Second, practitioners can function as mediators, negotiating the boundaries of confidentiality to meet the needs of particular clients and families. For example, therapists can discuss with clients the importance of keeping their families informed and can work with both parties in deciding what specific information will be shared. Third, in institutional settings separate staff members can be designated as family advocates. Family advocates can provide relevant information to families and can consult with the therapist to enhance treatment planning and coordination. Additional Considerations There are also a number of additional considerations regarding confidentiality.
Clients can always reveal information to their families.
By signing a release form, they can also assign that role to their therapists. Thus, clients should be encouraged as early as possible to make an informed choice about the information that will be shared with family members, as well as the ways in which information will be shared. Finally, confidentiality does not prohibit listening to family members, although it may be clinically contraindicated in certain cases. For example, families might wish to share observations about signs of impending relapse, risk of imminent harm, indications of substance abuse, evidence of treatment or medication noncompliance, or other serious matters. Her daughter did in fact attempt suicide, which might have been avoided if there had been better family-professional communication.