In the realm of talking therapies, confidentiality is a cornerstone, especially when working with younger patients. As a trusted therapy dog, I’ve observed that maintaining a high level of confidentiality isn’t just a procedural necessity—it’s essential for fostering a positive and effective therapeutic environment.

In the private sector, where patients and their families often seek specialized care, this principle is even more critical. Let me walk you through the reasons why confidentiality is so highly regarded in these settings.

1. To Maintain a Positive Therapeutic Relationship

A therapeutic relationship is built on trust, and trust hinges on confidentiality. Younger patients need to feel that their therapist is a safe and non-judgmental space where they can express their thoughts and feelings freely. When a patient is confident that what they say will remain private, they are more likely to open up, allowing the therapist to better understand and address their concerns. This trust is foundational in helping patients work through their issues, especially in psychodynamic therapy, which delves deeply into personal history and unconscious processes.

2. Encouraging Honest and Open Engagement

Confidentiality ensures that patients feel secure in sharing their true thoughts, emotions, and experiences without fear of repercussions. This is particularly important for younger individuals, who might be grappling with sensitive issues such as identity, relationships, or mental health struggles. When they know their disclosures won’t be shared without their consent, they are more likely to engage honestly in therapy, leading to more effective treatment outcomes. In the same breath, with patients of any age, they may use fictitious tales and accounts of things, and these need to be understood for what they are, and the reasons behind them without influence from others when deemed appropriate by the professional.

3. Avoiding the Role of a Go-Between

One of the challenges in therapy with younger patients is managing the relationship between the patient and their parents or guardians. If a therapist were to share information disclosed in sessions, they could inadvertently become a go-between, which could harm the therapeutic process. The goal is to empower the patient to take the insights gained in therapy and apply them in their own life, including communicating with their parents when they feel ready. This autonomy is crucial for their development and self-efficacy.

4. Preventing Coercion and Control by others

In some cases, there may be dynamics of control or coercion at play within a care system or carers. Confidentiality protects the patient from potential manipulation by ensuring that the therapy space remains their own. This is particularly important in psychodynamic therapy, where exploring family dynamics is typically key component. By maintaining confidentiality, therapists help to create a space where patients can examine these dynamics critically and independently.

5. Upholding Gillick Competency

Gillick competency is a legal principle that recognizes the capacity of minors to consent to their own medical treatment, including therapy, if they are deemed capable of understanding the implications. This principle underlines the importance of respecting a young person’s autonomy and judgment. By maintaining confidentiality, therapists acknowledge and respect the patient’s capacity to make decisions about their own mental health care, reinforcing their sense of agency.

6. Supporting the Development of Self-Reliance and Responsibility

Confidentiality in therapy encourages younger patients to take ownership of their thoughts and emotions. Knowing that their disclosures are private, they are more likely to feel able and take responsibility for their feelings and actions. This sense of responsibility is crucial for personal growth and development, which is a key objective of psychodynamic therapy.

7. Fostering a Sense of Control Over Personal Information

For younger patients, having control over who knows what about their inner world is empowering. It allows them to decide when and how they share aspects of their therapy with others, particularly with parents or guardians. This control can be particularly important for those who may feel powerless in other areas of their life, giving them a sense of agency within the therapeutic process.

8. Building a Safe Space for Exploration

Confidentiality helps create a safe space where younger patients can explore difficult or complex emotions without fear of judgment or external consequences. This safe space is essential for psychodynamic therapy, where the exploration of unconscious thoughts and feelings can bring up challenging material. Knowing that this exploration remains private encourages deeper and more meaningful engagement in therapy.

At Teenage Mental Health (TMH), we, like many other professionals in the private sector, are committed to providing a high level of confidentiality in our therapeutic work with younger patients.

This confidentiality is not just a policy; it’s a key element of effective therapy, helping to foster trust, encourage honest communication, and support the patient’s autonomy and development. However, we also recognize our duty of care to keep our patients safe, particularly when there is a risk of harm to themselves or others. Confidentiality is balanced with this duty, ensuring that while we protect our patients’ privacy, we also take necessary steps to safeguard their well-being.

As the onsite therapy dog, I’ve seen first hand how confidentiality can transform therapy for younger patients, helping them to engage more deeply and honestly in the process. And at TMH, we are committed to maintaining this confidentiality to ensure that every patient feels safe, respected, and empowered in their therapeutic journey.