Confidentiality

In deciding whether to disclose to third parties any information given by clients the BACP expects all Counsellors/Art Therapists and supervisors, and those managing them, to adhere to four basic principles:

Beneficence: what will achieve the greatest good?
Non-maleficence: what will cause least harm?
Justice: what will be fairest?
Respect for Autonomy: what maximises the opportunities for everyone involved to implement their own choices?

Legal Obligations and BACP Ethical Framework
1. All counsellors and therapists must follow the legal obligations, as well as adhere to the BACP Ethical Framework for the Counselling Professions. Any disclosures that may lead to a breach of confidentiality must consider these legal and ethical considerations.

1. Purpose of the Policy

To offer a definition of confidentiality.
To outline the key principles of confidentiality as it relates to the counselling service at

Woman’s Trust.
To clarify the key responsibilities of volunteer Counsellors/Art Therapists, supervisors and staff members regarding the provision of counselling and supervision services.
To clarify the issues which fall outside the boundaries of confidentiality.
To provide a mandatory procedure for reporting anything that might fall outside the

boundaries of confidentiality.

2. Definition

The Oxford English Dictionary does not offer a definition of confidentiality as such, but one of the definitions of ‘confidence’ is, “the telling of private matters with mutual trust”.

Confidentiality within Woman’s Trust’s counselling service entails not disclosing to any third parties anything that clients say, including any identifying material (especially clients’ names), unless it falls outside the boundaries of confidentiality outlined below (Item 5); this includes not re-telling a client’s story in supervision unless it has some purpose, e.g.
As part of a risk assessment to assess with the supervisor and peers whether the client’s disclosures fall outside the confidentiality policy.
As part of a risk assessment to assess with the supervisor and peers whether a client needs and should be offered additional sessions.
As a brief outline of the client’s way of being, or story, or process, to get to the bottom of why a Counsellors/Art Therapists might be having difficulties with a client’s process, their own process or the process of their relationship.

3. Key Principles

Confidentiality, and limits to confidentiality are necessary to:
Promote the client’s trust and confidence in the Counsellors/Art Therapists and the service.
Demonstrate respect for the client’s process and history.
Protect the client from possible further harm (e.g. from perpetrator/s).
Protect staff and volunteers from possible harm from perpetrators.
Protect and safeguard against possible abuse of children and vulnerable adults.

4. Key Responsibilities
Staff, volunteers and supervisors will keep confidential all disclosures made by clients, unless they fall outside the boundaries of confidentiality, and within the principles and guidelines of the Child & Vulnerable Adult. Safeguarding Policy and Procedures for the Counselling Service.
All client notes will be kept in locked cabinets only accessible to members of staff and volunteer Counsellors/Art Therapists
Notes will be brief and factual; only record general themes and factual occurrences, including phone calls, texts, e-mails, and letters.
Any queries about what written or verbal information must/must not be kept confidential should, in the first instance, be directed to the supervisor, or, in her absence, the Senior and/or Assistant Counselling Coordinator for the volunteer Counsellors/Art Therapists’ area (West London or East London).
Confidentiality is within Woman’s Trust and therefore all information can be shared with the relevant WT staff member, on a need-to-know basis.

5. Issues Falling Outside the Confidentiality Boundaries
Harm to self (but not ‘self-harm’ as in cutting, etc) or others
Terrorist activity or planning such activity by the client or anyone known to the client
Money laundering
Drug or human trafficking
Child and Vulnerable Adult Safeguarding (see Woman’s Trust policy and procedures)
Receipt of court summons, i.e. case notes may be subpoenaed
Miscarriage of justice
In cases of child abuse or harm, Safeguarding Lead must be consulted to ensure the appropriate steps are taken.
Seeking Legal Counsel
• In any case where legal implications are unclear, such as receiving subpoenas or legal risks to the organization, it is mandatory to seek legal counsel before making any decisions about breaching confidentiality. This includes cases where police disclosure may be necessary.
6. Procedure for Reporting Issues that fall outside the Boundaries of Confidentiality

Procedure Stage 1

If you have a concern that what you are listening to falls outside the boundaries of confidentiality:

