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ABSTRACT
The concept of confidentiality is fundamental to all forms of psychotherapy. The idea of protecting confidential material goes as far back as the Hippocratic Oath in ancient Greek history. Centuries later, authors continue to assert that "only by maintaining confidentiality can the essential groundwork of trust in treatment be developed"( Hough, 1992, p. 106). Others have even argued that without confidentiality, psychotherapy has no value (Epstein, Steingarten, Weinstein, & Nashel, 1977).
Confidentiality in group psychotherapy is more complicated than in individual therapy because self-disclosure is at the core of group therapy and there are numerous people hearing the disclosures. Confidentiality in group therapy, once ignored in the literature on ethics, is gaining more attention as this modality becomes more widely practiced; so too is an acknowledgement that ethical dilemmas surrounding confidentiality in groups are commonplace. This article discusses the major considerations and dilemmas on confidentiality in group psychotherapy. We first review confidentiality broadly and discuss the ethical principles that are related to confidentiality. In the next section, we discuss the complexities of confidentiality in group psychotherapy. Finally, we review research on confidentiality in groups and describe common ethical dilemmas.
OVERVIEW
Confidentiality is the therapist's respect for and protection of private information disclosed by or about the client. According to Koocher and Keith-Spiegel (1998), "confidentiality refers to a general standard of professional conduct that obliges a professional not to discuss information about a client with anyone" (p. 117). In addition to an ethical obligation to protect information, therapists also have to comply with legal protections of confidential information. Legally, this type of privacy is covered by the concept of privileged communication, which states that in specific types of relationships, information is protected from disclosure in legal proceedings.
Although confidentiality is closely safeguarded because it is so important to the process of psychotherapy, it has important legal limitations. There are instances in which confidentiality needs to be breached in order to protect the individual or the greater community. A threat of suicide, danger to others (with imminent intent and a specific victim), or suspicion of child abuse are examples of situations requiring that confidentiality be breached and actions taken in order to provide safety to those involved.
Ethical Principles Relevant to Confidentiality
In order to...