In Australia, psychologist confidentiality has key exceptions for serious risk of harm (to self or others, especially children/vulnerable persons), court orders (subpoenas), legal requirements (like mandatory reporting), and when sharing info with a GP (for Medicare plans) or with your consent (e.g., to a lawyer or for NDIA reports). Psychologists must disclose info if there's a serious, imminent threat to life, health, or safety, or to prevent abuse of children or the elderly, often without needing your consent in those urgent situations.
The only scenario in which counselor-client confidentiality can be broken is in situations that necessitate protecting the client or others “from serious and foreseeable harm,” such as suicidal intent.
The Privacy Act 1988 (Privacy Act) is the principal piece of Australian legislation protecting the handling of personal information about individuals. This includes the collection, use, storage and disclosure of personal information in the federal public sector and in the private sector.
Professionals should only break confidentiality if: They're concerned that you're at risk of serious harm or you're in danger. For example, if you've told someone that you're being abused, they should share this to make sure you stay safe.
If a client is presenting as suicidal or mentally unwell placing themselves or others at significant risk of harm, our psychologists have a duty of care to clients as well as the public. This means they may need to inform others (family members, doctors, police services) who can help to ensure client safety.
The four types of "notifiable conduct" that require a mandatory report to AHPRA (Australian Health Practitioner Regulation Agency) to protect the public are: impairment (placing public at risk of harm), intoxication (practicing while intoxicated), sexual misconduct, and significant departure from professional standards (placing public at risk of harm). These specific concerns, if reasonably believed by another practitioner or employer, must be reported to AHPRA.
the following are the most frequent grounds for licensing board complaints against counselors:
There are three exceptions where confidentiality might be waived without a consent: 1) client is an immediate danger to self or others (i.e. suicide or homicide); 2) there is suspected child or elder abuse, neglect or maltreatment; 3) in legal cases, information may be subpoenaed by the court.
Breaching confidentiality is only justified in specific circumstances where there's a severe threat to the patient or others, legal mandates require disclosure or public health concerns require sharing information to prevent harm.
Sexual Relationships
It is never okay for a therapist to engage in a sexual relationship with a client. Not only do sexual relationships impair the professional performance, but they can also have dire emotional and psychological consequences.
The Notifiable Data Breaches (NDB) scheme
An eligible data breach occurs when the following criteria are met: There is unauthorised access to or disclosure of personal information held by an entity (or information is lost in circumstances where unauthorised access or disclosure is likely to occur).
Australia's 7 patient rights, outlined in the Australian Charter of Healthcare Rights, are Access, Safety, Respect, Partnership, Information, Privacy, and the right to Give Feedback, ensuring everyone receives high-quality, dignified care that meets their needs, with clear communication and protection of personal data across all healthcare settings.
Below we list some common breach of confidentiality examples.
You must make a mandatory notification if you form a reasonable belief that your practitioner-patient is placing the public at substantial risk of harm (a very high threshold for reporting risk of harm to the public) by practising in a way that significantly departs from accepted professional standards.
If you present an imminent threat of harm to yourself or others. When there is an indication of abuse of a child, dependent adult or elderly adult. If you become gravely disabled. If information is required by a court subpoena or court order.
NIH Clinical Center researchers published seven main principles to guide the conduct of ethical research:
You disclose something that your treating therapist is required to report (e.g., child abuse, child sexual assault, and elder abuse). In these cases psychologists are required to telephone and file a written notification to the relevant public office, such as Child Protective Services.
When does a therapist have to break confidentiality?
All information that you disclose in your session with a psychologist is confidential. There are two exceptions to this rule. The first exception is if you are at risk of harm to yourself or someone else and the second exception is in relation to court orders.
Because therapy is such a personal thing, what you tell a therapist must remain confidential. This includes things like affairs, past crimes, and "bad behavior" that isn't necessarily criminal behavior. You can talk to a therapist about how you were abused in the past, and they will not share that information.
Dos of confidentiality
Confidentiality may only be broken in the most exceptional situations where the risk to the health, safety or welfare of the patient, or others, outweighs the right to privacy. The decision whether to break confidentiality depends on the degree of risk of current or potential harm, not on the age of the patient.
You can only be given medication after an initial 3-month period in either of the following situations: You consent to taking the medication. A SOAD confirms that you lack capacity. You haven't given consent, but a SOAD confirms that this treatment is appropriate to be given.
According to the American Psychological Association (APA), unethical behavior by a therapist generally means: Having more than one kind of relationship with a patient: Having a sexual relationship with a patient, for example, is generally considered unethical.
Examples of psychologist malpractice include: