Assignment: Counseling And Therapy For Couples And Families

Want create site? With you can do it easy.



Struggling to find relevant content or pressed for time? – Don’t worry, we have a team of professionals to help you on
Assignment: Counseling And Therapy For Couples And Families
Get a 15% Discount on this Paper
Order Now

Addressing Secrets in Couples Counseling: An Alternative Approach to Informed Consent

Barry A. Bass Julie L. Quimby Towson University

This article presents an alternative approach to informed consent that addresses unique concerns regarding confidentiality in marital and relationship counseling. Professional ethics codes rarely pro- vide therapists with specific guidance on how to respond to clients who wish to keep secrets from their spouse or partner. Moreover, scholars writing about confidentiality frequently offer contradictory advice on how to ethically treat those couples presenting with se- crets. This article suggests that regardless of one’s viewpoint on the issue of secret keeping in counseling, therapists best serve couples by advising them at the onset of treatment of the counselor’s policies regarding confidential communication. In addition to discussing is- sues regarding privacy and confidentiality in couples counseling, this article presents one example of an informed consent document designed to address this important concern.

Keywords: confidentiality; privacy; ethics; family secrets; cou- ples counseling

Mental health professionals working with couples andfamilies frequently are confronted with moral and eth- ical issues not faced by therapists or counselors treating indi- viduals. Writers addressing the complicated issues surround- ing privacy and confidentiality when treating married and unmarried couples have described the minefields conscien- tious therapists must navigate (Gottlieb & Cooper, 1993; Hare-Mustin, 1980). Others have mapped out some of the pathways around these obstacles (Karpel, 1980; Patten, Barnett, & Houlihan, 1991). One particularly thorny issue

likely to present itself to counselors working with couples concerns the topic of secrets shared with the therapist by one client but withheld from the client’s spouse or partner (Brendel & Nelson, 1999; Glass, 2002). Indeed, there has been considerable debate on whether counselors should reveal client secrets (Margolin, 1982). Professional ethics scholars emphasize the importance of establishing clear poli- cies regarding confidential communication when working with couples (Margolin, 1998; Vangelisti, Caughlin, & Timmerman, 2001). However, a search of the literature found no explicit written examples of such policies to guide thera- pists when working with couples. Thus, the purpose of this article is to present one approach to informed consent that addresses unique concerns regarding confidentiality in marital and relationship counseling.

A carefully constructed confidentiality agreement becomes essential when therapists agree to treat clients indi- vidually as well as conjointly with their spouse or significant other. Although none of the ethical codes indicate that con- ducting concurrent individual and conjoint counseling is unethical, many organizations caution their members about the ethical pitfalls inherent in doing so. Thus, counselors working with couples will likely, perhaps inevitably, find themselves grappling with the issue of one person’s right to privacy versus a partner or spouse’s right to obtain access to information relevant to their personal well-being. Although marital and relationship counselors encourage open and hon- est communication, they occasionally compromise and con- cede to requests from their clients to keep certain information secret. Often, this means withholding important, sometimes critical data involving highly charged topics such as infidelity from the innocent or naïve partner or spouse (Weeks, Gambescia, & Jenkins, 2003).

There are additional concerns when the disclosures relate to illegal activities. For example, adultery is considered a crime in some states. As a result, it is possible that keeping a


THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES, Vol. 14 No. 1, January 2006 77-80 DOI: 10.1177/1066480705282060 © 2006 Sage Publications

Authors’ Note: Please address correspondence concerning this manuscript to Julie L. Quimby, Ph.D., Department of Psychology, Towson University, Towson, MD 21252-0001. Dr. Quimby may be reached by e-mail at The editor of this sec- tion welcomes future discussion on the alternate approaches that professionals take in addressing secrets and confidential informa- tion in couple counseling. Please submit discussion to Fran Steigerwald at

secret of illegal activity from a spouse could result in being charged with conspiracy or “alienation of affection.” Although this charge is highly unlikely, some writers have argued that counselors must not condone illegal activity by keeping secrets (Cottone, Mannis, & Lewis, 1996). There- fore, counselors should be familiar with their state laws and ethical standards.


The ethical codes of conduct address, with varying degrees of specificity, appropriate therapist behavior relating to confi- dentiality when working with couples. For example, the American Counseling Association (1995) stated unequivo- cally that “information about one family member cannot be disclosed to another member without permission” (p. 6). Similarly, the code of ethics for the therapists of American Association of Marriage and Family Therapy (2001) required that “therapists may not reveal any individual’s confidences to others in the client unit without prior written permission of that individual” (p. 3). The International Association for Mar- riage and Family Counselors (1993) likewise recommended that “unless alternate arrangements have been agreed upon by all participants, statements made by a family member to the counselor during an individual counseling or consulting con- tact are to be treated as confidential and not disclosed to other family members without the individual’s permission” (p. 2). In contrast, the American Psychological Association (2002) suggested that psychologists clarify their role and their use of information, but it does not explicitly prevent psychologists from sharing material divulged by one family member in an individual session with the other family members in therapy.

Because of differences among professional organizations and state licensing boards regarding appropriate ethical behavior, it seems likely that counselors would receive con- flicting and contradictory messages about this issue. One position is that counselors should refuse to keep secrets (American Counseling Association, 1995). From this per- spective, secrets are seen as counterproductive to open and honest communication that is necessary for successful coun- seling. For example, Pittman (1987) wrote, “the secret doesn’t belong to the adulterer or to the therapist but is the property of the marriage” (p. 121). Likewise, Weeks et al. (2003) recom- mended that counselors should terminate conjoint treatment if the client refuses to divulge the secret information. On the other hand, others argued that maintaining secrecy, at least some of the time, allows the therapist to get more honest and complete information from family members, increases the likelihood of accurate assessment, and facilitates successful therapy (Corey, Corey, & Callanan, 2003). Still, others have made the case for a third position, stressing the need for flexi- bility and encouraging counselors to use their professional judgment when determining whether to reveal or maintain a

secret. In effect, this middle-ground approach argues that counselors should make the decision in accordance with the greatest benefit for the couple and the therapeutic process (Remley & Herlihy, 2005).

