Keeping Secrets: The Complicated Ethics of Conditional Confidentiality

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CE Credit: 3

Length: 3 hours

Exam Items: 10

Closed captioning provided.

Our Ethics Code allows us to offer only "conditional" confidentiality. But if we do not always protect confidences, how can we “respect the rights of individuals to … confidentiality” (Aspirational Ethical Principle E)?  The initial informed consent conversation is our first and best chance to protect confidentiality rights; but clinically, what is the impact of beginning a relationship by warning that we might disclose what we hear?  How can we describe legally-imposed "limits of confidentiality" if we aren’t sure what they really are? For navigating this ethical-clinical-legal maze, we will use a Practice Model and checklists from the presenter's APA book. Original webcast date: February 16, 2018.

Learning Objective 1
Outline the preparation necessary for protecting patients’ confidentiality rights.

Learning Objective 2
Explain why there is an ethical difference between “voluntary” disclosures and legally-required (“involuntary”) disclosures.

Learning Objective 3
List five ways to avoid some of the “preventable” disclosures of confidential information.

Presenter: Mary Alice Fisher, PhD


Mary Alice Fisher, Ph.D., is founding Director of the Center for Ethical Practice in Charlottesville, Virginia, a clinical psychologist in private practice, and an adjunct faculty member at the University of Virginia.  APA recognized her accomplishments with the 2016 award for “Outstanding Contributions to Ethics Education.” This workshop is based on her 2013 book, The Ethics of Conditional Confidentiality: A Practice Model for Mental Health Professionals (Oxford University Press), as well as her 2016 desk manual on the same topic, published by APA Press: Confidentiality Limits in Psychotherapy: Ethics Checklists for Mental Health Professionals.

Supplementary Materials

  • PowerPoint Presentation
  • Keeping Secrets Handout
  • APA Ethical Standards Relevant to Confidentiality

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"good summary"
— joan b.