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(p. 57) Step 2: Telling Patients the Truth About Confidentiality’s Limits 

(p. 57) Step 2: Telling Patients the Truth About Confidentiality’s Limits
Chapter:
(p. 57) Step 2: Telling Patients the Truth About Confidentiality’s Limits
Author(s):

Mary Alice Fisher

DOI:
10.1093/med:psych/9780199752201.003.0006
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date: 02 April 2020

Chapter 5 walks therapists through Step 2, and covers two conversations in which therapists must explain confidentiality and its limits, and how therapists are ethically required to conduct informed consent conversations about confidentiality in two different contexts. It discusses how patients must be given enough information to allow them to make an informed decision about whether to confide in this therapist in the first place, and how that conversation must be reopened if the therapist believes the patient has forgotten the rules about confidentiality, or if the disclosure risks have increased because of changes in the patient’s circumstances, changes in the law, or changes in the therapist’s policies. It shows how this later conversation allows the prospective patient to pause and assess the risks of confiding further, and why informed consent about confidentiality must be an ongoing process, not a static, one-time event.

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