At Teenage Mental Health we abide by a strict confidentiality policy within our service. It is important to us that our clients can relax in knowing that Teenage Mental Health is a safe and a private place to express themselves and tell us about their experiences.
We offer our clients the highest level of confidentiality consistent with the law and the ethical framework of the British Association of Counsellors and Psychotherapists. Confidentiality within our service means that anything a client tells their counsellor is kept entirely private within the Teenage Mental Health team, subject to a few exceptions outlined below.
All our counsellors meet regularly with a professionally trained supervisor to ensure that their work is to the highest standard. Our supervisors are included within the confidentiality of the service.
1. Confidentiality within Teenage Mental Health
1.1 Teenage Mental Health offers confidentiality within its service. This means that information given will not go outside of the Teenage Mental Health team.
1.2 Teenage Mental Health offers its clients the highest level of confidentiality consistent with the law and the codes of ethics of the BACP. This protects a client from the voluntary disclosure of confidences without the client’s permission unless legally or professionally required to do so.
1.3 The respecting of client confidentiality is a fundamental requirement for keeping trust. The professional management of confidentiality requires the protection of personally identifiable and sensitive information from unauthorised disclosure.
1.4 Counsellors must be willing to be accountable to their clients and to their profession for their management of confidentiality in general and, particularly, for any disclosures made without their client’s consent.
1.5 The requirement to respect client confidentiality is also obligatory upon all members of Teenage Mental Health staff and workers, whether paid or voluntary. It includes all office staff, fundraisers, educators, and trustees as well as face-to-face and helpline team members and those contributing in any other therapeutic or organisational capacity to our work with or without direct client contact.
1.6 The obligation to maintain confidentiality also continues after the counselling relationship has ended. Teenage Mental Health undertakes to ensure that all client records are kept secure so that only authorised persons can gain access to them.
1.7 All members and ex-members of Teenage Mental Health staff or volunteers, whether counsellors, trustees, paid workers, or volunteers are required to protect the anonymity of all individuals who have been or still are clients of our service. This includes an obligation to refrain from all verbal or written references by which our clients may be identified unless the client has given consent to do so.
1.8 The majority of our clients are children under the age of 18 who are accompanied to the centre by parents. Parents are welcome to stay in the waiting areas but are not usually permitted into counselling sessions with their children, unless the children specifically request it. Our counsellors are still bound by confidentiality not to disclose anything to their client’s parents about the session. Parent’s may be given an overall update that things are progressing well or that the child needs a little more time to explore things, but no specific details will be offered. This is important to preserve the counselling session as a safe space for children to express themselves without fear of their disclosures being relayed back to their parents and care givers.
2. Boundaries of Confidentiality within the Counselling Team
2.1 In a situation whereby two or more Teenage Mental Health counsellors are seeing different members of the same family or other close-knit relationships (e.g. a supporter and the survivor), it is best practice for the Teenage Mental Health counsellors not to talk to each other about their work with the linked clients.
2.2 If it is thought to be therapeutically beneficial for the counsellors to talk to each other about their client work, then this should first be discussed with the counsellors’ supervisor and Teenage Mental Health’s Clinical Director to agree what is appropriate to divulge and who will be best to communicate this information. For example, it may be best for the Clinical Director to be the channel of communication between the counsellors.
3. Rights to Confidential Client Records
3.1 There are situations in which counsellors may be required by law to submit their handwritten counselling process notes for investigation. However, The Police and Criminal Evidence Act 1984 provides explicit and wide-ranging protection for counselling records during police investigations. Section 12 of the Act specifically defines personal records. These are excluded from the powers of the magistrate to issue search warrants, which must be issued by a circuit judge. The aim is to preserve confidences from invasion of privacy by the police.
3.2 A solicitor’s letter requesting disclosure of client information is not sufficient to obtain disclosure of confidential client records. A court order is required before disclosure of such material can be obtained.
3.3 Following the Data Protection Act 1998, it had been widely accepted that a client had legal entitlement to information and that the therapist had a legal obligation to provide it. However, a new ruling has now established that a client does not have a legal right of access to the handwritten process notes made by the counsellor following counselling sessions.
