Introducing limits of confidentiality in real-life consultations: psychologist-driven or client-centred?

Introducing limits of confidentiality in real-life consultations: psychologist-driven or client-centred?

The Australian Psychological Society Code of Ethics explicitly states that clients are to be informed about the legal limits of confidentiality prior to engaging in any psychological relationship. Maintaining and respecting client confidentiality is also seen as a major professional obligation. Despite this, little research has examined how limits of confidentiality is introduced, discussed, and oriented to in real-life psychological consultations. An initial consultation between a client and a provisionally registered psychologist was used to explore how a psychologist and client interactively managed limits of confidentiality. Using a discursive psychological framework, analysis revealed that while the psychologist complied with the ethical obligation of informing the client of the limits of confidentially before counselling began, the way in which the psychologist enacted this restricted the client's opportunities to ask questions or seek clarification about these limits. Further, when the psychologist explicitly asked for client confirmation of understanding and acceptance of these limits, what the client confirmed and accepted appears unclear. Given that breaches of confidentiality are Registration Board matters, this lack of clarity and limiting of client interaction is concerning.

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