There has been much discussion on the issue of confidentiality in counselling (Review counselling system in all institutions, by Madam Shirley Woon Li Lin, June 19; and School counsellors need more support, by Mr Kuharajahsingam Karalasingam, June 21).
Confidentiality is an ethical principle the counsellor abides by to respect the client's privacy. The underlying presumption is that the client must be able to make sound decisions.
Hence, in the case of a person who is suicidal or unable to make decisions, confidentiality is waived. Counsellors are advised to tell clients beforehand that confidentiality is not absolute in such instances. My experience is that despite this, clients are still able to self-disclose without inhibition.
In schools, principals have a duty of care to students under them, which may conflict with the counsellor's duty of confidentiality.
As an employer, the school owns the counselling notes. However, the notes are still subject to the duty of confidentiality owed to the student.
A school owning the counselling notes does not give any individual, including the principal, the right to access the record.
There is no legal principle which definitively answers which duty, care or confidentiality, takes precedence in any given situation. The facts will determine whether it is appropriate for the counsellor to break confidentiality when it conflicts with the school's duty of care as entrusted by the student's parents.
In practice, I strongly recommend putting in place a protocol for the sharing of information before a conflict arises. The principal and the counsellor should agree in writing what information is to be disclosed to the principal. Relevant disclosure information should include, for example, intended harm to self and others as well as offences against the law.
Counselling as a profession in Singapore has evolved over the past decade. It may be time for a formal licensing system, to ensure the quality of counselling service as well as the accountability of counsellors.
Tan Chue Tin (Dr)
