This document supplements the Disclosure Agreement that has been provided to you and describes my policies on confidentiality when I am seeing a couple in therapy. In my experience, it is best when these issues are talked about and understood from the start of treatment. In most cases of therapy with more than one client, I will also meet at least once with each person individually after treatment has begun.
The guidelines I have outlined below constitute my preferred approach to couples counseling, for the reasons I list. However, I will discuss these parameters with the couple at the outset of the counseling relationship, and if all parties, (both partners and myself) would like to adjust the expectations and limits of confidentiality between the partners, that can be done by agreement. Any changes that are made by agreement will be documented.
In individual adult therapy, any information obtained from a client is confidential and cannot be shared with anyone without the specific consent or authorization of that client, or except as provided by law. However, in couples therapy, a couples therapist may meet individually with one partner, and then be influenced by this individual contact when meeting with the other partner. There are also many instances when it is therapeutically important for a therapist to use knowledge gained from individual sessions with the other partner. An example is when a therapist makes a statement such as: “When I speak to your wife/partner, I get the impression that she is interested in making your relationship better for both of you”. Therefore, in this way a couples therapist cannot promise complete confidentiality to each individual in joint therapy.
On the other hand, individuals may have some feelings, thoughts or actions that they would like to keep confidential. While I do not think it is therapeutically appropriate, nor will I make a blanket promise to keep secrets learned from one partner from the other partner, I believe in respecting these confidences or sensitive topics if possible. Therefore, any information provided to me, regardless of whether the partner/spouse was present, may be either withheld or disclosed to the other party at my discretion. Additionally, both parties must understand and agree that in order to keep proper records, I may make written record of any information provided by either party or any observation made of either party’s behavior.
Sometimes an individual client wants me to keep a confidence that places me in a position of behaving dishonestly. An example of this kind of situation would be a husband who tells me in private about plans to leave his wife or to continue an affair but wants to continue the couple’s therapy as if he planned to stay in the marriage and was being honest. I would work with him to communicate the truth to his wife, but we could not continue therapy if he expected me to deceive her. The time frame for maintaining confidentiality in this work is at my discretion.
There are exceptions to confidentiality. For example, the law allows me to report the direct suspected physical and sexual abuse of children or other legally protected vulnerable persons to the Department of Health and Human Services and also to take whatever steps are necessary to prevent someone from being a physical danger to himself/herself or others. Please also see the Notice and Agreement forms you have been given for any other allowed or required disclosures of information.
To summarize, my rules for confidentiality in couples or family therapy are as follows:
- I will maintain the same standards of confidentiality and privacy as in individual therapy when I contact anyone outside the relationship.
- I am willing to keep confidences from other partner as long as they do not conflict with the law, do not place me in a position of being deceitful with the other partner, and are not therapeutically inappropriate to withhold from the other partner. It must also be understood that due to the nature of the dual therapeutic relationship, I cannot guarantee the maintenance of confidences between partners. There are also occasions when I may advise the disclosing partner that a confidence needs to be revealed to the other partner, and I may set a timeframe for that to occur. I cannot guarantee that others will always agree with my choices.
- In addition, I would like to explain that my commitment is to the well-being of all individuals in a relationship. When both partners wish to work on their relationship, we will make a commitment to the relationship as long as it is the choice of both partners. It is my position that only the partners can make the decision about keeping a relationship together or separating, and realistically, divorce or separation may be a possibility. I must also be free to discuss the possibility of divorce or separation with either partner when I believe that this discussion is therapeutically appropriate or necessary.
- In regard to the Clinical Record involving a couple, it is important to know that either member of the couple who attended a joint, or individual session(s), may have access to a complete copy of the file, under the circumstances described in the Agreement. That means that in my chart notes, information about each person involved in the therapy may be available to the other(s) without further consent. In making this agreement, it is recognized that either party might further disclose information obtained from this file and I have no control over such re- release of information. If an “outside” third party wishes to access the file, signatures of both partners/clients will be required in order to release the requested information. Certain exceptions to these confidentiality rules and access provisions may be required by law.
- All parties agree to be jointly liable for any payment responsibilities, regardless of whether insurance or other arrangement is expected to pay some or all of my fee.