Even the most conscientious counselors often disagree about the best course of action when determining whether or not to reveal a secret. For example, marital and relationship counselors may find themselves working with someone who insists on keeping secret certain information that is vital to their partner’s well-being. In situations such as these, coun- selors often use their professional judgment to determine whether or not to break confidentiality (Remley & Herlihy, 2005). They may also consider options such as (a) maintain- ing confidentiality, (b) encouraging or perhaps insisting on full disclosure, (c) referring the couple to another therapist, or (d) revealing the secret to the naïve partner (Weeks et al., 2003). Regardless of one’s decision, it is critical that counsel- ors communicate their policy on such matters before the onset of counseling. As Margolin (1982) stated, “The most difficult predicament for the therapist would be if she or he failed to convey a policy on confidentiality” (p. 792). Indeed, when secrets such as physical or sexual abuse, sexual orientation, infection with a sexually transmitted disease, or drug abuse are revealed to counselors, they must be prepared to reiterate their policy on confidentiality and to follow the policy that was agreed on by all parties prior to starting treatment.


Although ethics scholars in family counseling recommend a comprehensive approach to informed consent on issues of confidentiality (e.g., Lakin, 1994), no publication has pro- vided a written guide for counselors to use when working with couples. This article presents one document for counsel- ors and therapists to consider. Before reading the following informed consent document, it is important that readers under- stand the perspective from which the authors approach these and related ethical issues.

We do not believe that there is but one right or ethically appropriate way to resolve the kinds of issues discussed in this article. However, we do share one primary therapeutic assumption, which guides us in our work. Specifically, we believe that it is an ethical and moral obligation to act within the best interests of our clients. In addition, we believe that practice in this field requires an awareness of our own values and how these values intersect with issues presented by our clients. Indeed, even professional judgments are influenced by personal values. Thus, it is imperative that counselors clar- ify their position on a variety of issues concerning, for exam- ple, the value and importance of friendship, love, and mar- riage, especially as they relate to the mental health of our clients (Walen & Bass, 1986).

In conclusion, determining whether or not to reveal a cli- ent’s secret involves careful assessment of the potential risks


and benefits. We understand that certain approaches bring with them greater risk than others. However, the least risky intervention may not always be the most therapeutic. Thus, counselors should minimize the potential for harm by estab- lishing a pretreatment contract that outlines and addresses such concerns with their clients.

An informed consent document, written by Barry A. Bass, a licensed psychologist and certified sex therapist of the American Association of Sex Educators, Counselors, and Therapists with 35 years of clinical experience, is included as an appendix. This document, which supplements a more generic privacy and confidentiality agreement that is given to all prospective clients, deals exclusively with those privacy issues specific to couples.



This document deals with privacy issues specific to couples and supplements the document already given to you that deals with related issues in therapy. Please read it carefully and jot down any questions you might have so that we can discuss them at our next meeting. When you sign this document, it will represent an agree- ment between us.

First of all, I wish to reassure you that I am personally and profes- sionally committed to protecting your privacy. I realize that therapy can only take place in a setting in which everyone feels secure in the knowledge that his or her thoughts and feelings will remain pro- tected and secure within the confines of the therapy office. To protect your privacy, I have put the following policies into effect.

To prevent an inadvertent breach of confidence, I have a policy of not greeting a client whom I meet outside of my office. Thus, should we happen to meet in public, I will intentionally not say hello to you, in order to protect your confidentiality. You may, however, feel free to greet me in public if you so desire.

My office has been designed to protect your privacy in that patients leaving my office will leave through a different door than the one by which they arrived. This arrangement spares you from bumping into someone with whom you are acquainted in the waiting room.

Issues concerning personal privacy and professional confidenti- ality are somewhat more complicated when working with married or unmarried couples. In addition to the exceptions to confidentiality outlined to you in the document titled “Welcome To My Office,” work with couples sometimes requires certain additional compro- mises in privacy.

Did you find apk for android? You can find new and apps.

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with MyCoursebay
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
Fantastic work on this project as usual.
Customer 452707, July 5th, 2022
Customer 452813, July 9th, 2022
Perfectly done!
Customer 452707, July 18th, 2022
Excellent PowerPoint! Thank you!
Customer 452707, June 29th, 2022
English 101
Although a little late, the content and structure of the paper was great! I would definitely use this writer again!
Customer 452561, July 12th, 2021
Thank you for the great job and timely delivery.
Customer 452457, December 18th, 2020
The skilled writer did a GREAT job!! Amazing .Thank you!
Customer 452547, June 16th, 2021
Did not receive paper on time.
Customer 452693, November 9th, 2022
Great paper!
Customer 452707, July 1st, 2022
Human Resources Management (HRM)
Great Work!
Customer 452767, November 18th, 2022
Customer 452813, June 20th, 2022
Great writer (Proske). I highly recommend
Customer 452531, July 10th, 2021
Customer reviews in total
Current satisfaction rate
3 pages
Average paper length
Customers referred by a friend
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat

Get your perfect essay with a 15% discount. Use DC15


Thank you for choosing MyCoursebay. Your presence is a motivation to us. All papers are written from scratch. Plagiarism is not tolerated. Order now for a 15% discount

Order Now