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Question: Boundaries of client confidentiality?

Asked by SaraMuma 5 years ago

10 answers

There was a controversry one day at school when we were learning about client confidentiality. Our teacher was telling us a story that in her town there was a man who was going to different therapists and trying to "put the moves on them" so to speak and some advances had gotten pretty scary. When a therapist would end the session and request he not return, he would call another therapist. I had asked if we would be able to call and warn other fellow therapist about the man. Our teacher said we couldn't because we would have to give his name and that would be a breach of confidentiality. I tried to argue that if a therapists' safety was at stake that should be void. When I said that, she wasn't for sure on the correct answer and changed the subject. Does anyone know for sure?

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5 years ago

Anyone having serious difficulty with a client in this regard would be wise to contact their local professional authority, for example the New York Executive Secretary of the Office of Professions State Board for Massage Therapy. If a client is behaving dangerously a therapist has a right to press charges with the police department. If a client is just creepy a therapist can stop the session, end the service, and discontinue the business relationship. Documenting bad behavior in SOAP notes is critical. Calling another therapist for advice and feedback is not unethical. Discussing the situation as a cocktail party topic is unprofessional and may lead to a lawsuit against you if the person being discussed were to find out.

Sources: Kathleen M. Doyle, Executive Secretary
NY State Education Department
Office of the Professions
State Board for Massage Therapy
89 Washington Avenue
Albany, New York 12234-1000

518-474-3817, ext. 150 (voice)
518-486-2981 (fax)

Other answers (9)

yogicris 5 years ago

If there is a risk to the practitioner,then certainly there shoul be an a safety net for others, its irresposable not to share information with other practitioners, as long as its kept within the field of the therapists involve.not a problem, in fact its common sense,rules are there to be expaned upon, nothing is set in stone, if it is then its dead..<3

Rebecca Urban Oasis 5 years ago

I would suggest that you can inform other therapists about this client. It is for their own safety.
Therapists offer proffesional treatments to clients and help them in their time of need. If somebody is taking advantage of that then in my eyes he is in the wrong and has stepped out of line.
It isn't fair on the next therapist that has him as a client and he may try to take it a step further.
Client confidentiality isn't there for certain clients to take advantage of.

Oakynleaf 5 years ago

I see this quandary three different ways:

1. Ethically, this does violate confidentiality.
2. Legally, if you did warn someone about this guy and he found out you did this, he could sue you for defamation of character. It's your word against his.
3. Practically, if it was my impression that the guy was dangerous (some advances had gotten pretty scary), I would warn others in a heartbeat. But what were the dynamics of his advances verbal requests or threatening; did he touch the MT; or did he get an erection.

Sources: http://www.claudemassage.net

Poweroftouch 5 years ago

I don't believe ethically that there is a violation of confidentiality in giving the mans name and warning other therapists if there was truly inappropriate behavior. Which you better be sure that it is and not just what you interpret it to be. Breach of confidentiality is more of a hey (name here) has HIV or cancer and such and such. Not Hey SO and SO habitually tries to make a move on his therapists.

Pavitra 5 years ago

Your "duty of care" normally includes confidentiality, but if your client is a risk to either himself or to other members of the public then you would not be critisised for informing relevant people. That may include other therapists, and certainly the police if this character is a danger. You may in fact be negligent if you do not do something and he attacks another therapist or other vulnerable person.
If you (or your teacher) are members of a professional organisation I suggest you discuss this with an advisor if you are worried.

SilverHand 5 years ago

Unfortunately the situation shared is heresy, and these stories abound within the professional networking’s. The stories always keep people agitated and sighting their particular brand of justice and choice words for every poorly behaved client wrapped up in to one tell-all tell-off. Ethically you can not relay any personal information about a client to anyone without the client’s explicit permission to do so. Legally you are bound by the same. It is unconscionable at times and a burden to say the least but one all agree too as well as abide by in the medical field and it’s ever growing and branching therapies. It is important to understand the legal ramifications this opens a Therapist to. A worse case scenario could consist of outright sexual harassment by the client that results in the Therapist being sued for breach of client confidentiality and losing their license to practice in the interim if not for good. Civil suits may then aggravate the circumstance further.

A suggestion in dealing with an uncomfortable situation would ideally start with prevention. That starts with your intake interview. We seek cues in body language as well as words to understand ailments clients share with us in the intake interviews. This is a time to also look for cues that may indicate inappropriate interests which then may lead to equally inappropriate behavior.

Also, most if not all Therapist will include a sexual misconduct clause in their intake paperwork as well. These generally will dictate that at any misconduct on the part of the client, the Therapist will then immediately end the session and the client will be required to leave. There may also be stipulations as to whether the client is required to pay for the session or not. *Some provinces will allow to be included in this clause specific terms in which the client understands and authorizes the Therapist to relay to other professionals whether or not they would work with that client again. Such a course should be investigated thoroughly with an attorney before being utilized.*

Additionally, should a situation arise, the Therapist must be certain of themselves and not fail to apprise the client of how they are perceiving the client’s intentions. Many clients will take this assessment as a reprimand and stop what behavior the Therapist has mentioned then and there. Other clients may persist, believing a game is in play. This would be the time to end the session and ask that they leave.

Last of all, be willing to go to the authorities. A Therapist being victimized in their own space is repulsive and should not be allowed. Having the self-esteem to stand up for ones self is important in all facets of business as well as life.

Regardless of the level of discomfort it is important that you document any and all misconduct in your SOAP notes. Long term behavior may be as revealing as any one obvious act. Such notes will also be relevant should a matter escalate and legal action be required. Discussions of a nameless/faceless client with other Therapists will allow doubts to be expressed and different understandings of the incident that can then be expounded upon in the SOAP notes as an addendum. This will serve in legal actions along with future sessions should they occur.

Reformednurse 5 years ago

I would report it to the police and ask them to warn the other therapists.

EmeryMassageandBodywork 5 years ago

When my clients come for their first visit I give them two forms to keep and there is a part that states my ethics and what would happen if that ethical line is broken, up to turning them into the police. No, you can not call other therapist because of our ethical standards but you can deny the person as a future client. I find building a clientele is difficult because they do go from therapist to therapist.

brittvp 5 years ago

Any therapist, whereever they practice, have the right to end a session if they feel uncomfortable at all for any reason. It would be a breach of confidentiality to warn other therapist's and give out his name, but I wouldn't refer him to anyone either.

Sources: Brittany Valdes-Pages
Massage Therapist

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