Informed Consent in Psychotherapy: A Survey of Current Practices Among Mental Health Professionals

The purpose of this study was to investigate the current use of informed consent procedures among a systematic sample of social workers and psychologists, as well as a stratified sample of mental health center directors. A brief questionnaire was constructed which listed thirteen of the informed consent issues suggested by several authors in the literature. A MANOVA and separate univariate ANOVAs were used to assess differences between individual professional and mental health center director groups. Post-hoc analyses revealed that mental health center directors reportedly address three informed consent issues to a greater extent than either individual professional group. These included informing clients regarding exceptions to confidentiality and client access to records. Mental health center directors reportedly also made greater use of consent forms than either professional group. Mental health center directors reportedly presented clients with a method of client recourse more frequently than psychologists, and also reportedly presented information regarding alternatives to psychotherapy more frequently than social workers. Social workers reportedly provided information concerning therapist qualifications more frequently than mental health center directors. Social workers more strongly expressed the attitude that informed consent should be confined to medical procedures than either mental health center directors or psychologists. Several correlates were generated for use as predictors of total scores for each of the three respondent groups (with higher scores indicating greater frequency in addressing a given issue), separate stepwise regression analyses revealed that social workers with high total scores were those who most strongly disagreed with the statement that informed consent issues should be dealt with as they arise during the course of therapy (attitudinal item 1). Social workers who reported presenting informed consent information solely in oral form had lower scores. Psychologists who most strongly disagreed on attitudinal item 1 and had behavioral orientations obtained higher total scores. No significant predictors of total scores were found for mental health center directors. Several items emerged which dealt with issues only infrequently addressed by all three groups of respondents. These included informing clients of the possible negative effects of therapist disclosures to third party payers, potential negative consequences of acknowledging participation in therapy to potential employers, and providing information about the ultimate destruction of records