Useful Book About Confidentiality



Fisher, M. A., (2016). Confidentiality Limits in Psychotherapy: Ethics Checklists for Mental Health Professionals. Washington, DC: American Psychological Association.

The American Psychological Association recently published a useful book outlining essential elements relating to confidentiality. The book is relatively inexpensive ($12.94 including shipping) and is available directly from APA and, of course, from Amazon. It is rather specialized – i.e., not a general “ethics” text, but focuses specifically on confidentiality. The text is highly recommended.

The author indicates in the introduction that this manual is designed to offer a “checklist format” aimed at helping mental health professionals avoid mistakes. The checklists and suggestion are far ranging and anticipate almost every situation one might encounter. Beyond that, however, this book offers a rational, step-wise approach to processing and understanding ethical challenges. When our motivations and professional morals are challenged, we tend to become emotional and less rational – at a time when it is most important to be careful, reasoned, and patient. These guidelines offer a tool aimed at ensuring that you stay grounded.

The book starts with an explanation of “basic ethical rules” that direct the practitioner to prioritize the ethical rules, to understand the law, and to avoid confusion between ethics and the law. This chapter alone is worth the “price of admission”. Fisher provides a model aimed at protecting your clients’ confidentiality rights, urging preparation and informed consent. Education (of yourself and your patients) about confidentiality is underscored.

What follows are chapters covering the entire range of potential difficulties, as well as seven appendixes that clarify the text. Chapters inform about how to tell clients the “truth” about limits of confidentiality – we usually do not do this even when we tell clients what we believe is correct. “Involuntary disclosures” are discussed, along with laws, both federal and state laws, that demand that these disclosures take place. Suggestions are given about how to avoid breaches of confidentiality that are preventable.

One of the more important chapters (the last full chapter) offers ideas about how to talk about confidentiality, both with the public, with clients, etc. These discussions must be honest and complete, because mandated disclosures that occur years later are particularly problematic. All therapists (and their patients) benefit from a complete and accurate knowledge. Beyond this text, however, it is very important for all practitioners to know and understand local and state laws, such as exceptions to “privileged communication”, and how those concerns have potential long-term, unintended consequences.

This volume includes seven very helpful appendixes that list online sources, for example, for professional ethics codes, texts about ethics, etc. It provides definitions, and discusses laws and regulations that affect confidentiality. Templates are provided for client handouts regarding the limits of confidentiality, along with forms for “release of information”.

Professional Training Resources gains nothing with this endorsement, and it does not matter to use if the APA makes money by selling this book. It is not an overwhelming text, and it is one of the more “useful” and “user-friendly” ethics texts I have seen. Please consider looking it over.