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Counselling Ethics FAQ

Will my Counselling be Confidential?

I abide by and adhere to the British Association of Counsellors and Psychotherapy’s Ethical Framework.

As part of that framework, I practice confidentiality with all of my clinical work.  This means that you can speak with me knowing that your friends, your family, your work colleagues and so on will not get to learn what you have said in a counselling session – and neither will my friends, family, work colleagues and so on.

But … what confidentiality also means is that I will discuss your case with a strictly limited number of other professionals for sound ethical reasons.  All clients and patients of therapists should be made aware of this (as you will be during our initial meeting), but unfortunately this is not the case with some other professional therapists.  I make it a particular point to discuss what confidentiality means – and what are its boundaries – with all of my clients at the start of counselling.  During our initial meeting I will also give you a printed copy of our counselling agreement.  After all, there’s a lot to remember during our first sessions.

Because confidentiality is not just about not talking about our therapy work, our written agreement explains what confidentiality means.

For example, in addition to the ‘not discussing what we say in the room’ part of confidentiality, I will have made you aware that:

  • I meet with my choice of clinical supervisor one a month to discuss my cases and my work.
  • During my yearly quota of continued professional development (eg training courses), I may refer to certain casework in order to review of reflect upon the case  (you details will be anonymised, meaning I won’t use your name nor other identifying information).
  • UK law may require of me to break our confidentiality if I learn of something that is unlawful.

The rest of this article expands upon these matters.

Confidentiality & Supervision.

As a private practising therapist who is a member of – and accredited by – the British Association for Counselling & Psychotherapy, I meet with a qualified supervising counsellor once a month for a minimum of 90 minutes. This is to discuss my practice and my case load and to check that I’m working to my best, keeping with ethical principals, and dealing with dilemmas that come up in most every case.

I will, from time to time discuss your case and our work together with my supervisor – but I will have first made sure that my supervisor does not know you, or is likely to come in contact with you (say, for example, though the workplace).  I will refer to you only by your first name (or another name if you prefer).  If I cannot assure your confidentiality in this manner – for example if my supervisor knows you in the work place or socially – then I will seek supervision from another supervisor for the duration of our work together.

Confidentiality & Continued Professional Development (CPD).

In seeking additional knowledge to keep me up to date with therapeutic thinking, it is sometimes useful to refer to an aspect of a case whilst attending a training course.  If, when we discuss our agreement, you request that I do not refer to you during my CPD then I will respect this.  Even so, it’s rare to-the-point-of-never-happens nowadays for me to bring up casework willy nilly, and I make sure that anything I discuss within the confines of other therapists in the context of CPD still keeps your identity anonymous and our casework vague enough to never identify you.

Confidentiality & UK Law.

Confidentiality sometimes has to be broken if I am required to do so by law (for example if you disclose to me your intent of harming yourself or others (including children) or if you disclose intent of committing a serious criminal offence or terrorism).  This may also apply if I learn of someone else who may be being harmed or in danger, or is planning to harm others.

This does not mean that I will go running to the police the moment that I hear about something illegal, but it is part of my ethical commitments to you to inform you that the law may not protect your confidentiality.

I will intend to discuss with you of my (admittedly very rare) intent to break confidentiality of our work before I do so, but you need to be aware that the law may require that I take action first and without your consent or knowledge.

Declining your request to break confidentiality.

I have been discussing where confidentiality is maintained but expanded in the form of supervision and CPD, and have discussed UK Law where I may not be able to keep knowledge confidential.

There is another aspect: your request to reveal information about our counselling work.

Confidentiality is very important – even to ensure it is not broken in situations where you request it (for example, giving your permission to a solicitor to request that I give a report about our case work).

If we are still working together it is best for us to have a sufficiently detailed discussion of the consequences of such events before I decide how I will respond – and I will not automatically respond with a ‘yes’.  What has been, up until this moment, vital to protect needs a serious conversation about why this need has now changed.

Should our counselling work have been completed, and we are no longer in contact, if I receive a request to reveal the contents of our counselling work with a third party… even having received your permission (eg written) to do so … I may decline [if I am unable to discuss the request and its consequences with you directly].

Confidentiality – In conclusion.

Counselling is not to be taken lightly – neither by therapist nor clients.  Clinical work such as counselling and psychotherapy requires ethics, respect and the highest form of protecting both the therapist and the client’s right to feel safe during the work.

I take a particularly thoughtful approach to protecting confidentiality – and this may surprise a number of clients who may assume that (a) nothing is ever revealed about the case to anyone … or conversely (b) I will summarise our casework to anyone when the client wants me to.

Confidentiality is vital.

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FAQ

Don’t I have to be mental to go to a counsellor?

Answer: no.

This article is talking about counselling for mental illness… in fact, a counsellor may not be able to work with you if you are mentally ill.

Counselling and psychotherapy are not psychiatry.  They are a valuable form of psychological support that can assist you in unravelling problems (sometimes emotional, sometimes cognitive) but only if you are able to participate in the process too.

If you are diagnosed with a mental illness, then counselling may be contraindicated – and certainly counselling won’t be as effective if you were not able to engage in the process with a good (or at least a reasonable) sound sense of yourself and a stable-enough mental health.

Beginning Counselling.

