Confidentiality in hypnotherapy is a fundamental of the therapeutic relationship, but what does that mean in practice? In this blog we examine the reasons for confidentiality, what a hypnotherapists will and won’t do with your information.
Why is confidentiality important in hypnotherapy
The main reason that confidentiality is important is that it allows a person to speak freely about personal matters.Confidentiality means being safe in the knowledge that their private information will not be shared or treated casually.
We use peoples personal data and stories with care because the world is more connected than we think it is. My patients and clients often recommend each other to me, and it is my job to ensure that even when i know that they are friends and connected, that i respect the confidentiality of their information. Equally, My family and I live in this community were there are many overlaps with people who know my patients. Further, in my career I have seen enough examples of unlikely connections; patients who live abroad but share online work environments with other patients. I such I know the need to respect confidentiality no matter how unlikely it seems that a breach will occur. However, hypnotherapists often have to share case notes and histories for a number of reasons,
When will a hypnotherapist share case notes and case histories?
There are many legitimate times when a hypnotherapist will discuss cases. When discussing cases these will be anonymised to protect privacy.
What is anonymisation of identifiable details?
There are many ways in which details will be anonymised, such as;
- Names – These can be shortened to; initials only, to a single name, a new name can assigned, or, my preference, which is to exclude the name entirely.
- Jobs and professions – A subtle shift in profession, for example from geography teach to history teacher can effectively disguise someone. Generalisation of work can also help i.e. just saying “ secondary school teacher”. This allows relevant work issues to be discussed without giving away the details of a specific person.
- Geographical location – Subtle changes in town, for example switching Sandwell to Tipton. Alternatively, a generalisation, such as the “industrial West midlands” can allow this context to be present in a shared case history whilst not endangering privacy.
Times when a hypnotherapist will legitimately share anonymised case details.
- Teaching; a lot of hypnotherapists teach hypnotherapy. When teaching a hypnotherapist will often use case examples to illustrate a point. Equally, hypnotherapists often share instructive cases as peers in less formal circumstances to enhance everyone’s knowledge.
- Discussion with clinical experts; it is not uncommon for a hypnotherapist to consult with a colleague who has a specialism in a particular field or an expert from outside of hypnotherapy. In these situations a broad idea of the case history is needed to give context to any subsequent expert advise given.
- As part of clinical supervision; Many hypnotherapists will have clinical supervision. Clinical supervision is a place where therapists can explore cases for technical advice, but also to explore their own reactions to cases and any limitations to themselves as therapist. In this supervision some details of cases need to be disclosed for the supervisor to understand.
- In therapy; hypnotherapists frequently use examples of former patients to illustrate points and to help explain techniques to patients.
Non-anonymised sharing of information.
There are circumstances under which a hypnotherapist may share identifiable details of a patient. Some of these circumstances are legitimate; for example;
- Sharing with health care services or relevant governmental bodies; for various reasons such as accessing benefits or seeking a diagnosis, a client may need a letter from a hypnotherapist. Such letters must be written only with the clients explicit consent and it is wise to give the client the opportunity to look over the letter before it is sent to ensure they do not dispute anything which is being written about them.*1
There are however a small number of circumstance under which a hypnotherapist may disclose a patients details without their consent.
Confidentiality in hypnotherapy – When is it permissible to disclose information
When the client or public are endangered by the clients behaviour the hypnotherapist may have a duty to disclose. The requirement to do so may be moral/ethical or legal. A hypnotherapist will discuss a potential disclosure with a member of their professional body before doing anything. If they go forward, it is likely to be due to one of these situations;
- Disclosure of ongoing abuse of a minor or vulnerable adult. Here, the therapist may need to make a safeguarding disclosure to social services or police.
- Disclosure of life threatening criminal behaviour such as; involvement in terrorism, trafficking in dangerous narcotics, potentially life threatening health and safety violations.
- If the therapist believes there to be a serious and impending risk of the client committing suicide.
- If the therapist believes there is a serious and impending risk of the client committing a serious violent offense.
With the last two examples; the hypnotherapists has to distinguish between the very common reality of discussing violence against the self or other, which is a common topic in therapy, and the possibility that they will actually engage in these behaviors in the immediate future.
Confidentiality
Hopefully this helps to explain what confidentiality in hypnotherapy is, what it is for, and what its limits are. Related issues which may be worth reading about are;
- Taking and storing notes.
- Therapeutic contract.
The author
Dr Matt Krouwel PhD is a hypnotherapist based in Birmingham (UK) with over 25 years experience as a therapist. He has experienced the practical applications of confidentiality in multiple environments including clinical and academic environments. Further, he has taught the practicalities of confidentiality to hundreds of trainee hypnotherapists. Like all good hypnotherapists he is a member of a professional body. Professional bodies provide a place to discuss professional matters and set minimum behaviour standards for confidentiality. .
Footnotes
*1 Please note: clients should not be allowed to influence the content of letters overly, the hypnotherapist has to feel that everything they write is true and accurate. Being true and accurate often means that the therapist will have to give a very limited amount of information and opinion which they can evidence.