…the client’s right to insist on access to his or her records is currently restricted to those that are held electronically or have been made on behalf of a public service, such as education, health and social services (Freedom of Information Act 2000). Clients who have been receiving services in any other context no longer have a legal entitlement to their handwritten records. In the absence of any legal duty to disclose records to clients, therapists are entitled to use their own judgement in deciding whether to disclose records in response to [a request from solicitor on the client’s behalf]. This is fundamentally an ethical decision to be made in accordance with the ethical principles that inform your work. (Bond, T. and Sandhu, A. (2005) Therapists in court: providing evidence and supporting
witnesses. London: Sage).
However, this should be talked through between counsellor and client and the counsellor will seek to make decisions in the best interest of the client.
3.4 In circumstances whereby client and counsellor are in favour of releasing counselling notes to the police or a solicitor for a court case, this should only be done after Teenage Mental Health’s official ‘Release of Counselling Notes Consent Form’ is filled in, signed and the requirements written in the form are fulfilled.
4. Exceptions to Confidentiality:
There are circumstances in which Teenage Mental Health cannot legally or ethically maintain confidentiality within the service. Wherever possible, Teenage Mental Health will make every attempt to communicate first with the client explaining the reasons for the need to pass on information and to whom this will be given. These exceptions are listed below and would qualify as areas of authorised disclosure:
4.1 Safeguarding Children: If information is disclosed that a child is at risk of immediate significant harm, Teenage Mental Health has a duty under the Children Act to pass on this information to the Social Services and Police. The safeguarding policy is available upon request.
4.2 Serious Harm: If planned serious harm to the life of self or another person is disclosed, we have a duty to pass this on to the appropriate authority (GP, Police, Ambulance service etc.) in order to do all that is possible to see the person protected.
4.3 Safeguarding Vulnerable Adults: If there is a serious risk of harm/abuse to a vulnerable adult, Teenage Mental Health has a duty of protection to such vulnerable adults. Information may need to be passed on to the appropriate agencies in order to protect vulnerable adults who could be at risk. See Teenage Mental Health’s Policy P11 Safeguarding Vulnerable Adults to understand how a ‘vulnerable adult’ is defined.
4.4 Offences under the Prevention of Terrorism Act 1987: If information is given on any planned act of terrorism, Teenage Mental Health is, by law, obliged to report this to the Police without informing the person who gave the information.
4.5 Court Cases: In the event of a Court case, the Judge has power to subpoena a client’s counselling notes, or request that a counselling report is provided as evidence for the case.
4.6 Drug Money Laundering: Teenage Mental Health has a duty to disclose any information given in regards the laundering of drug money.
4.7 Road Traffic Accidents: Teenage Mental Health does not have a duty to initiate disclosure of information known in regards road traffic accidents. However, if the Police contact us as part of such enquiries, we have a duty to pass on any information relevant to that road traffic accident.
4.8 Hearsay witness to murder: There is no legal requirement for Teenage Mental Health to initiate the disclosure of any information in which a client alleges being witness to or causing murder/manslaughter. However, it may well be appropriate for the Counsellor to encourage the client to disclose information to police. If the Police contact us as part of such enquiries, we would have a duty to pass on any relevant information about the alleged murder.
4.9 Complaints: If a Counsellor is formally accused of wrongful conduct, then the need for the Counsellor to divulge information about a client is recognised in order for the matter to be investigated. The breaking of confidentiality will be kept to a minimum, in consultation with advisors. The Counsellor will continue to have regard for the wellbeing of the client.
4.10 Communication with GP: Teenage Mental Health is only able to offer counselling if a client provides the contact details of their General Practitioner or agreed alternative medical back-up. With the client’s permission, Teenage Mental Health’s usual practice is not to inform the GP of the commencement of counselling with this Service. No other personal information about the client should they request we inform their GP would be passed on, unless direct permission was given by the client. GP contact details are given by the client for any possible future emergency situation.
5. Suicide and self-harm
From time to time a client may express a desire to end their life or practice self-harm.
5.1 We will not disclose this to the client’s parents or the authorities unless we believe that this admission carries a risk of significant and immediate harm to the child.
5.2 Should an admission of intention to significantly self-harm or commit suicide be made by a patient Teenage Mental Health Safeguarding protocols will be immediately enacted, and appropriate referrals made.
5.3 We will never make referrals to the police or other health or social care services without attempting to inform the patient first.
5.4 We will never tell a parent of a child about admissions they may make of intention to self-harm or commit suicide without telling the child first.