The Adult Client\u27s Conception of Confidentiality in the Therapeutic Relationship

The adult client\u27s conception of confidentiality in the therapeutic relationship and the valuing of this confidentiality was examined and defined in this paper. The importance of confidentiality and its effect on the therapeutic process was explored. Many professionals in the field of mental health believe that confidentiality is a critical factor in the successful outcome of therapy (Hayt, 1977; Lowenthal, 1968; Reynolds, 1976; Tancredi & Slady, 1975). It is viewed that confidentiality is expected by clients when entering into a therapeutic relationship, and is essential in the therapeutic process. The variables that may affect the client\u27s conception of, attitudes toward, and valuing of confidentiality were examined and reported (i.e., age, sex, annual income, treatment modality inpatient vs. outpatient). One of the main purposes of this paper was to develop and accurately assess how important confidentiality is to the client undergoing mental health treatment. It was proposed that data for 76 persons undergoing either inpatient or outpatient mental health treatment would be obtained at a local mental health center with both inpatient and outpatient mental health services available. An additional 50 subjects (employees of the hospital) were utilized as a control group. All 126 of the subjects completed a 20-item survey which assessed general attitudes toward casehandling issues, privileged communication, and past experience of perceived violations of confidentiality in a therapeutic relationship. Questions 19 and 20 were deleted for the control group. The subjects ranged in age from eighteen to seventy. It was expected that the subjects of the treatment groups would value confidentiality highly and support the hypothesis that confidentiality is a crucial issue in psychotherapy. The results of the research support the hypothesis that clients undergoing mental health treatment do, in fact, highly value confidentiality. Also, differences do exist between sample groups, the inpatient group valuing confidentiality more highly than either the outpatient sample or the control sample, respectively. Casehandling issues (i.e., secretarial typing of reports, taking of sessions) is of no concern to clients. Most clients also believer their communications in a therapy session are protected legally. Finally, most clients have not perceived a violation of confidentiality in a past or current therapeutic relationship