There are very few of these strict, traditional-style analysts practicing today. Therapy offices are generally set up for both the client and therapist to be seated, facing one another. While turning to a friend for advice may work in some instances, there are times when all of us could use an unbiased, professional opinion. It takes even more courage to ask for help. Rather than a sign of weakness, I believe it is a sign of strength when someone wishes to improve his or her life, and has the courage to ask for assistance in this process.
Confidentiality is a valid concern.
This is important everywhere, but it is especially important in a small town, on an island, in a rural setting, or anywhere with a relatively small population, where many people know each other. Training for Psychology, Social Work, and probably all forms of counseling and therapy includes training in ethics. Maintaining confidentiality is an important aspect of this training. If you are considering therapy, but have concerns about confidentiality, this is a good thing to discuss, up front, before you begin your first session.