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The 4 exceptions of the professional secret of the psychologist

The 4 exceptions of the professional secret of the psychologist

July 19, 2024

When studying the career of psychology, the professors emphasize again and again the norms that must be followed in the context of the therapist - patient relationship. Among many of these norms is the confidentiality pact and, of course, the deontological code reflects this set of rules.

Our patient has the right to the confidentiality of the information he or she provides and everything that happens in the therapeutic context, and perhaps that is what puts us on many occasions "between the sword and the wall". And is that there are situations in which psychologists offering therapy must break professional secrecy . Let's see what they are.

  • Related article: "Decalogue of the psychologist: ethical and professional requirements of our profession"

Exceptions: when to break professional secrecy as a psychologist

First we must understand that professional secrecy is a very important part of the therapeutic framework. The simple fact of letting the patient know that he can trust you completely, as his therapist, and that everything that is talked about and done in the session will be confidential, strengthens the basis for a positive and productive therapeutic relationship.

Having said that, the exceptional situations that lead to breaking professional secrecy of the psychologist are the following.

1. Sexual and Physical Abuse

Being prepared to handle all types of cases is something that only experience can give. But there are more difficult cases than others, and in students, the therapist must position himself beyond the framework of therapy and its objectives.

Sexual, physical and psychological abuse is quite common; The problem is that silence and fear often dominate most people who suffer. In the clinic, those who put the therapist in a more difficult situation are children, as there are cases that come because of suspected sexual abuse. In this situations, the psychologist must inquire, collect and verify if the abuse is real .

When the therapist finds that such abuse is happening, it is his job to notify the parents, but what happens if the abuser is someone from the nuclear family and none of them takes action on the matter? This is a very serious question, because this is where we must break that confidentiality beyond the family framework. This will depend on the country in which it occurs, but in most cases, the psychologist must report it immediately to other family members and the corresponding authorities . Take note, you should only break confidentiality beyond the family framework if none of the child's caregivers do anything to stop this situation.

2. Suicidal patients

Another very common case in the office has to do with patients suffering from depression, especially severe depression. As a summary, those who suffer from a major depressive disorder usually present certain characteristics such as sadness, hopelessness, loss of energy, loss or increase of appetite, trouble falling asleep and thoughts or suicidal acts.

These patients usually have seizures if they are not taking the appropriate psychotherapy treatment and if they do not take the antidepressants from the hand of a psychiatrist. The most indicated is that when noticing ideas, plans or suicidal acts work with the family and prepare it to be aware of the patient .

What is done when no member of the family is aware that the patient wants or plans to commit suicide? It is this moment where you must break the confidentiality rule and notify the closest parents, siblings or relatives.

  • Maybe you're interested: "Suicidal thoughts: causes, symptoms and therapy"

3. Judicial processes

Sometimes we will attend patients who are referred by a court or an institution of justice . This means that perhaps at some point our presence in the process is necessary, therefore, breaking professional secrecy.

There are many situations that can reach this point, and all put psychologists in complex situations. For that reason I suggest to know well the laws and the responsibility that we have with them psychologists, depending on the legal framework of the country.

4. In situations of risk

Any situation that puts at risk the life of the patient or other people close to this (or not close if the case is serious), will force the psychologist or psychotherapist to break this professional secret, regardless of whether this occurs within the framework of a judicial process or not.

Remember that…

These situations are very special, and for that same reason the psychotherapist breaks professional secrecy, in order to protect and provide the best service . Otherwise the psychotherapist should not break this commitment.

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