LEGAL ISSUES: FACTS AND THOUGHTS
CONFIDENTIALITY IN GROUP THERAPY

FACTS:
Susie, Jan, Jim, Alex, Gloria and Ted are in a group therapy session. In this meaningful exchange each person "lets it all hang out."

But on the other hand, suppose Jan is a gossip, or Alex, unknown to the other participants, is on a very friendly and confidential basis with several acquaintances of the other individuals, and learns "secrets" in group therapy that are too good to keep to himself. What are the consequences if Alex or Jan talk out of turn, even if they indicate to their mutual friends that this is special information that should be confidential. Is anyone liable for breaches of confidentiality, and if so, who?

Certainly the group therapy leader is bound by all the therapeutic ethical and legal rules of confidentiality. The group members have an ethical responsibility but not necessarily a legal one. (Source: Psychotherapy Finances - June, 2002. … See also: PORTABLE LAWYER, Bernstein & Hartsell, John Wiley & Sons, Group Therapy, Confidentiality pp. 63-67)

Thus, there has to be some discussion and preparation for group members before the group is formed which notifies the participants that confidentiality is the foundation of therapy sessions and it is not to be breached.

THOUGHTS:
In order to protect the group as well as the group leader, the following guidelines would be helpful for facilitators:

• At the onset or formation of the group spell out clearly the need for confidentiality and repeat this guideline or rule at the beginning of every session.
• Have every participant sign a lawyer drafted confidentiality form before the first session. Include a clause that indicates they are "liable" for any damages, which are caused by their individual breaches of confidentiality. So: "caveat." (1)
• Emphasize often, the seriousness of the confidentiality process.
• Indicate that a consequence of any violation of confidentiality is immediate expulsion from the group. Enforce this rule.
• Explain, before the group commences, the legal limits and exceptions to confidentiality. (This is mandated by most licensing ethical standards.)

Remember, as a therapist, you are required to protect, mentally and physically, the members of the group. Confidentiality is one of the protections. Educating group members concerning the need to keep secrets from non-group third parties is essential to the ultimate success of each individual's therapy. But caveat (2), should there be a married couple in the group, and should this couple later divorce and custody become an issue, confidentiality would be hard to maintain.

Thomas L. Hartsell, J. D. 214 363-0555. Mr. Hartsell is an Academically Certified Mediator and Professor of Mediation at Southern Methodist University

Barton E. Bernstein, J.D., LMSW

THOMAS L. HARTSELL, JR.
Attorney & Counselor at Law
402 University Tower
6440 North Central Expressway
Dallas, Texas 75206-4133
214/ 363-0555
FAX 214/ 369-3590
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E-mail tlhartsell2@aol.com