Privacy Vs. Secrets



When dealing with couples, therapists will sometimes see each individual separately. This can lead a therapist into some ethical dilemmas if the limits of confidentiality are not discussed at the onset of therapy. 

 

First - lets make clear the difference between a secret and privacy:

 

Privacy is information that one person knows and would prefer their partner doesn't know.  Private matters do not affect the relationship and can be thought of like a person's "personal space."

 

Secrets are pieces of information that one partner has that directly affects the relationship.  People can keep secrets for a number of reasons: fear, anxiety or shame.  An example of some secrets could be infidelity or addiction.  Secrets many times lead to lies.

 

 

 



 

 There are ethical ways for a therapist to approach secrets:

 

First and foremost, the therapist should address how secrets are handled in the beginning of therapy, this way everyone will be informed and will understand the policy.

 

-  One way to handle secrets is the therapist could choose to keep all secrets private.  A therapist may chose this method to ensure trust with both parties.  Choosing this option could put the therapist in a sticky situation if a secret is divulged during individual therapy and then lied about during joint sessions.  It could undermine the work of all parties to the therapy. 

 

- A second way a therapist could handle secrets is to let both parties know that all information is property of the couple.  Anything that is shared during individual meetings would be divulged during joint therapy.  Choosing this option may keep the parties from being honest and truthful, and may lead to neglecting to recognize the real relationship issues if they are never brought to light. 

 

- A third way a therapist could handle secrets is to only keep certain information confidential.  The therapist would need to consider the information and deduce some facts about the information:

1. does the secret currently affect the relationship negatively: an example of this would be if one partner currently has a substance abuse problem that the other partner does not yet recognize.
2. does disclosing the secret have a therapeutic outcome: an example of this would be if one partner discussed an affair from 10 years ago.  If it is not an ongoing thing, divulging this information may only hurt one partner and not gain any therapeutic benefit and could actually halt all movement towards relationship goals.
3. does the secret put one partner at risk if the secret is revealed: an example of this would be if one partner discusses physical abuse during individual therapy, communicating that during joint therapy could put the abused in a position for further abuse.

If the therapist believes that divulging the information would have therapeutic gain, they would urge the participant to share the secret during joint sessions so the issue could be worked through, ultimately creating a stronger relationship.  If the party is unwilling to divulge the secret, the therapist could decide to cease all therapy until both parties are truly committed to the process. 

Because this third option relies totally on the therapist's judgment, the therapist must be committed to providing an unbiased view of the value of the secret.  The therapist must truly use their professional judgement to weigh the individuals right to privacy against the safety of the relationship.

This sticky situation is a prime example of why therapists need to discuss their policies at the onset of therapy and make sure that all parties understand and agree on them, only then can therapy progress in a healthy and open manner. 



Source: Pukay-Martin, Nicole D. Ethical Considerations in Working with Couples: Confidentiality within the Couple. retrieved online http://www.e-psychologist.org/index.iml?mdl=exam/show_article.mdl&Material_ID=92