Effects of Confidentiality Limitations on the Psychotherapeutic Process

¹ Division of Psychodynamic Psychiatry, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee.

Dr. Roback, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37232.

This review article examines the impact of confidentiality limitations on the psychotherapeutic process. Findings from analogue studies with nonpatienis indicate that perceived confidentiality limitations will deter people from seeking therapy and will inhibit self-disclosures once they are in treatment. However these findings da not hold up in research with actual therapy patients. A methodological issue is whether the subject pool for clinical studies is primarily persons at risk for only mild to moderate social injury if their communications are repeated to others. In the few studies of persons at risk for serious sociolegal consequences, warnings of mandatory reporting served as a barrier to therapeutic disclosure or entry into treatment.