Are psychotherapists consistent in their ethical attitude to patient confidentiality?

The issue of confidentiality often causes an ethical dilemma for the psychotherapist.

We investigated if therapists are consistent in their attitude to confidentiality or judge each case on its own merit.

A questionnaire consisting of a series of clinical vignettes representing different ethical dilemmas in confidentiality in psychotherapy was completed by 93 therapists of different professional backgrounds and by a control group of 55 students from the fields of law and the humanities.

Subjects in both groups were inconsistent in their attitude to confidentiality in two-thirds of cases, and most of the participants based their decisions on the particular history and circumstances of each case.

The rules guiding psychotherapists for the disclosure of confidential information are unclear. These findings failed to pinpoint a common denominator to explain the manner in which professionals handle information that may demand a break of confidentiality.