Understanding Client Roles, Goals, and Confidentiality in Therapy (Full Transcript)

Speaker 1: You should never sit in your office and not know those three things. Who is the client, what is the role, and what is your goal?

Speaker 2: Okay, so I'm trying to think that through, and I'm thinking the majority of our viewers likely are clinicians or psychotherapists, and a client comes in for help, they're trying to help them, I think it lines up. I mean, I'm not sure what the confusion is, I guess.

Speaker 1: No, you're right. In that basic situation, and it's a good one to start with, because someone comes in seeking some care from a mental health professional, and so the situation is clear. The person in the room is your client. Your role is you are their therapist, and your goal is to define the problem or offer a diagnosis and create a treatment plan. If you've done that, then you can answer more complicated questions. For example, who has the right of confidentiality? Well, that would be the client. He also or she also has the right to access the records and the right to seek a protective order asserting a claim of privilege. So that's all clear when you know who's the client, what's the role, and what's the goal.

Speaker 3: I've got the idea of privilege fairly clear. It's simply a law. It's a law that protects specific confidential conversations from disclosure by the legal process. It means simply certain things can't be subpoenaed. Right so far?

Speaker 2: Right.

Speaker 3: The legislature decides what is privileged, and they make a list of the conversations that are privileged and between whom. Each state's list may vary a little, but they're basically the same from state to state. Well put, Nellie. Good. So now confidentiality grew out of the special relationship between a therapist and the patient or client, and rules about confidentiality have now been codified so they are in every state's statutes and administrative regulations as well as in all ethical codes. Yeah, since the Hippocratic Oath. Really? Really. Wow. Okay. So after we talked about the case having to do with confidentiality and privilege, where the policeman shot the attacker, we talked about the duty to warn, the Tarasoff case. Then we talked about the duty to report with Nurse Brown and Dominick. Those cases were exceptions to the general idea of confidentiality, right?