Confidentiality Limits of Managed Care and Clients’ Willingness to Self-Disclose

The confidentiality of the client–therapist relationship has been seriously challenged by managed care oversight and reporting requirements. The impact of such requirements on psychotherapy clients\u27 willingness to disclose was explored. Three descriptions of confidentiality limits were presented: standard limits of therapeutic confidentiality, a rationale for client acceptance of limited confidentiality, and the typical informational requirements of managed care. Clients and potential clients showed less willingness to self-disclose under managed care conditions than standard confidentiality limits. Psychologists must increase awareness of confidentiality issues and advocate strongly for changes in managed care requirements that inhibit disclosure and interfere with psychotherapy