldard. D. & Geldard K., 1998. Basic Personal Counselling, 4th edition, Frenchs Forest: Prentice Hall.
- Psychologists Registration Board of New South Wales. (2000). “Ethics: Vignettes.”
- South Carolina Department of Labour, Lincencing and Regulation. (2009). “Codes of ethics.”
- Stone, A. A. (1984). Law, Psychiatry, and Morality. Washington, DC: American Psychiatric Press, Inc