All counselling begins with an assessment.  This is not a mental diagnosis because counsellors are not qualified to make such diagnoses.  Instead, we are making sure (as much as we are able because we are human and don’t have foresight!) that you are able to engage well enough with the counselling processes, and with us as your counsellor. 

Counsellors won’t announce that you have an undiagnosed mental illness during the assessment.  Apart from anything, counsellors are not qualified to make diagnoses of mental health – although we have experience and training in being aware if there is something amiss in a person’s mental health (which may help us judge if we are the right sort of therapy for an individual, or might help us to help a client find the right sort of therapy).

Counselling and maintaining mental well-being.

If we do become concerned for your mental well-being, we have resources (such as our supervision and access to psychiatric support where needed) that we can consult.  This is to make sure that we have your best mental health in hand.

If we are concerned for your mental health it may be ethical to bring this matter up with you (it’s not likely we will go behind your back to your GP or other mental-health processional).

All in all it’s not very often that a person coming to counselling will cause us to seek such advice, but we are prepared if this might be the case.  At least … counsellors should be so prepared.

Psychiatry & mental illness.

Mental illnesses are diagnosed by psychiatrists.  A psychiatrist would fully assess someone in person (ie face to face), taking a history of the person’s mental behaviour & capacity from the person themselves and also from as many other sources as possible.  More than one problem can be identified during diagnosis.

Once there is a diagnosis a full treatment plan can be put in place, requiring the psychiatrist to consider medical, social and psychological (eg counselling) treatments available.

Whilst a counsellor/psychotherapist may be aware of a person’s mental illness, they are not in a position to diagnose.  An ethical counsellor’s approach would be to discuss their concerns with their supervisior and other psychological resources before deciding whether or not to discuss with you their observations and their advice about seeing your GP.  Think of this like having a potential problem highlighted for you, and the choice to take the matter any further remains yours.

Talk with a Counsellor.

If you’re thinking about counselling and that it might help you, but you’re afraid that you might be seen by others (or, indeed, the therapist) as having a mental illness, be assured that this is most likely not the case … irrational fears are certainly very powerful, but we can deal with stuff like that in counselling.

Talk it through with the counsellor.  You may be relieved.

Categories
FAQ LGBT LGBT

Counselling for Closet Gay People

Whilst my whole website discusses confidentiality, sexuality, gender and my therapeutic practice, it would not go amiss for me to produce at least a brief post that combines all of these counselling features into providing a safe containment for one particular area of society in which I specialise as a therapist: closet gay & lesbian individuals & couples.

Website Search – close, but no cigar.

Someone arrived on this website having searched for ‘counselling for closet gay’.  In response to the query, Google sent the visitor to my search page.  My search software dutifully produced a list of pages that were mostly about counselling, some about LGBT couple therapy, some about me, but none that expressly spoke about counselling for the closet individual.

Notwithstanding I’m taking a look at my search producing software, it was very clear that the visitor had not been presented with anything about what they were looking for from my website, and they went away.

Quite rightly.

But mistakenly so.

Counselling for LGBT People.

As male counsellor who specialises in offering counselling for the specific needs of lesbian and gay individuals & LGBT couples, it would seem to me that the whole of my therapy service would cater well for those people who are not ‘out’:

Yet, perhaps, my counselling information is (unintentionally) aimed at those LGBT people who are already out and leading happy and successful lives, regardless of their sexuality, but who sometimes wishes to meet with an LGBT counselling to work through some issues.

Being in, and coming out of, ‘the closet’.

The term being in the ‘closet’ means that a person’s sexuality or gender-identification is something other than what appears to the public, but that the person has not yet made a public declaration.  The term goes hand in hand with the phrase ‘out’ or ‘outing’ meaning that when a person becomes known for their homo or bi sexuality, or desire for a change in gender, they have come out of the closet, or they have been “outed” by a third party.

It’s perhaps interesting that it is sexual minorities that have to go through this process, as it is perhaps assumed that a person is heterosexual, gender-phoric (as opposed to dysphoric) or cis-gender until other facts are known.

It’s perhaps also interesting that as more people – particularly role (or pseudo-role) models – announce their sexuality or gender-reassignment (or gender ambivalence as not transgender people feel the need to make a full transition from one gender to another) – the process of coming out of the closet (outing ones self) is becoming easier and more socially acceptable (Seidman, Meeks, and Traschen (1999) argue that “the closet” may be becoming an antiquated metaphor in the lives of modern day Americans).

Nevertheless, society still assumes one is a heterosexual cis-gendered person until one corrects the notion.

Not everyone wants to be ‘out’.

It would not be surprising that some people would benefit from discussing their sexuality with a helpful & friendly professional, someone with whom they might feel safe, in order to find support before they go through a (sometimes) traumatic process as outing themselves.

It is not the counsellor’s position to encourage self-outing (or maintaining self-closeting) as the decision for action is down the client, with the counselling processing being available to assist the client on reflection: pros, cons, effects, affects.  LGBT counselling is not a solution of itself but a helpful tool.

In closing, I hope this brief post goes some way to correct, clarify and reconcile my services into a clearer statement of some of the kinds of counselling services that I offer.

Other sites of interest: Counselling via Skype, Online Zoom Counselling, Havant Counselling & Online Counselling for LGBTQ+ Partners.