“Confidentiality is one of the foundations of psychoanalytic practice. A psychoanalyst must protect the confidentiality of patients’ information and documents. In regard to the treatment of minors, certain additional factors may have to be considered: When there is a concern of a credible threat of serious injury to self or others or of imminent suicide, a breach of confidentiality may be required. Appropriate steps may have to be taken that may include notification of a third party (e.g., parent/guardian, school official, etc.). Where local laws and/or regulations mandate reporting (e.g., of sexual abuse), the analyst, in determining how to respond, should weigh the impact on the treatment of reporting, bearing in mind the best interest and protection of the child and adolescent as well as his or her right to quality treatment. Whenever the question of reporting or appropriately informing parents, guardians, or other professionals comes up against patient confidentiality, the analyst must take into account the clinical situation, the age and stage of development, and weigh this against the need to keep the parent/guardian and other professionals appropriately informed.” 23 Some analysts working with children and adolescent have developed ways of including restoration of the parent-child relationship when this is possible as one of the treatment goals concomitantly with the restoration of the minor’s path of progressive development (e.g. Novick and Novick, 2013). This conceptualization avoids a defensive splitting which excludes parents while protecting the confidentiality of the minor’s work on him- or herself. There may be scope for further discussion in this field by IPA groups concerned with child and adolescent psychoanalysis: the Committee on Child and Adolescent Psychoanalysis (COCAP), the Committee on Child Abuse, and the Inter-Committee Project on Child Abuse. We believe the IPA should, when requested, give support to institutions whose members are objecting on ethical grounds to attempts by external agencies to override the protection of confidentiality. This does not mean that we condone a disregard for the law or for public safety, nor does it mean that we fail to recognise the important functions of the courts in enforcing the law in cases concerned with violence, sexual abuse, exploitation, etc., as well as in resolving conflicts, or the functions of insurance companies in managing disability or life insurance policies. Rather, we believe that discretionary privilege is a necessary support for psychoanalysts who have to make difficult clinical decisions. We hope that, when requests that confidentiality be breached arise, local and national psychoanalytic societies will explain to legal authorities and community institutions the grounds for their concerns about confidentiality. There is evidence, for example, that the production of psychotherapy notes in court cases is more likely to obscure the truth than to enhance it, a fact that has been recognized over the last 20 years by Canadian and American courts ( Jaffee v . Redmond , 1996; R. v. Mills, 1999). Recently when efforts have been made
23 Recommendation from the Ethics Committee to the Board, January 2017.
27
Made with FlippingBook - professional solution for displaying marketing and sales documents online