Oleh:

Nasrudin Subhi
Pusat Pengajian Psikologi dan Pembangunan Manusia,
Fakulti Sains Sosial dan Kemanusiaan,
Universiti Kebangsaan Malaysia.

Confidentiality
Client have the right to expect that communications

will be kept within the bounds of the professional

relationship.
The APA (1992) ethics code provides the following
guidelines for disclosure of confidential information:
Psychologists disclose confidential information without

the consent of the individual only as mandated by law, or

where permitted by law for a valid purpose, such as (1) to
provide needed professional services to the patient or the
individual or organizational client, (2) to obtain
appropriate professional consultations, (3) to protect the
patient or client or others from harm, or (4) to obtain
payment for services in which instance disclosure is
limited to the minimum that is necessary to achieve the
purpose.

Confidentiality
American School Counselor Association (1998)
The professional school counselor informs the counselee
of the purposes, goals, techniques and rules of
procedure under which she/ he may receive counseling
at or before the time when the counseling relationship is
entered. Notice includes confidentiality issues such as
the possible necessity for consulting with other
professionals, privileged communication and legal or
authoritative restraints. The meaning and limits of
confidentiality are clearly defined to counselees through
a written and shared statement of disclose . (2a.)

Confidentiality
American Counseling Association
When counseling is initiated and throughout the
counseling process as necessary, counselors inform
clients of the limitations of confidentiality and identify
foreseeable situations in which confidentiality must be
breached.

Confidentiality
American Association for Marriage and Family

Therapy (2001)
Marriage and family therapists have unique

confidentiality concerns because the client in a

therapeutic relationship may be more than one person.
Therapists respect and guard confidences of each
individual client.

Confidentiality
Kod Etika Kaunselor (PERKAMA)
Tanggungjawab Kaunselor Terhadap Klien
2.

9.

10.

Kaunselor hendaklah menghormati privasi klien dan

merahsiakan segala maklumat yang diperolehi semasa
kaunseling melainkan jikalau maklumat itu akan
membahayakan klien atau orang-orang
dipersekitarannya.
Kaunselor hendaklah mencapai persetujuan dengan
kliennya diperingkat awal sesi kaunseling mengenai
batasan umur kerahsiaan.
Apa-apa persetujuan di antara kaunselor dan kien
mengenai kerahsiaan boleh disemak semula dan diubah
dengan persetujuan bersama.

Confidentiality
Kod Etika Kaunselor (PERKAMA)
Tanggungjawab Terhadap Organisasi dan Majikan
6.

Kaunselor hendaklah mewujudkan hubungan

interpersonal dan persetujuan kerja dengan penyelia dan
stafnya mengenai khidmat kaunseling khususnya
kerahsiaan, perbezaan di antara fakta umum atau
peribadi, beban kerja dan akauntabiliti.

Confidentiality
Kod Etika Kaunselor (PERKAMA)
Penyelidikan dan Penerbitan (Persetujuan Subjek)
5.

Sentiasa menjalankan penyelidikan, maklumat peribadi

subjek hendaklah dirahsiakan kecuali dengan persetujuan
subjek. Jika terdapat sekiranya ada kemungkinan orang
lain boleh memperolehi maklumat itu, kemungkinan ini
bersama dengan perancangan untuk mengawal
kerahsiaan perlu diterangkan kepada subjek sebagai
sebahagian daripada prosedur memperolehi persetujuan
bermaklum.

Confidentiality
Kod Etika Kaunselor (PERKAMA)
Latihan
3.

Klien hendaklah diberitahu jika diberi khidmat kauseling

oleh pelatih dan juga diberitahu implikasi ke atas batas
kerahsiaan.

Privileged communication
It is a legal concept that protects against forced

disclosure in legal proceedings that would break a

promise of privacy.
Privilege is the clients right to prevent a counsellor
from revealing confidential communications in a legal
proceeding.
All states (in US) gave enacted into law some form of
counsellor-client privilege, but the specific of this
privilege varies from state to state.

Privileged communication
These laws ensure that clients disclosures of personal

and sensitive information will be protected from

exposure by counsellor in legal proceedings.
In other words, counsellor can refuse to answer
questions in court or refuse to produce a clients
records in court.
This privilege belongs to the client and is designed for
the clients protection rather than for the protection of
the counsellor, regardless of his or her license (DeBell
& Jones, 1997).
Both confidentiality and privilege belong to the client,
not the practitioner and it is the client who can waive
his or her privacy.

