What is a ground for breaching confidentiality in a therapeutic setting?

In a therapeutic setting, breaching confidentiality is considered acceptable primarily when there is a clear and imminent threat of harm to the client or others. This principle is grounded in ethical and legal standards that prioritize safety. When a therapist believes that a client poses a risk of self-harm, such as suicidal ideation, or poses a danger to others, such as threats of violence, they may disclose confidential information to appropriate authorities or individuals to prevent harm. This is done to protect both the client and potential victims, emphasizing the therapist’s responsibility to ensure safety over confidentiality in these critical scenarios.

In contrast, loss of trust, failure to comply with treatment, or a change of therapist does not constitute justifiable grounds for breaching confidentiality. Loss of trust can be a significant issue in therapy; however, it does not legally or ethically require sharing private information. Similarly, non-compliance with treatment may indicate a need for different therapeutic approaches but does not justify disclosure. Lastly, a change of therapist may involve discussions about the client but does not inherently warrant breaking confidentiality without the client's consent or a safety-related reason.