Counselling Service policy: Confidentiality

The counsellors at Oxford Brookes University are aware of their responsibility both to students who come for counselling and to the wider university community. At times there can be tensions between the need to maintain an agreement of confidentiality with the individual client, and the counsellor's awareness of the needs of the wider community. This statement aims to define the response of the Counselling Service to these tensions.

The counsellors are members of the British Association for Counselling and Psychotherapy, and adhere to its Ethical Framework for Good Practice in Counselling and Psychotherapy. The Framework draws attention to issues of confidentiality in discussing two key ethical principles: ‘Fidelity’ and ‘Autonomy’.

Fidelity: honouring the trust placed in the practitioner
Being trustworthy is regarded as fundamental to understanding and resolving ethical issues. Practitioners who adopt this principle: act in accordance with the trust placed in them; regard confidentiality as an obligation arising from the client's trust; restrict any disclosure of confidential information about clients to furthering the purposes for which it was originally disclosed.’
Autonomy: respect for the client's right to be self-governing
This principle emphasises the importance of the client's commitment to participating in counselling or psychotherapy, usually on a voluntary basis. Practitioners who respect their clients' autonomy ... protect privacy; protect confidentiality; normally make any disclosures of confidential information conditional on the consent of the person concerned ...’
Ethical Framework for Good Practice in Counselling and Psychotherapy BACP 2001/2002, p3

The counsellors do not normally divulge information about whether or not a student has attended counselling, or what was discussed within a session, to any third party: fellow student, doctor, member of staff or parent. Sometimes a counselling client requests that information is passed on (for example, if a 'medical certificate equivalent' is needed), or the counsellor feels that it might be helpful to communicate with another person, such as a doctor. In these circumstances, the counsellor would discuss with the client the nature and form of such a communication and obtain their explicit permission (usually by asking them to sign an Exchange of Confidential Information Form).

All the counsellors attend counselling supervision and team meetings in which cases are discussed, but the identity of clients is disguised. Counsellors may also discuss cases with the psychiatric consultant to the Counselling Service on a similar basis. The counsellors keep records for statistical purposes, and individual notes, which are held securely. An individual who would like to see their notes can discuss this with their counsellor. Information about confidentiality, supervision and record keeping is included in the Counselling leaflet, and on the form which students complete to register for counselling. The form states that registration with the service confirms the student's acceptance of these record-keeping procedures.

The BACP Framework acknowledges that in some circumstances, particularly where a client may be at risk of serious self-harm, or harm to others, a counsellor may face a dilemma about whether or not to breach confidentiality:

‘Situations in which clients pose a risk of causing serious harm to themselves or others are particularly challenging for the practitioner. These are situations in which the practitioner should be alert to the possibility of conflicting responsibilities between those concerning their client, other people who may be significantly affected, and society generally. Resolving conflicting responsibilities may require due consideration of the context in which the service is being provided. Consultation with a supervisor or experienced practitioner is strongly recommended, whenever this would not cause undue delay.’
Ethical Framework for Good Practice in Counselling and Psychotherapy BACP 2001/2002 p6

In reaching such a decision, a counsellor would attempt to assess the severity and immediacy of the risk involved, and to distinguish between, for example, violent intent and violent fantasy. As the Framework indicates, any decision to breach confidentiality would normally be discussed with a supervisor, psychiatric consultant or experienced colleague.

In deciding whether or not to breach confidentiality the counsellor will also consider where to pass on information, on a 'need to know' basis. In the case of a suicidal client, for example, this will usually be a doctor or other medical professional. If a client were posing a threat to the safety of others, it might be necessary to involve the police. The BACP Framework is clear that any breaking of confidentiality should be done in a careful and controlled way:

‘In all cases, the aim should be to ensure for the client a good quality of care that is as respectful of the client's capacity for self-determination and their trust as circumstances permit.’
Ethical Framework for Good Practice in Counselling and Psychotherapy BACP 2001/2002 p6

There may be occasions where an individual is behaving in a way that others find disturbing, but unless the counsellor feels that their client is a risk to self or others, they will not pass on information about them. The Counselling Service is aware that this can sometimes be a difficult situation for other students and university colleagues, and where possible the Service will try to offer support to everyone involved in such a situation. Although counsellors will not discuss individual clients without their permission, the Service is happy to be consulted by staff who are concerned about a student, or unsure about how to respond to a situation; such enquiries can often be made without naming the student involved.

If a counsellor is concerned that a client's behaviour might be a potential risk to themselves or others, they would normally draw this to the client's attention and encourage them to take responsibility for their actions. Part of this might involve a decision by the client to inform others - for example, if their difficulties necessitated temporary withdrawal from their course. In the majority of cases, it is usually possible to negotiate with the client, so that any breaking of confidentiality occurs with their consent. As stated above, only in exceptional situations would a counsellor decide to pass on information without permission from their client.

In some subject areas, such as Health Care, Social Work or Education, students are involved in placements where they are working with young or vulnerable people. There may be particular concerns that a student's personal difficulties may put others at risk, and counsellors are mindful of this when working with clients in these areas. If a counsellor felt concerned that a client's behaviour could put others at risk they would normally share this with the client and encourage him/her to take responsibility for addressing the situation. If the client denied there was a problem or refused to take action, the counsellor would consider whether they felt the risk was sufficiently great to warrant breaching confidentiality. The Counselling Service feels that it is important that students in these subject areas have the same offer of confidentiality as students on other courses; to do otherwise would be discriminatory and might dissuade students from seeking help - thus potentially creating an even more serious situation.

The Counselling Service appreciates the extent to which other members of the University respect this policy on confidentiality, even if they can sometimes find it frustrating. The Service hopes that this statement clarifies the thinking behind its approach, and the counsellors are happy to discuss particular issues relating to this. The counsellors believe that it is in the interests of the University community to have a Counselling Service that offers students and staff a promise that confidentiality will be maintained in all but the exceptional circumstances discussed in this document.

top of page