The 4 exceptions to the professional secret of the psychologist

When studying psychology, professors repeatedly emphasize the rules that must be followed in the context of the therapist-patient relationship. Among many of these rules is the confidentiality pact And, of course, the code of ethics reflects this set of rules.

Our patient has the right to have the information they provide us and everything that happens in the context therapeutic is something confidential, and perhaps that is what puts us on many occasions "between a sword and a Wall". And is that there are situations in which psychologists offering therapy must break professional secrecy. Let's see what they are.

• Related article: "Decalogue of the psychologist: ethical and professional requirements of our profession"

Exceptions: when to break professional secrecy as a psychologist

We must first understand that professional secrecy is a very important part of the therapeutic setting. The simple fact of letting the patient know that he can completely trust you, as her therapist, and that everything about what is said and done in the session will be confidential, it establishes the foundation for a positive therapeutic relationship productive.

Having said that, exceptional situations that lead to breach of professional secrecy from the psychologist are as follows.

1. Sexual and Physical Abuse

Being prepared to deal with all kinds of cases is something that only experience can give. But there are more difficult cases than others, and in students, the therapist must position himself beyond the framework of therapy and its objectives.

Sexual, physical and psychological abuse is something quite common; the problem is that silence and fear tend to dominate most of the people who suffer it. In the office, those who put the therapist in a more difficult situation are the boys and girls, as there are cases that come in on suspicion of sexual abuse. In this situations, the psychologist must investigate, collect and verify if the abuse is real.

When the therapist finds that such abuse is taking place, it is her job to notify the parents, but, What if the abuser is someone from the nuclear family and neither of them takes action on the matter? This is a very serious question, because it is here that we must break that confidentiality beyond the framework of the family. This will depend on the country in which it occurs, but in most cases, the psychologist he must report it immediately to other family members and to the corresponding authorities. Take note, you should only break confidentiality beyond the family framework if none of the child's caregivers does something to stop this situation.

2. Suicidal patients

Another very common case in the office has to do with patients who suffer from depression, especially severe depression. In summary, those who suffer from a major depressive disorder usually present certain characteristics such as sadness, hopelessness, loss of energy, loss or increase in appetite, trouble falling asleep, and thoughts or actions suicidal.

These patients usually have seizures if they are not undergoing adequate psychotherapy treatment and if they do not take antidepressants from the hand of a psychiatrist. The most indicated is that when noticing suicidal ideas, plans or acts work with the family and prepare it to be aware of the patient.

What is done when no member of the family is aware that the patient wants or plans to commit suicide? It is this moment where you must break the confidentiality rule and notify the parents, siblings or closest relatives.

• You may be interested: "Suicidal thoughts: causes, symptoms and therapy"

3. Judicial processes

Sometimes we will attend patients who are referred by a court or a justice institution. This means that our presence in the process may be necessary at some point, therefore, breaking professional secrecy.

There are many situations that can get to this point, and they all put psychologists in complex situations. That is why I suggest knowing the laws well and the responsibility that psychologists have with them, depending on the legal framework of the country.

4. In risky situations

Any situation that endangers the life of the patient or others close to him (or not close if the case is serious), they will force the psychologist or psychotherapist to break this professional secret, regardless of whether this occurs in the framework of a judicial process or not.

Remember that…

These situations are very special, and for that very reason the psychotherapist breaks professional secrecy, in order to protect and provide the best service. Otherwise the psychotherapist must not break this commitment.