Privileged communication
The legal concept of privileged communication does

not apply to group counselling, couples counselling,

marital and family therapy or child and adolescent
therapy.
Members from the above groups can assume that they
could be asked to testify in court concerning certain
information revealed in the course of a group session

Privacy
Privacy, as the matter of law, refers to the

constitutional right of an individual to decide the

time, place, manner and extent of sharing oneself with
others (Stromberg et al., 1993).
The use of telecommunication devices can pose a
number of potential ethical problems regarding the
protection of privacy of clients.
Counsellors need to exercise caution in discussing
confidential or privileged information with anyone
over the telephone.

Privacy
Remley and Herlihy (2001, p. 124-125) offer these guidelines

for counsellors using the telephone:

Do not acknowledge that client are receiving services or give

out information regarding clients to unknown callers.

Strive to verify that you are actually talking to the intended
person when you make or receive calls in which
confidentiality information will be discussed.
Be aware that there is no way to prevent your conversation
from being recorded or monitored by an unintended person.
Be professional, brief, and very careful in talking about
confidentiality information over the phone.
Avoid making any comments that you would not want your
client to hear or that you would not want to repeat in a legal
proceeding.

Privacy
There are also privacy issue involved in using

answering machines, voice mail, pagers and mobile

phone; thus some precautions:
Answering machine: do not allow unauthorized persons

to hear answering machine messages as they are being

left or retrieved.
If you use voice mail or an answering service ensure that
your access codes are not disclosed to unauthorized
persons.
When you leave a recorded message, there is no way for
you to know that the intended person will be the one
who retrieve your message.
If you are talking to a client by mobile phone assume
that the client is not in a private place.
If you use a pager exercise the same cautions as sending
a message using answering machine.

Privacy
Fax machine: It is the counsellors responsibility to

make sure fax transmissions arrive in a secured

environment in such a way as to protect confidential
information.
Before sending a confidential fax, it is a good idea to
make a phone call to ensure that the appropriate
person will be able to retrieve this information in a safe
and sensitive manner (Cottone & Tarvydas, 1998).

Privacy
Communication via email is fraught with potential

privacy problems. If you use email to make contact

with your clients, realize that there are a number of
ethical and legal issues, one of which is the
impossibility of ensuring client confidentiality.
It should not be assume that email is private because
email messages can easily be accessed by people other
than the intended recipients (Shapiro & Schulman,
1996).
Avoid sending clients email messages at their
workplace because employees have no right to privacy
in that situation.

The duty to warn and protect

Counsellors have a double professional responsibility:

to protect other people from potentially dangerous

clients and to protect clients from themselves.
Bednar et al., (1991) maintain that counsellor must
exercise:
Identifying clients that are likely to pose harm to third

parties.
Protecting third parties from those clients judged
potentially dangerous.
Counsellors are recommended to take precautions in
record keeping and to conduct a mutually respectful
consultations with clients.

The duty to warn and protect

Counsellors faced with potentially dangerous clients

should take specific steps to protect the public and to

minimize their own liability:
Should take careful histories

Advise clients of the limits of confidentiality

Keep accurate notes of threats and other client

statements
Seek consultation
Record steps they have taken to protect others

The duty to warn and protect

Most states permit counsellors to breach

confidentiality to warn or protect victims.

Many states grant counsellors protection from being
sued for breaching confidentiality if the counsellor can
demonstrate that he or she acted in good faith to
protect third parties (Stromberg et al., 1993).

The duty to warn and protect

The limit of confidentiality:
1. Client request for release of information
2. Court orders for confidential information
3. Client complaints and litigation against counsellors
4. Other client litigation
5. Limitations based on state and federal statutes
6. Dangerous clients
7. Client planning future crimes
8. Counselling clients with HIV
9. Counselling clients at the end of their lives

Kajian kes
Maria seorang kaunselor di sebuah agensi kesihatan di mana

beliau seringkali berhadapan dengan kes-kes mencabar

berhubung kesihatan mental klien-kliennya. Untuk
membantu Maria menangani stress kerjanya, beliau telah
berkongsi maklumat dengan suami beliau yang juga seorang
kaunselor (bekerja di tempat lain). Di dalam perbualannya
bersama suami, Maria tidak menggunakan nama klien tetapi
berkongsi hal-hal intervensi dengan mendalam. Maria
berasa yakin tindakannya ini tidak bercanggah dengan etika
dan merasakan dia akan kurang berkesan sekiranya tidak
bertindak sedemikian rupa. Tambahan suaminya juga
seorang kaunselor yang faham keperluan kerahsiaan dalam
sesebuah kes. Adakah anda bersetuju dengan pandangan
Maria di dalam soal ini?