Remind the client about the Confidentiality Agreement; refer to the specific issue that relates to what your client is telling you, e.g. that harm to others (including children/vulnerable adults) is outside the limits of Woman’s Trust’s Confidentiality boundaries. Let the client know that you will contact your supervisor to consult with her (within 24 hours) about what to do. Reassure the client that it is Woman’s Trust’s aim to work with her and support her to enable her to contact any relevant agency/ies and inform them herself, if this is assessed as necessary.
If the issue is child or vulnerable adult abuse refer directly to the Child & Vulnerable Adult Safeguarding Policy and Procedures.
Get clear information about the situation from the client for an initial verbal report to your supervisor.
Contact your supervisor within 24 hours. If your supervisor is not contactable then you must contact the Senior and/or Assistant Counselling Coordinator/s (or as a last resort, the Woman’s Trust Director) directly.
In all cases involving legal risks or complex ethical concerns, seek legal counsel and/or senior management guidance.

All potential breaches of confidentiality must be assessed on a case-by-case basis to balance client rights and ethical duties.
Procedure Stage 2

Basic Principles
If possible, a client will be kept informed by her Counsellors/Art Therapists and/or the Senior/ Assistant Counselling Coordinator/s at all stages of the process. Woman’s Trust is aware that there are cases where it would not be appropriate to keep the client informed, e.g. if, in the opinion of Woman’s Trust, Social Services, or the police, that it would put a child or vulnerable adult at further or greater risk.

After making a disclosure to another agency, Woman’s Trust will maintain contact with that agency, ensuring that appropriate procedures are followed and actions taken to protect the safety of the children and vulnerable adults concerned.

When an Appointed Individual (a supervisor, Senior/Assistant Counselling Coordinator/s , or

Director) is contacted

Contact the two other Appointed Individuals as soon as possible or at least within 24

hours. Once they have been contacted a discussion will take place as soon as possible, ideally within 4 hours.
If the group is satisfied that there are grounds for serious concerns (i.e. that the client knows someone who is planning terrorist activity), a verbal report will be made to the police (or Social Services, as appropriate for the non-confidential information) within 24 hours, followed by a written report which will be emailed/posted (within 48) hours to the relevant agency’s representative already contacted.
If the group is unclear about how to proceed, they should consult (within 24 hours) on a ‘for instance’ basis with an identified agency (Social Services or the Police) worker who has agreed to provide this assistance to Woman’s Trust staff.
If the group is satisfied that no child or vulnerable adult, or other member of the public is at risk of serious or lethal injury or significant psychological damage, but there are safeguarding concerns, Procedure Stage 3 will be put into action.
The Senior/Assistant Counselling Coordinator/s will make a written record of the information/material, and any reporting, which will be kept on the client’s file, and, if appropriate, a separate Child and Vulnerable Adult Safeguarding Report File for 6 years. After which it will be shredded.
Procedure Stage 3
Notwithstanding Basic Principles Woman’s Trust will, once the incident has been reported and/or recorded, work with a client through counselling sessions or support groups (as appropriate) to enable her to process the issues arising as a result of the reporting of material which fell outside the boundaries of confidentiality.
After 6 weeks counselling after the disclosure a review will be held with the client and Counsellors/Art Therapists to assess the usefulness, uptake and the outcome of the six weeks counselling (with the aid CORE if deemed appropriate).
Following that, a further discussion must take place between the Counsellors/Art Therapists and supervisor within 48 hours.
The supervisor will then contact or meet with Senior/Assistant Counselling Coordinator/s within 48 hours to discuss any possible need for further action or contact with the Police and/or Social Services. If the Counselling Coordinator/s are unavailable, the supervisor will meet with the Director.
If further action is considered necessary Procedures 1 and 2 will be followed again within 24 hours.
Procedure 3 will not be followed again but a decision will be made, based solely on the merits of the case, about whether or not the client may complete her 18 sessions if she has not already done so, or if she should/could be offered further sessions, or referral on to another agency, or private counselling if appropriate and affordable.
The client will be informed of all final decisions within 24 hours.
The Director will be kept informed of the progress of the case and its outcome. The Director will inform the trustees if the progression of the case gives rise to any legal liabilities for Woman’s Trust.