Confidentiality is a sensitive issue commonly addressed in terms of the provision of health care. This aspect is specifically relevant in addiction counseling that is associated with sensitive information and the need to solve ethical dilemmas. On the one hand, the counselor is obliged to act in the best interest of the client, but, on the other hand, it is critical to ensure the clients’ and other people’s safety and wellbeing (Davenport, 2017). Diverse guidelines and regulations have been developed to guide counselors in making decisions linked to confidentiality. These guidelines have proven their effectiveness, so they should be further elaborated on and widely utilized by professionals.
One of the pillars of effective counseling is trust, and the counselor’s ability to establish trusting relationships defines treatment outcomes. Patients should be confident that they are safe and can share anything with their counselor. At the same time, counselors have to balance this client’s need and their safety, as well as the safety of others. Addicted people may cause harm to themselves or pose a threat to others (Davenport, 2017). The chances of such adverse outcomes increase during the client’s intoxication. Therefore, a common practice during addiction counseling is to establish certain limits of confidentiality. The client provides their written consent where specific cases when disclosure is possible or necessary are described (Davenport, 2017). The counselor should explain the benefits of such an agreement so that the client could provide their consent and remain open during sessions.
The confidentiality issue is particularly relevant in adolescent treatment. When treating adolescents with addiction, counselors have to estimate the risks linked to their clients’ mental state and inform their parents or authorized third parties about potential issues (Vallance, 2016). According to the United Nations Convention on the Rights of the Child (UNCRC), children’s best interest should be the highest priority, although what this best interest actually is can be quite ambiguous (Vallance, 2016). However, even though this ambiguity makes it hard to implement treatment in many cases, it is quite straightforward in various instances, such as a direct threat to the health or life of a person or similar risks. American Psychological Association’s Code of Conduct (and other regulations) is another helpful guideline that can inform counselors’ decisions (Davenport, 2017). As mentioned above, these guidelines are not void of a certain degree of ambiguity, so it is necessary to eliminate or minimize it gradually. Clearly, information disclosure is the last resort, but this option should remain available for counselors. At that, practitioners and researchers should continue developing new guidelines that can be specifically helpful for new counselors.
On balance, confidentiality in addiction counseling is one of the burning issues that have to be addressed. Clients’ right to confidentiality is the highest priority, but it can be breached to avoid potential harm to the client or other people. People with addictions may engage in high-risk behaviors, especially during their intoxication, and such cases can often be prevented effectively if certain information is disclosed in a timely manner. Written consent is one of the tools that can help in establishing trusting relationships between the counselor and the client. Practitioners can also be guided by diverse regulations when making decisions linked to confidentiality. Although these rules and protocols are characterized by a certain degree of ambiguity, they are still instrumental in addressing a wide range of situations. Clearly, further improvement and development of such guidelines is necessary.
Davenport, R. G. (2017). The integration of health and counseling services on college campuses: Is there a risk in maintaining student patients’ privacy? Journal of College Student Psychotherapy, 31(4), 268-280. Web.
Vallance, A. K. (2016). ‘Shhh! Please don’t tell…’ Confidentiality in child and adolescent mental health. Bjpsych Advances, 22(1), 25-35. Web.