7.8 Limitations to Confidentiality
Exceptions exist for every rule, including client confidentiality and relevant codes below. When confidentiality is breached, it is done to support human safety. More specifically, confidentiality is typically broken for one of the following (or both) purposes:
- The first is based on a subset of rules that govern when a counselor must release confidential information without client consent. This includes abuse of minors and vulnerable adults, protecting potential third parties from threatened or suspected harm, protecting clients from threatened or suspected suicidal actions, and defending oneself from violent behavior from a client.
- The second is based on a subset of rules regarding the formation obtained in counseling (i.e., verbal or written) in a legal context. This is discussed further in section 7.11.
The ACA (2014) discusses this in its ethical code:
“The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identifiable others from serious and foreseeable harm or when legal requirements demand that confidential information be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues” (Standard B.2.a.).
Similarly, NAADAC (2021) highlights limits of confidentiality:
“Addiction professionals, during informed consent, shall disclose the legal and ethical limits of confidentiality and shall disclose the legal exceptions to confidentiality. Confidentiality and limitations to confidentiality shall be reviewed as needed during the counseling relationship. Providers shall review with each client all circumstances where confidential information may be requested and where disclosure of confidential information may be legally required” (Standard II-7).
Because counselors value confidentiality and safety, they engage in careful ethical decision-making consultation and supervision to conclude that they must break it. Federal and state statutes confer confidentiality practices in counseling. Statutes, in general, have determined that protecting the well-being and safety of vulnerable populations in society, minors, and vulnerable adults due to their lack of rights and decision-making capacities, is more critical than protecting confidentiality. If they are actively or at risk of being abused (verbally, emotionally, physically), counselors must report this to relevant county agencies. Specifics are outlined in sections 7.9 and 7.10.
Key Takeaways
- Confidentiality may be breached to prioritize human safety, including situations involving abuse, harm to others, or suicidal threats.
- Exceptions to confidentiality include mandatory reporting of abuse, protecting third parties from harm, and legal requirements related to counseling information.
- Ethical codes (ACA and NAADAC) emphasize the importance of informing clients about the limits of confidentiality during the informed consent process.
- Counselors must engage in careful ethical decision-making, consultation, and supervision when deciding to breach confidentiality.
- Federal and state statutes prioritize protecting minors and vulnerable adults over maintaining confidentiality to safeguard their well-being.